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The goal of this clinical trial is to learn whether a one-time injection of a person's own processed fat tissue (autologous lipoaspirate), a procedure called Adipose Stem/Stromal Cells for Enthesis/Tendon Therapy (ASSET), can reduce pain and improve function in adults (ages 18-80) with chronic tendinopathy- tendon pain lasting more than 3 months (for example, in the shoulder, elbow, hip, knee, or Achilles) - that has not improved with usual treatments such as physical therapy, cortisone shots, or platelet-rich plasma. The main questions it aims to answer are: * Does injecting a person's own concentrated fat into a painful tendon reduce tendon pain? * Does it improve how well the tendon works, how long does any improvement last, and is the procedure safe? This is a single-group study, so there is no separate comparison group; each participant's pain, function, and ultrasound results af
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