There is a rich supply of nerves in the connective tissue that offer feedback to determine different types of pain.  The weakest link is typically at the attachment, but can also occur in the zone where the tendon changes to muscle (musculotendinous junction).  When an area is injured, the body reacts with "inflammation" to "clean" out the damaged tissue and bring in the elements for repair.  Anti-inflammatories (Motrin, Aleve, steroids, etc.) interfere with this healing process if used incorrectly. Healing is not complete when the pain resolves. Studies have demonstrated that after 2 weeks there are no inflammatory cells so there is not continued inflammation, but if unresolved a degenerative process (tendinitis v. tendinosis) occurs.  Weak areas cause overload to adjacent and remote regions in the body.

Since there is poor blood supply to most of these injured areas, they are at greater risk for impaired healing.  The classical proliferant is dextrose (i.e. sugar).  This substance stimulates healing in at least two ways.  First, it is more concentrated where injected as opposed to the surrounding injured tissue.  This causes water to shift from the inside to outside of the cell; leading to bursting and causing a minor injury.  The cell substances as well as the dextrose itself stimulates the healing cascade of cells to clear the damage and use new substances to re-build the area (macrophages, growth factors, etc.).  Rehabilitation is very important once the healing has begun to prevent recurrence.  If the precipitating cause can be identified and altered, this should also be addressed.