{"type":"rich","version":"1.0","provider_name":"Transistor","provider_url":"https://transistor.fm","author_name":"The Run Smarter Podcast","title":"The Future Direction of Chronic Tendon Treatment: What New Pain Science Is Revealing About Tendinopathy","html":"<iframe width=\"100%\" height=\"180\" frameborder=\"no\" scrolling=\"no\" seamless src=\"https://share.transistor.fm/e/5e6dfb34\"></iframe>","width":"100%","height":180,"duration":2086,"description":"Learn more about Brodie's Research Database & AI Assistant 📄🔍For MORE Run Smarter Resources 🏃‍♂️📚- Including Free Injury Prevention Courses 🩹🎓- The Run Smarter Book 📖- Access to Research Papers 📄🔍- & Ways to Work with Brodie 🤝👟👉 CLICK HERE! 🎉✨For years, chronic tendinopathy has been treated as a tendon problem — load it, strengthen it, remodel it. But what if, for some runners, the tendon itself isn’t the main driver of pain anymore?In this episode, Brodie breaks down a new 2026 systematic review that may reshape how we think about stubborn, long-standing tendon pain. The paper explores whether nerve ingrowth and abnormal blood vessels around tendons — not degeneration of the tendon tissue itself — may be the real pain source in chronic cases.We unpack the emerging research, explain each intervention in plain language, and discuss who this may (and may not) apply to — especially runners stuck in repeated rehab cycles despite “doing everything right.”This is early, evolving science. But it’s a fascinating glimpse into where chronic tendon treatment may be heading next.What You’ll Learn in This EpisodeWhy some chronic tendon pain may be neuropathic (nerve-driven) rather than structuralHow abnormal blood vessels and nerves grow into painful tendons over timeWhy traditional loading programs sometimes stop working in very chronic casesWhat “neural modification” treatments aim to do — and why they’re gaining interestThe six intervention categories reviewed in the paper (explained simply)How strong (or limited) the current evidence actually isWhere this research fits alongside exercise-based rehab, not against itInterventions Reviewed (Plain-English Overview)1. High-Volume Injections (HVIGI / HVDI)Large volumes of fluid are injected around the tendon (not into it) under ultrasound guidance to mechanically disrupt abnormal blood vessels and pain-sensitive nerves.Key takeaway:Consistent short- to medium-term pain and function improvements, especially in people who had...","thumbnail_url":"https://img.transistorcdn.com/yu6CIQL0sKEEn32UMHvSGj80p9Ns_xcjLGp-EWyJlqQ/rs:fill:0:0:1/w:400/h:400/q:60/mb:500000/aHR0cHM6Ly9pbWct/dXBsb2FkLXByb2R1/Y3Rpb24udHJhbnNp/c3Rvci5mbS9zaG93/LzM5ODgwLzE2Nzkw/MTQzMTYtYXJ0d29y/ay5qcGc.webp","thumbnail_width":300,"thumbnail_height":300}