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Nitric oxide is a small, highly reactive molecule that functions as an intracellular and intercellular messenger molecule and participates in numerous physiologic processes. Nitric oxide plays a role in the basic physiology and metabolism of cartilage, tendon, ligament, muscle, and bone, and is involved in the response of these tissues to injury and in their repair. For example, nitric oxide inhibits proteoglycan synthesis in cartilage, regulates blood flow to skeletal muscle during exercise, and affects collagen synthesis in tendon and ligament. Nitric oxide is also involved in inflammation, which is common after sports injury. Thus, nitric oxide is a fundamental participant in the basic biology of sports-related injury.