Tendinopathy is a big problem for athletes, ordinary people and clinicians. At present neither the aetiology and pathology, nor the rehabilitations is well understood, and good evidence is lacking within all these areas.
During the last 10 years substantial research has been performed. New data indicate that in the chronic state, tendinopathy in humans is characterised by focal changes in the expression of matrix proteins, increased collagen turnover, smaller collagen fibrils and increased microvascular volume. These changes are attenuated with increased loading as during running. Despite this new knowledge, models for investigating the development of tendinopathy are still lacking and the complex nature of tendinopathy is still a great challenge. However, by developing novel human and animal models, hopefully a thorough understanding of human tendinopathy will be possible within the near future.
In relation to treatment, new methods such as injection of platelet rich plasma (PRP) and large quantities of isotonic saline (HVI) have been developed based on sound rationales, but with only minor scientific evidence. More research is needed in this area too.
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