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Tendons and muscles are two aspects of the same entity: the fleshy part is thicker, more elastic, and responsible for generating contraction force; the tendon (sinew) part is relatively thinner, more resilient, attached near the joints, responsible for transmitting pulling force, pulling the limbs, and generating movement.

Lingshu-Jiuzhen Lun states "the liver governs the tendons." In ancient thought, the movement of "muscles and tendons" was caused by the "blowing" of "internal wind," much like the wind in nature moves the branches and leaves of trees. The essence of this "internal wind" is nerve conduction, which causes muscle contraction and tendon movement. When the "internal wind" blows normally, the body moves normally; if the "internal wind" blows abnormally, it causes abnormal twitching of the limbs, which Traditional Chinese Medicine (TCM) calls "internal stirring of liver wind." This condition is often caused by insufficient kidney water and liver blood. When the nourishing yin is insufficient, yang qi becomes compensatorily hyperactive, manifesting in the liver system as an unstable nervous system, erratic discharges, causing the phenomenon of "wind movement."

Suwen-Liujie Zangxiang Lun states "the liver... manifests its vitality in the tendons." The liver is the metabolic center for various energy-producing substances (such as glucose, fats, amino acids). The fuel required for the operation of "muscles and tendons" and "nerves" mostly needs to be metabolized or stored by the liver; the liver also contributes to the "special nutrition" of nerves, for example, the liver stores various vitamins, minerals, and trace elements needed by nerves for emergencies (this is the concept of liver storing blood). If these special nutrients are lacking, nerves cannot function properly. For example, when vitamin B₆

is insufficient, the brain is prone to erratic discharges, causing epilepsy and spasms. TCM calls this the pattern of "liver blood deficiency" (pattern = a state of imbalance in a certain human system).

Suwen-Shanggu Tianzhen Lun "At seventy-eight, liver qi declines, tendons cannot move." As people age, liver function also declines, and the fuel and nutrition that muscles, tendons, and nerves can obtain gradually diminish, leading to a gradual dulling of nerve conduction function, eventually making movement difficult.

Comparison:

• The concept of "spleen governing muscles" lies in the digestive system providing nutrients for muscle growth and strength, focusing on whether the muscles are robust;
• The concept of "the liver governs the tendons" lies in the liver providing fuel and generating kinetic energy for muscles, tendons, and nerves; the "internal wind" blowing (i.e., nerve conduction) causes muscle contraction, generating movement. Both focus on the activity of muscles and tendons.

TCM believes that "nails are the surplus of tendons." Nails are seen as an extension of tendons and can also reflect the prosperity or decline of the liver system. When liver function weakens, liver blood deficiency occurs, nails do not receive sufficient nutrition and do not grow well, easily becoming thin, wrinkled, or even brittle.