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Tendons are swell

 •  • by Paul Ingraham
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Weekly nuggets of pain science news and insight, usually 100-300 words, with the occasional longer post. The blog is the “director’s commentary” on the core content of PainScience.com: a library of major articles and books about common painful problems and popular treatments. See the blog archives or updates for the whole site.

Photo of the back of a heel on blue-green surgical sheets. There is a large posterior incision fully exposing the shiny, white Achilles tendon.

Surgically exposed Achilles tendon.

Maybe your painful tendons are … swollen? We do not normally think of tendons as something that can swell, but we should, because they can. Like most everything else in anatomy, they are specialized “containers.” From a new paper by Pringels et al (and including Jill Cook, well known for her tendon research):

“Although somewhat ignored in tendons, every structure in our body (eg, nerves, muscles, joints, brain) has a total tissue pressure…”

I can’t really recommend actually reading this paper — it’s a slog, quite technical — so here is the cool gist of it: The pressure inside tendons has never really been studied, and it might be an important key to how tendinitis works and how to treat it. We certainly aren’t doing very well treating tendinopathy based on our current understanding! So clearly we need to understand it better, and this is a serious attempt to figure out how tendinopathy really works. Just basic science, with no real clinical implications yet. But maybe someday. I would love to see more like this.

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