Since writing last night, I’ve had some welcoming comments and more understanding of my mis-interpretation.


For me to hear “liters” is most likely “leaders“.  T’s and D’s are drawn out together around here 🙂  Too bad I didn’t get corrected by my patients or colleagues !  But either way, that was the reason I posted it.


So the more likely answer, thanks to Eric, Andrew and Travis; is that the old slang refers to leaders instead of liters.  This relates to a fishing term (you can tell I don’t fish…) when the line gets taut and pulls, like a muscle or tendon.  Either way you interpret it, enjoy the original post below 🙂



Growing up and now working professionally in southern Virginia for almost 8 years has taught me a lot …particularly that this region has its own language!  I have come across many phrases and jargon…most resulting in a giggle then a shake of my head as I’m from these parts.  We tend to leave off the “g” in our words, such as “sitting” turns to “sittin”  or “all of you all” turns to “all y’all”.  The almanac is King, hearing thunder in winter and seeing cardinals means it will snow.

There is one that continues to arise, seemingly day in and day out, from my older population in regards to what we all deal with in the PT profession….Liters.

Liters as a description of muscles/tendons from my patients…but according to the online slang dictionary…it can be used for one’s tendons, joints or ligaments of any location in the body.

A conversation from patient may go something like this,

“My liter is tight & pulling down back of my leg”

“What do you think is wrong with my liter

I will ask patients, tactfully, how they came up with liters as meaning of muscles & tendons.  I get answers ranging from my doctor told me that to simply having no idea as it was passed down from their parents/grandparents.  I have also heard someone say, “no one has ever told me I had a liter problem”.

So I wanted to find the origin of this puzzle.

Just like any sound human being, I went to google to search but really found nothing.

So here are my thoughts.   With an emphasis on maybe

  • Maybe the origin came from the heart (although not skeletal muscle) pumping out 5 liters of blood each minute.
  • Maybe the Latin root “liter” meaning “letters” translating in English to “literacy, illiterate, literature” somehow links to muscles/tendons…?
  • Maybe that skeletal muscle is 70% water…and a metric unit of water is a liter…whereas one liter of water is equal to 1 kilogram of mass.  Mass of the body can be measured in kilograms and ~55-65% of mass in body is from the muscles.
  • Maybe liter could have been mis-pronounced from litter…and there could be differences in skeletal muscle in a litter of cats (but found will catch up later in life) and skeletal muscle in litters of rats have been studied…
  • Liter can also be defined as objects strewn or scattered about.  Maybe its relation to fascia?
  • Dialect and accent from the south…phonetically… litter from a doctor sounds like muscle or tendon.

None of my patients know (even ones that use the verbage), I don’t know, so you tell me/us…what is the origin of liter as it relates to muscles/tendons?



  1. I work in Texas so the regional differences could be infinite but perhaps searching for a connection to ‘liters’ is incorrect and most likely, or at least in my case, patients are saying ‘leaders’. You can find plenty of info on the word ‘leader’ referring to tendons and even some that talks about muscles being referred to as ‘leaders’, or in other terms – prime movers. Also, in the fishing community leaders are small cables or lines of thicker monofilament which could easily draw some relations to muscles or tendons. Again, maybe I’ve not heard the term ‘liters’ because of the regional differences but in my practice this has been a pretty common reference that tends to be a little more meaningful, especially in the older and more rural population.

    1. Hey Travis,
      Thanks for your response. You and Eric both mention ‘leader’. There is a device called tendon leader to pull tendons in surgery so makes more sense than Litter…”d’s” and “t’s” sound differently here and Texas too I’m sure.

      Thanks for the response, always learning!

  2. Hey HV,

    Do you think they are sayin “leader” and not “liter”? Hope all y’all are good down at InTouch.


    1. Always sounds like liter to me, not leader. But my wife says I don’t listen well either.

      It can be jumbled in the strong accents tho 🙂


  3. Harrison,
    I heard this very phrase within the first week at my first clinic out of PT school. I was also bewildered as to the origin of the phrase. The patient kept saying that he felt like his “arm feels like a liter.” When I questioned him about it, he referred to it as something like a leader (liter) in fishing–something that gets taut when the fish bite, which made sense to me in terms of the description of tension that patients sometimes feel with that description.

    1. Andrew,
      Thanks for commenting. Come on down this way and you will hear it very often!

      So it definitely seems to be a leader, not a liter. You can tell I don’t fish 🙂


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