Biology and physiology of tendon healing

•Three distinct phases regulate the physiology of tendon healing.•Tendon cells and tendon stem/progenitor cells regulate the process.•IL1β and IL-6 expression is increased during the inflammatory phase.•The main growth factors involved are TGFβ, bFGF, PDGF, BMP, VEGF and IGF-1.•Mechanical loading throughout the entire process is essential for proper healing. Tendon disorders affect people of all ages, from elite and recreational athletes and workers to elderly patients. After an acute injury, 3 successive phases are described to achieve healing: an inflammatory phase followed by a proliferative phase, and finally by a remodeling phase. Despite this process, healed tendon fails to recover its original mechanical properties. In this review, we proposed to describe the key factors involved in the process such as cells, transcription factors, extracellular matrix components, cytokines and growth factors and vascularization among others. A better understanding of this healing process could help provide new therapeutic approaches to improve patients’ recovery while tendon disorders management remains a medical challenge.