The reason is straightforward: tendons and ligaments have poor native blood supply, which means they heal slowly under the best circumstances and often stop progressing entirely after initial recovery
Outside References Sikiric P, et al
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This phenomenon may help explain the obesity paradox, which suggests that, even though people who are obese are at greater risk of developing heart issues, once heart disease develops, individuals with higher BMIs appear to have a lower mortality risk than people with normal BMIs