# The Future Direction of Chronic Tendon Treatment: What New Pain Science Is Revealing About Tendinopathy

Page: https://stenobird.com/podcast/the-run-smarter-podcast-530646/the-future-direction-of-chronic-tendon-treatment-what-new-pain-science-is-revealing-about-tendinopathy
Text version: https://stenobird.com/podcast/the-run-smarter-podcast-530646/the-future-direction-of-chronic-tendon-treatment-what-new-pain-science-is-revealing-about-tendinopathy.md
Podcast: [The Run Smarter Podcast](https://stenobird.com/podcast/the-run-smarter-podcast-530646)
Published: 2026-01-18T20:00:00+00:00
Episode link: https://share.transistor.fm/s/5e6dfb34
Audio file: https://media.transistor.fm/5e6dfb34/b424b558.mp3
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JSON: https://stenobird.com/v1/public/podcasts/the-run-smarter-podcast-530646/episodes/the-future-direction-of-chronic-tendon-treatment-what-new-pain-science-is-revealing-about-tendinopathy
Duration seconds: 2015

## Resource

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 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 t…

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