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The blood supply to tendons is notoriously poor compared to muscles, which is a big reason why they heal so agonizingly slowly

PubMed, doi:10.1371/journal.pone.0066592

MSCs mainly work by releasing signaling molecules that interact with immune and nerve cells

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In general, this is fully compatible with the healing of tendon and muscle injuries that could not spontaneously heal, such as a transected or detached tendon, transected, crushed, and denervated muscle, and severed junction reestablishment (i.e., osteotendinous, myotendinous, and muscle-to-bone attachment) [80,81,82,83,84,85,86,87,88,89,90,91]

Each route has a distinct pharmacokinetic profile and a distinct body of supporting evidence, and the choice between them should be driven by the clinical target