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In the orthopedic literature, reviewers describe preclinical work involving muscle, tendon, ligament, and bone injury models, with proposed effects on growth hormone receptor expression, angiogenesis-related pathways, and inflammatory cytokines (Emerging Use of BPC-157 in Orthopaedic Sports Medicine)

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The most common cause is overuse or repetitive twisting, like that required for a backhand tennis stroke

However, since this reaction occurs primarily in the liver, glycine deficiency could impede the elimination of excess acylCoAs from the liver of individuals with obesity and contribute to MASLD pathogenesis