How can I repair my tendons naturally?

The seventy-two hour curve: what a tendon does after it is loaded

How can I repair my tendons naturally is a question the honest page answers with a graph rather than a list, because the most useful thing a lifter can know about tendon repair is the shape of what happens inside a tendon after it is loaded, and the shape dictates the programme. Researchers measuring collagen turnover directly in human tendon, by sampling the fluid around the patellar and Achilles tendons after exercise, found that a bout of loading raises both of the tendon's collagen processes at once: the breakdown of existing collagen, through the matrix enzymes, and the synthesis of new collagen by the tenocytes. The two do not rise together. Breakdown leads, rising within hours and peaking in the first day or so; synthesis follows, rising more slowly, peaking around twenty-four hours after the session and remaining raised for as long as seventy-two hours. The net collagen balance, synthesis minus breakdown, is therefore negative in the hours immediately after a session, when the tendon is briefly losing more than it makes, and crosses to positive somewhere around thirty-six hours, staying positive out to around seventy-two, which is the window in which the tendon is actually rebuilding itself, laying new collagen into its matrix in response to the load it felt. This curve is the natural repair programme written out in biology, and three consequences follow from its shape. The first is that a tendon repairs itself after loading, not after rest: an unloaded tendon's synthesis falls below baseline, so complete rest of a sore tendon does not let it rebuild but tells it there is nothing to rebuild for, which is why the rested tendon comes back weaker and why loading is the treatment of tendinopathy. The second is that a tendon repairs itself between sessions, in the positive half of the curve, and needs the second and third day for that half to run; a tendon loaded heavily again at twenty-four hours is hit while its balance is still negative and the next session's breakdown lands on top of the last one's, so that daily heavy loading of a sore tendon keeps it in the negative half permanently, which is the biology of the lifter who trains through patellar tendon pain and gets steadily worse. The third is that timing substrate to the curve is at least coherent: the collagen protocol's rationale is to raise blood amino acids and collagen peptides in the hour before loading so that the synthesis the load provokes has material to hand, and the marker trial showed a doubled synthesis marker when 15g of gelatin with vitamin C preceded a loading bout, an adjunct whose logic sits exactly on this curve.

The programme the curve dictates, the materials, the brakes, and the adjunct

The programme the curve dictates is simple enough to write on a card. Load the tendon heavily and slowly, through its full range, at a load high enough to provoke the adaptation, because the tenocytes respond to the magnitude of strain and light loads do not move the curve; the tendinopathy rehabilitation trials use heavy slow resistance, three slow repetitions of several seconds each way at loads near the heaviest the person can manage for the set, or the eccentric programmes that preceded them, and both outperform rest and passive treatment. Then leave the tendon for two or three days while the positive half of the curve runs, so that heavy sessions land every second or third day rather than daily, with the next session arriving as the balance turns positive and the tendon has rebuilt from the last. On the days between, use isometric holds for pain: five holds of around forty-five seconds at roughly seventy percent of maximum reduce tendon pain for around forty-five minutes afterwards and provide a low-breakdown stimulus that does not reset the curve, which is why they fill the recovery days in the rehabilitation continuum. Progress over months, from isometrics to heavy slow resistance to the energy-storage work the sport demands, with a return decided by tests rather than the calendar, because the remodelling that follows each positive window takes months to accumulate into a tendon that tolerates the sport. The materials come from the plate: protein at 1.6 to 2.2g per kilogram supplying glycine, proline and lysine for the chains, vitamin C and iron for the hydroxylases that fold them, copper for the cross-linking enzyme and zinc for the remodelling enzymes, all met by an ordinary varied diet carrying enough protein, with the under-fed lifter in a hard deficit the one who has starved the positive half of its materials. The brakes come off, because each of them flattens the curve: smoking, which slows every connective tissue repair; a corticosteroid injection into the tendon, which weakens it; fluoroquinolone antibiotics, which carry a tendon warning; sleep debt and under-eating. The adjunct, if a reader wants it, is the collagen protocol timed to the curve, 15g of gelatin or hydrolysed collagen with vitamin C about an hour before the loading session, with its marker trial and one small six-month Achilles outcome trial at 2.5g beside calf strengthening, never a replacement for the loading whose curve it rides. Nothing in a bottle repairs a tendon; the curve does, if it is given its days, and the natural in the reader's question turns out to mean the tendon's own schedule respected. The worked example is the habit version of the adjunct, 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, carrying vitamin C's collagen formation sentence for cartilage and bones and no tendon claim, since collagen holds none in the UK. How can I repair my tendons naturally: load them heavily, then leave them for the two days in which they do the repairing, and feed the days.

What to check on the label