• apoptosis
• overuse injuries
• supraspinatus
• tendinopathy

We commend Professor Murrell for making a major novel contribution to the understanding, and thus potentially the treatment, of chronic tendinopathies.¹ He has shown in patients with supraspinatus tendinopathy that a substantial portion of the cellular compartment of the tendon shows nuclear fragmentation, a key characteristic of apoptosis.²

Does Professor Murrell feel that apoptosis would necessarily be a “harmful” pathological event in tendon or might there be an optimal, basal level of apoptosis? We appreciate that excessive apoptosis—programmed cell death—is a feature of degenerative …