Episode 125 – Nutrition For Tendon Issues

Key Topics Covered

Tendinopathy on ankle.

Background

  • The majority of the information covered in this episode is largely based on a systematic review that came out last year titled “The impact of nutrition on tendon health and tendinopathy: A systematic review“.
  • This review largely focuses on both preventing and managing tendinopathy.
  • There are so many areas that can be discussed on this topic, but focusing specifically on this review allows us to keep focused on what the research has shown.

Note: Nutrition is only one of many factors contributing to tendon management. We are just exploring the options available from this perspective.

Alcohol

Alcoholic drinks on table.

  • Alcohol consumption, particularly in higher amounts is linked with tendinopathy.
  • The mechanism proposed is largely related to a decrease in collagen synthesis. But there can be other explanations too e.g. even displacing other nutrients that could be relevant.
  • So limiting alcohol intake is a good option and an easy win here

Gelatin and HCP

Hydrolysed Collagen Peptides.
  • The majority of gelatin and hydrolyzed collagen studies were shown to improve clinical and structural outcomes.
  • 8 studies used collagen or gelatin and 7 of the 8 showed improved outcomes. The one that didn’t show positive outcomes used a very low dose of 2g per day. Typically we recommend 15-25g.
  • Many of these collagen studies also featured other ingredients too – which makes the research a little bit less clear than it sounds.

Other Ingredients

Curcumin

  • Other ingredients such as curcumin, Boswellia serrata, MSM, and arginine all were used in studies in that review and were linked with positive outcomes.
  • As these studies often used multiple ingredients, it’s hard to identify which individual ones helped.
  • Research has been mixed on omega-3s. Some research has linked it with improving outcomes. Other research has found no difference.

Thoughts Outside of That Review

  • We’ve seen good outcomes from Keith Baar’s research on higher-dose collagen pre-workout.
  • A recent study using 30g collagen post-workout found no increase in muscle connective tissue synthesis.
  • A general healthy diet is a good idea. This review highlighted that there isn’t much research looking at the impact of general nutrition outside of targeted strategies on tendinopathy.
  • For example, the potential effects of having an antioxidant-rich, inflammatory-style diet, avoiding nutrient deficiencies, being metabolically healthy etc.
  • Quite a few studies that involved a list of ingredients that theoretically could help with tendon issues have shown improved outcomes vs placebo.
  • If you had no financial constraints, you could theoretically make your mix of these (aiming for ones with very few downsides). Even if individually some may not help, overall it likely will.

Summary

  • It is hard to tell when something has helped when it comes to tendon issues and nutrition interventions.
  • For example: If collagen helped 20%, but you were in the middle of a powerlifting prep when you developed tendinopathy – taking collagen for the rest of the prep likely wouldn’t even be noticeable since there are high odds the tendon pain would get worse regardless if you kept training that way.
  • Similar logic to creatine. If creatine helped 1-3%, it would be difficult to determine if you were a responder or non-responder. However, it is still worth taking anyway because it consistently helps so many people vs placebo.
  • So with tendon issues perhaps it is best to take the approach of ticking as many boxes as you can from a nutrition perspective, especially since issues like this can be very frustrating and there is usually a high motivation to get it sorted as quickly as possible.

Relevant Blogs / Resources

Studies

Blog Posts