Most available data are preclinical or derived from non-orthopaedic clinical contexts, and robust human orthopaedic trials were not identified
At the same time, special stresses, such as inflammation, infections, stimulants and environmental toxins, can also overload our glutathione supplies and lead to glutathione being consumed faster than it is formed
Modern therapeutic options include intratendinous injections of substances believed to inhibit neovascularization, such as corticosteroids (which can cause collagen sclerosis and long-term damage to the tendon), or of substances that relieve pain by other pathways (acupuncture, extracorporeal shock wave therapy [ESWT]) or that stimulate tendon repair (platelet-rich plasma [PRP]) [12,13,14,15]
That molecular complexity means it is inherently fragile