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Gibbs et al., 1968

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(2010) Increased prevalence of the pfdhfr/phdhps quintuple mutant and rapid emergence of pfdhps resistance mutations at codons 581 and 613 in Kisumu, Kenya

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Evidence-backed treatments include: Isometric exercises, which can help with pain control Heavy slow resistance training and eccentric loading to stimulate healing Supportive therapies like shockwave, topical NSAIDs, or in some cases injections When tendon degeneration is severe, we often focus on strengthening the healthy parts of the tendon what some clinicians call treating the doughnut, not the hole. Recovery takes time, consistency, and a plan tailored to the person not a quick fix