# The Future Direction of Chronic Tendon Treatment: What New Pain Science Is Revealing About Tendinopathy Page: https://stenobird.com/podcast/overcoming-proximal-hamstring-tendinopathy-3563667/the-future-direction-of-chronic-tendon-treatment-what-new-pain-science-is-revealing-about-tendinopathy Text version: https://stenobird.com/podcast/overcoming-proximal-hamstring-tendinopathy-3563667/the-future-direction-of-chronic-tendon-treatment-what-new-pain-science-is-revealing-about-tendinopathy.md Podcast: [Overcoming Proximal Hamstring Tendinopathy](https://stenobird.com/podcast/overcoming-proximal-hamstring-tendinopathy-3563667) Published: 2026-01-12T20:00:00+00:00 Episode link: https://share.transistor.fm/s/874dff54 Audio file: https://media.transistor.fm/874dff54/4e778ff6.mp3 Processing state: not_requested JSON: https://stenobird.com/v1/public/podcasts/overcoming-proximal-hamstring-tendinopathy-3563667/episodes/the-future-direction-of-chronic-tendon-treatment-what-new-pain-science-is-revealing-about-tendinopathy Duration seconds: 2049 ## Resource 👉 Complete the 30 Sec Survey & Find Your Best PHT Recovery Plan 🎉 Sign up for the FREE PHT 5-Day Course HERE 🎉 For all other PHT resources, go to: https://proximalhamstringtendinopathy.info/ 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 Episode Why some chronic tendon pain may be neuropathic (nerve-driven) rather than structural How abnormal blood vessels and nerves grow into painful tendons over time Why traditional loading programs sometimes stop working in very chronic cases What “neural modification” treatments aim to do — and why they’re gaining interest The six intervention categories reviewed in the paper (explained simply) How strong (or limited) the current evidence actually is Where this research fits alongside exercise-based rehab , not against it Interventions 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 d… ## Actions - request_transcript: `POST https://stenobird.com/v1/public/podcasts/overcoming-proximal-hamstring-tendinopathy-3563667/episodes/the-future-direction-of-chronic-tendon-treatment-what-new-pain-science-is-revealing-about-tendinopathy/transcription-requests` — Idempotently request low-priority transcript generation for this episode. - read_markdown: `GET https://stenobird.com/podcast/overcoming-proximal-hamstring-tendinopathy-3563667/the-future-direction-of-chronic-tendon-treatment-what-new-pain-science-is-revealing-about-tendinopathy.md` — Read the agent-friendly Markdown representation of this episode resource. A page view does not enqueue transcription. Agents should invoke `request_transcript` explicitly when they need this episode processed. ## Transcript Full transcripts are not published on public pages unless there is a clear rights basis.