24Osteogenesis imperfecta (OI) is a heterogeneous group of connective tissue disorders 25 characterized by variable short stature, skeletal deformities, low bone mass with increased bone 26 fragility, and motor deficits. The majority of cases are caused by mutations in type I collagen, or 27 by mutations that affect collagen processing and/or modification. Like bone, the extracellular 28 matrix of tendons and ligaments is largely made up of type I collagen; however, despite the fact 29 that a subset of OI patients presents with joint hypermobility, how tendon/ligament dysfunction 30 contributes to this is unknown. Here, we performed a detailed phenotypic characterization of the 31 flexor digitorum longus (FDL) tendon, Achilles tendon and patellar ligament in the Crtap mutant 32 mouse model of severe, recessive OI. Stable, pyridinoline collagen cross-links were increased by 33 5-to 10-fold in mutant tendons and ligaments. Collagen fibril size in all three structures was also 34 smaller in Crtap -/mice compared to wildtype or heterozygous littermates. Together, these 35 ultrastructural and biochemical changes resulted in thinner tendons and ligaments with increased 36 cellularity compared to controls, as assessed by histology. To examine how alterations in tendons 37 might affect motor function, we performed a battery of behavioral assays. During open field 38 assessment, Crtap -/mice exhibited reduced horizontal and vertical activity. Crtap -/mice also 39 exhibited motor impairments on the rotarod and grid footslip tests. In addition, Crtap -/mice had 40 reduced grip strength and displayed reduced time on the inverted grid test, indicating that they 41 are weaker than wildtype and heterozygous mice. In summary, these data demonstrate that the 42 tendons/ligaments of Crtap -/mice are pathologically altered compared to wildtype -a 43 phenotype that correlates with motor deficits and grip strength impairments. As such, Crtap -/-44 mice provide a preclinical model with which to examine downstream mechanisms and therapies 45 pertaining to tendon/ligament pathology and motor dysfunction for OI patients. 46 48 ligaments connect articulating bones to support joint alignment and function 1, 2 . The extracellular 49 matrix of tendons and ligaments is primarily composed of type I collagen as well as smaller 50 quantities of other collagens and proteoglycans 3 . During development, the collagen fibrils in 51 tendons and ligaments develop through addition and lengthening before transitioning to 52 appositional fusion of existing fibers with continued lengthening in post-natal life 4 . The synthesis 53 and assembly of this collagen-rich matrix is influenced by other small collagens and 54 proteoglycans as well as by the cross-linking chemistry of type I procollagen fibrils, which in 55 turn regulates fibril size and strength 5 . Like tendon and ligament, the organic matrix of bone 56 consists largely of type I collagen 6 , and disruptions in collagen synthesis and folding have been 57 shown to negatively impact its biochemical ...