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Chronic tendinopathy is a significant problem particularly in active populations limiting sporting and occupational performance. The prevalence of patella tendinopathy in some sports is near 50% and the incidence of lower limb tendinopathy is 1.4% per year in the British military.

Management includes isometric, eccentric, heavy slow resistance exercises and extracorporeal shockwave therapy (ESWT). Often these treatments are inadequate yet there is currently insufficient evidence on the effectiveness of injection therapies, and success rates from surgery can be as low as 50%.

High Volume Image Guided Injection (HVIGI) aims to strip away the neovascularity and disrupt the nerve ingrowth seen in chronic cases and has shown promising results in case series.

The Biomechanical Associations and Efficacy of Injectable Therapy (BEFIT) study will investigate the efficacy of HVIGI in a randomised control trial and will add high-level evidence to the management of chronic tendinopathy resistant to conservative treatment.

The Higher Education Funding Council for England (HEFCE) has supported this project through a catalyst fund.

Watch a video about the study.

Institutions / organisations and researchers

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