Evidence supporting the use of: Protease
For the health condition: Tendonitis

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Synopsis

Source of validity: Scientific
Rating (out of 5): 2

Protease enzymes, such as bromelain, papain, and other proteolytic blends, have been explored as supportive agents in the management of tendonitis, primarily due to their potential anti-inflammatory and fibrinolytic properties. The scientific rationale is that these enzymes may help break down inflammatory protein complexes and reduce swelling, thereby facilitating tissue repair and alleviating pain. Several small clinical studies and animal models have investigated the effects of oral proteases on soft tissue injuries, including tendonitis. Some research, particularly with bromelain, has demonstrated modest reductions in pain and swelling in musculoskeletal injuries, though studies are often limited by small sample sizes, short durations, and methodological weaknesses.

A few randomized controlled trials and systematic reviews have suggested that proteolytic enzymes may provide benefits comparable to non-steroidal anti-inflammatory drugs (NSAIDs) for soft tissue injuries, but the quality of evidence is considered low to moderate. Most guidelines still recommend conventional treatments (rest, ice, NSAIDs, physical therapy) as first-line therapy, with protease supplementation regarded as adjunctive at best. Safety data suggest proteases are generally well-tolerated but may cause gastrointestinal upset or allergic reactions in some individuals.

In summary, while there is some scientific basis and preliminary clinical evidence for using protease enzymes to support tendonitis recovery, the strength of evidence is limited. Larger, high-quality trials are needed to establish clear recommendations and to better understand the efficacy and safety profile of these supplements for tendonitis.

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