Does collagen help tendon stiffness?

Two stiffnesses pointing opposite ways: the symptom a reader wants less of, the property a reader wants more of, and how the two relate inside a tendon

Does collagen help tendon stiffness is a question whose central word means two different things, and the honest page separates them before answering because a reader asking about one is almost always asking for less of it and a reader asking about the other should be asking for more, so that a single answer would help one reader and mislead the other. The first stiffness is a symptom. A tendon with tendinopathy, an Achilles, a patellar tendon, a gluteal or a hamstring tendon, announces itself with a feeling of tightness and stiffness that is worst after rest: the first steps out of bed in the morning on an Achilles that feels like a cable set in cold wax, the knee that will not bend freely after an hour of sitting, the hip that has to be walked loose before a run, a stiffness that eases over the first minutes of use as the tendon warms and moves and that returns after the next period of rest. This is the felt stiffness, and it is a tendon that is reactive, thickened and disorganised reporting its state through the nerves and the sensitised tissue around it, with the morning stiffness of tendinopathy distinguished from the inflammatory morning stiffness of an arthritic joint by lasting minutes rather than an hour; a reader with this stiffness wants it to go, and it is the stiffness most readers mean. The second stiffness is a property. Mechanical stiffness is the force needed to stretch a tendon by a given amount, the slope of its force-elongation curve, measured in the training studies by ultrasound tracking of the tendon's stretch while a dynamometer records the force the muscle produces, and it is a property a tendon has whether or not it hurts. A stiffer tendon transmits the force of its muscle to bone faster, since less of the muscle's shortening is spent stretching the tendon before the bone moves, and stores and returns elastic energy more efficiently in running and jumping, which is why sprinters' and jumpers' tendons are stiffer than sedentary people's and why heavy loading programmes raise tendon stiffness measurably over around three months as the tendon remodels its matrix and cross-links; a reader who lifts, runs or jumps wants more of this stiffness, and the training that produces it is the training that treats tendinopathy. The two stiffnesses are not opposites inside the tendon, and the relation between them is worth knowing: a tendinopathic tendon, thickened and disorganised, is often mechanically less stiff than a healthy one despite feeling tighter, because its disorganised matrix stretches more under load, so that the tendon that feels stiff is the tendon that lacks stiffness, and the programme that raises the property is the programme that relieves the symptom, which is the doughnut of a reactive rim around a degenerate core on the does tendonitis go away page. But they are opposite in what the reader wants, less of the first and more of the second, and the question about collagen has to be asked of each.

Collagen and the property, collagen and the symptom, what moves each, and the worked example

Collagen's evidence bears on the property, and the honest page gives it its exact size. One small randomised trial in young men added specific collagen peptides or placebo to around fourteen weeks of supervised resistance training and measured the Achilles tendon's cross-sectional area and mechanical properties by ultrasound and dynamometry, reporting a greater increase in tendon cross-section in the collagen group than with the same training alone; cross-sectional area is one of the two components of a tendon's mechanical stiffness, the other being the material's own stiffness, so the result is a structural proxy for the property moved once, in a manufacturer-funded study that awaits replication by anyone else, and the honest word for it is perhaps. Beside it sits the pre-loading protocol's marker, 15g of gelatin with vitamin C about an hour before loading raising a blood marker of collagen synthesis in healthy men, which is evidence of building and not a measurement of stiffness, and the strength of every connective tissue measured tissue by tissue, with bone's one density trial and this tendon trial as the two positives, is on the collagen strengthen connective tissue page. What moves the property for certain is the loading: heavy slow resistance at loads near the heaviest manageable, every second or third day to match the seventy-two hour synthesis curve, raises tendon stiffness measurably over about three months in trained and untrained people alike, on the turnover clock on the strengthen connective tissue page, and a reader who wants a stiffer tendon gets it from the loading with collagen beside it as a perhaps. Collagen's evidence does not bear on the symptom directly, and the honest page says so. No trial has measured felt tendon stiffness, morning tightness or the time it takes an Achilles to loosen after collagen, and the one tendinopathy outcome trial, 2.5g a day for six months in people with Achilles tendinopathy, measured pain and function beside six months of calf strengthening, finding more improvement than placebo beside the same exercise, an adjunct's result inside a loading programme rather than a result on stiffness alone. What moves the symptom is known and is not swallowed. Isometric holds, a heavy sustained contraction of the muscle on the tendon held for around forty-five seconds and repeated several times, relieve tendon pain and tightness for around forty-five minutes in the trials, which is why a reader with a stiff morning Achilles does calf raise holds before the day's first walk and a reader with a stiff patellar tendon does wall sits before training. Movement itself eases the felt stiffness as the tendon warms and the fluid around it moves, which is the reason it eases over the first minutes of use. And a progressive loading programme over months remodels the reactive, disorganised tendon toward an organised one, which is the only thing that makes the morning stiffness leave rather than ease, and which raises the property while it relieves the symptom, so that the reader who wanted less of one stiffness and the reader who wanted more of the other are on the same programme. Under it runs the floor, protein, vitamin C, sleep and no smoking, and beside it sits collagen at the protocol dose before the heavy session, as a perhaps for the property and an adjunct for the programme. The worked example is that adjunct at habit scale, stated on its true terms: two capsules, 1200mg hydrolysed type 1 marine collagen with 12mg vitamin C at 15% of its reference value plus zinc, 120 for £16.99 at 28p a day, lab tested and UK made, below the 15g protocol dose and the training trial's dose, carrying vitamin C's collagen formation sentence for cartilage and bones and no tendon claim. Does collagen help tendon stiffness: for the property, perhaps, once, beside the loading that certainly does; for the symptom, no, and the isometrics and the programme do.

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