Reference

The pathogenesis of tendinopathies is primarily due to degeneration rather than inflammation. According to various sources, including a systematic review and expert opinions, tendinopathies are often characterized by a degenerative process within the tendon, with inflammation playing a limited role. The degenerative changes can include mucoid degeneration, angiofibroblastic degeneration, and collagen disorganization. While some studies mention the presence of non-acute inflammatory cells, the prevailing paradigm is that tendinopathies are largely degenerative in nature. This understanding is supported by the images and diagrams that illustrate the degenerative changes within the tendons, such as the continuum model of tendon pathology and the failed healing theory for the pathogenesis of tendinopathy. Therefore, it can be concluded that the primary pathogenesis of tendinopathies is degeneration, with inflammation being a secondary or less significant factor.