Figure 6. Our model of tendon growth shows significant proliferation prior to P30 that coincides with expansion and maturation of the tendon matrix.

By P30, tendon cells transition from relatively high to very low rates of proliferation, signifying a transition from growth to physiological tissue maintenance. Others have shown that matrix maturation and expansion continue after P30, but these changes do not involve proliferation-driven cell growth or longitudinal growth of the tendon.