Inflammation and the continuum model: time to acknowledge the molecular era of tendinopathy

[...]clear pathological and molecular evidence exists of its dysregulation throughout the spectrum of human tendon disease, while inflammatory change may help to explain the mismatch between pain and macroscopic tendon structure. 4 The use of a quotation from a twitter feed as evidence that cytokines are biologically inert within the context of tendinopathy seems biased and inappropriate, considering the strong evidence base throughout landmark publications in the scientific literature demonstrating a key role of cytokines in musculoskeletal pathologies. 5 We agree that much remains to be elucidated surrounding inflammatory mechanisms in tendinopathy and, in particular, where inflammatory mediators sit within the hierarchal pathophysiological mechanisms involved in clinical disease.