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In a previous clinical study, the Achilles tendons of patients with rheumatoid arthritis who received dexamethasone treatment for at least 3 months had a low density of collagen type 1 ( In vitro analyses have shown that dexamethasone treatment reduces the gene expression of collagen type 1, collagen synthesis, and proliferation of tenocytes (Wong et al., 2003

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The theoretical basis for synergy involves the concept of recovery periodization. Just as athletes periodize training loads to optimize adaptation, strategic timing of recovery modalities may enhance overall outcomes