Background on Tendons
Tendons connect muscle to bone. Any movement with repetitive loading of a muscle comes with an increased risk of tendon injury. Over use of a body part potentially can injure the tendon. This is often called 'tendonitis'. 'itis' simply means the immune system is active in that area cleaning up damage. Immune system activity is also sometimes called inflammation.
This means certain activities come with higher incidence of tendonitis due to repetitive loading of the tendon. Running and Tennis are documented to have especially high rates of tendon injuries in knees, achilles and elbows.
Tendons are made from a type of protein called 'Collagen'. Your body has 2 types of collagen. Tendons are made from 'Type 1 Collagen' and cartilage is made from 'Type 2 Collagen'.
Here I will discuss nutritional changes you can make to prevent injury, but also discuss nutrition for tendon healing.
How can you use nutrition for quicker tendon healing?
A thicker tendon is a stronger tendon. A thicker tendon can withstand more load and makes it lower risk to tendonitis. It has been observed supplementing with collagen before specific tendon loading exercises has led to increased tendon thickness.
Collagen is the protein tendons are made from. Read why taking the right type of protein matters. However, tendons have little blood supply, so delivering collagen to the tendon is hard. This is why supplementing before exercise is suggested to get the collagen to the tendon. Blood supply will be increased to the muscle you're using during exercise and more nutrition will get to the tendon.
Additionally, the exercise is suggested to be short in duration. More is not more in this case. Longer bouts of exercise seem to gradually shift load on to the muscle, rather than the tendon. One piece of research used skipping for 6 minutes to load the achilles tendon.
Vitamin C is often given at the same time as collagen. Vitamin C increases collagen production by stabilising mRNA encoding for collagen proteins. Vitamin C can also clean up damaged cells; reducing immune system activity (inflammation). Both of these properties make Vitamin C valuable in tendon health.
To summarise, research shows collagen can increase tendon thickness and quicken recovery from tendon injuries. This research is small and has flaws, but with little harm from supplementing, I support collagen as a therapy.
What other nutrition is there for tendon healing?
I mentioned above Vitamin C helps reduce inflammation. There are other foods which have good or bad effects on inflammation.
Fish oils have a positive effect on inflammation as they can hoover up damaged cells which triggers immune system activity. Oils such as Omega 3s have been shown to have a positive effect on tendonitis.
Fruits and Vegetables also contain many substances which reduce inflammation. These are too numerous to name and many are yet to be identified. This highlights the importance or maintaining a balanced and healthy diet surrounding supplementation with collagen.
Alcohol has been linked with weaker tendons. The linked paper discusses alcohol reduces collagen synthesis rates 'through toxic effects'. Alcohol also increases inflammation by allowing some gut bacteria into you blood, triggering the immune system, but also directly by damaging cells it comes into contact with.
Finally, chronically high blood sugar levels have been linked with higher rates of tendon injuries. Sugar in the blood binds to proteins, including collagen, changing their shape and making collagen more brittle. This is Prevented by following generic healthy eating advice and engaging in regular physical activity or controlling diabetes well.
This is by no means an exhaustive list and it is likely other life stresses also play a part in recovery and development of tendon health.
How and when to take collagen?
For optimal results you want to perform an exercise loading your weak tendon when your blood is most full of collagen. It is also advisable to take vitamin C and Omega 3 with your collagen.
Research suggests this protocol:
Take 20g Collagen, Vitamin C and Omega 3 60 minutes before exercise.
Perform an exercise which loads your tendon for less than 10 minutes.
Another protocol suggested by an established sports nutritionist is as follows.
I find this particularly interesting as I used to divide sports nutrition into fuelling before with carbs and recovering after with protein. This is a new way of combining nutrition and exercise. You use an exercise to specifically target part of the body to deliver nutrition.
If you have found this useful or know someone who would please share and engage in a discussion in the comments below.
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