Br J Sports Med 41:227-231 doi:10.1136/bjsm.2006.034447
  • Review

Using nitric oxide to treat tendinopathy

  1. George A C Murrell
  1. Correspondence to:
 Professor G A C Murrell
 Orthopaedic Research Institute, University of New South Wales, The St George Hospital, Level 2, 4-10 South Street, Kogarah, Sydney, New South Wales 2217, Australia; admin{at}
  • Accepted 14 December 2006
  • Published Online First 8 February 2007


Nitric oxide (NO) is a small free radical generated by a family of enzymes, the nitric oxide synthases (NOSs). Following injury to a tendon, NO is induced by all three isoforms of NOS and NOS activity is also upregulated in tendinopathy. In animal models when NOS activity is inhibited by competitive inhibitors of NOS, tendon healing is reduced. When additional NO is added, tendon healing is enhanced. In humans, in three randomised clinical trials, we have shown that NO delivered via a transdermal patch enhances the subjective and objective recovery of patients with tennis elbow, Achilles tendinosis and supraspinatus tendinosis.


  • Published Online First 8 February 2007

  • Competing interests: None declared.

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