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Instead, it is studied through several overlapping marker systems, including angiogenesis, nitric oxide signalling, VEGF related markers, fibroblast migration, collagen organisation, tendon fibroblast activity, inflammatory mediators and gastrointestinal mucosal models

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Randomized controlled trials by Zwerver et al in 2011, Thijs et al in 2017, and Lee et al in 2020 reported that extracorporeal shockwave therapy (ESWT) is no more effective than placebo or exercise alone

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