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Wound healing and repair of injured tissues follows several steps in the healthy individual. Following birth, the process is initiated by the inflammatory response and subsequent steps are based on this initial response. Whereas wound healing generally leads to a repair of the injured site, it does not lead to tissue regeneration. This difference between repair and regeneration has influence on tissues such as ligaments and tendons that function in a mechanically active environment. Thus, the dynamic interface between mechanics and biology influence the effectiveness of the healing response. The biology of the host is also influenced by a variety of factors including age, gender, genetics, and tissue history, factors that impact the outcome of the healing response. This review focuses on several of the issues surrounding the healing of tissues in general and ligaments and tendons more specifically. In addition, the use of interventions such as cell and gene therapy to improve healing is discussed.