Fu’s theory of failed healing

Fu’s theory of failed healing (that’s a mouthful!), stems from the belief that there is release of pro-inflammatory mediators causing relevant metallpotonise release and hence collagoynic injuries. A  tendon that was previously damaged therefore may not have healed adequately prior to an external load being added/increased . At this point Fu believes mechanical weakness and pain are not significant and therefore the tendon still has the ability to heal spontaneously. This is different from the reactive stage described by Cook and Purdum, where the cells are activated but no damage is described.


The failed healing stage occurs when the cells are not able to repair the collageniylic injuries and the exact cause of this is unknown. It is widely appreciated that tendon healing requires many sequential process’s in order to repair damaged tissue.

These include:

  • Inflammation,
  • neovasulrisation,
  • neural ingrowth,
  • recruitment of healing cells,
  • proliferation and
  • aptosis.

Somewhere along this process disturbances occur. Either the tendon has not received significant rest in order for these processes to happen, or the initial inflammatory process is disturbed by the prescription of NSAIDS causing an increase in pro-inflammatory cytokaines and not the ordinary inflammatory infiltration into the damaged tissue. Fu also surmises that depending on the location of the pathology, there could be a peritendious reaction which may lead to a restrictive fibrosis due to increased innervations and vascular in-growth may also occur from the paratendon.

Symptomatic tendons are diagnosed by activity related pain and medical imaging. Rupture will occur due to mechanical weakness in the tendon. The pain mechanisms in this phase are now non-phlogstic such as agitation to periteninous nerves by nocioceptive substances and swelling. Due to the failed healing response previously mentioned, tendons will not be homogenious in their presentation, depending on which stage of the healing has been distrupted. Fu suggests that new treatments could be based on this failed healing model,” to override on the failed healing tissues and restart the healing process”.


Book an Appointment

Pass This Post On

Share on facebook
Share on google
Share on twitter
Share on linkedin

Book an Appointment

Don’t Stop Here

More To Explore

5 Benefits of Physiotherapy for Athletes

Here are five great benefits of using physio that athletes, whatever their level should know about. 1. Enhance Physical Strength Training can take a toll on the body, straining the muscles, joints, bones, and ligaments. Physiotherapy will be able to help increase the strength in your body. 2. Help To De-Stress Your Body Physiotherapy can be used to destress your

Opening a Clinic After Covid

We are finally open! It’s been a tough few months but we see a little light at the end of the tunnel. We are still offering online appointment for anybody not able to travel, however for those of you that feel you need a face to face appointment we are now opening our clinics for 1:1 appointments. There will be

Changing Times

These are changing times for all of us, Co-Vid 19 has literally stopped the world. As a small business we are going through the most challenging time of all and we are desperately trying to keep our head above water. Our clinics have shut, however we have not!! We believe with the entire nation working from home we are not