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Tendons and ligaments: Have low vascularity (limited blood flow) Depend heavily on collagen alignment and remodeling Heal slowly and often incompletely Are prone to scar tissue and reinjury Traditional treatmentsrest, physiotherapy, NSAIDs, corticosteroid injectionscan reduce pain but often do not improve tissue quality

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This is recounted by more than 80% of patients (98) and it has been estimated that two-thirds of ME/CFS cases arise following viral infection (85, 99)