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The mechanisms most relevant to knee pain: VEGF upregulation — stimulates new blood vessel formation in cartilage and connective tissue, areas that are notoriously slow to heal due to limited blood supply Nitric oxide modulation — regulates inflammation and promotes vasodilation, improving blood flow to damaged tissue Collagen synthesis — accelerates organized collagen deposition at repair sites instead of disorganized scar tissue Tendon-to-bone healing — particularly relevant at the patella tendon and other knee attachment points Animal studies across rat, rabbit, and canine models showed consistent findings across these pathways

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PLoS ONE 9 , e116386 (2014)