Neuromechanical adaptations to tendon injury and the proposed framework for intervention

Achilles tendinopathy is a well-known pathology that can vary in both chronicity and symptom presentation. Pain, although often being used as an indicator of the severity of the pathology, is not always present and symptoms fluctuate throughout the stages of pathology. Advanced tendinosis accompanied by altered morphology show persistent changes in neuromechanics indicating adaptations in sensory-motor [1, 2] as well as central nervous system [2]. Here, we first ask if any of these adaptations are reversible by targeting the diminished mechanical properties of the tendon. And, second, we propose to seek a new intervention paradigm that is directed at the whole-body level by incorporating the control system in addition to targeting the compliant tendon.