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US shows that in the patellar tendinopahies, before sclerosing therapy, there is neovascularization outside and inside the dorsal part of the tendinopathic area and, after sclerosing therapy, no blood flow can be seen and no pain can be feld alongside. Probably, the ingrow of neurovascular bundles play a key role, likewise in the degenetative discopathies (The American Journal of Sports Medicine, Vol. 34, No. 11, DOI: 10.1177/0363546506289168).
Reduction of pain in patellar tendinopathies does not indicate a positive structural changes, it is associated with many degenerative changes in response to loading, including the absence of inflammatory cells in the tendon, a tendency toward poor healing, and decreased quality and disorganization of collagen fibers, all of which may lead to decreased tensile strength and reduced pain.
What if the tendon has not entered the degeneration stage of Tendinopathy and the patient reports improved outcomes i.e. reduction in pain, return to activities with no further aggravation, possible healing?
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