How can I speed up tendon healing?

Why there is no accelerator, and the brakes that are on

How can I speed up tendon healing is asked by every lifter with a sore patellar tendon and every runner with a thick Achilles, and the honest answer has to begin by removing the accelerator from the picture, because a tendon heals on a clock that nothing swallowed, injected or applied has been shown to shorten. The clock runs through three stages: inflammatory days in which damaged tissue is cleared and repair cells recruited, proliferative weeks in which fibroblasts lay down a disorganised scar of mostly type III collagen, and remodelling months to over a year in which type I collagen replaces type III, fibres align to load and the tissue regains most but not all of its original strength. Tendon is slow because it is designed to be: dense, aligned collagen with few cells and a sparse blood supply is what gives a tendon its tensile strength, and the same features give it a low metabolic rate and a long repair time, a trade that cannot be renegotiated by a supplement. What a reader can do is notice that a tendon often heals slower than its own clock because something is holding it back, and that the brakes, unlike the clock, are within reach. The first and most common brake is rest in place of loading: complete rest or immobilisation after the first few days produces weaker, more disorganised healing tissue than early controlled loading, because tendon cells raise collagen synthesis in response to strain and lower it when unloaded, so the instinct to rest a sore tendon until it stops hurting is the brake most readers are pressing hardest. The second is smoking, which impairs blood flow and oxygen delivery and slows repair across tendon, ligament and bone, among the best documented of all modifiable brakes. The third is corticosteroid injection into or around the tendon, which relieves pain for a period and weakens the tendon, with an association with rupture that is why clinicians have moved away from it for most tendinopathies. The fourth is the fluoroquinolone class of antibiotics, which carries a regulator's tendon warning, with the Achilles the usual site and risk higher in older adults and with concurrent steroids, so a reader prescribed one with an active tendon problem mentions the tendon to the prescriber. The remaining brakes are systemic: poorly controlled blood sugar slows connective tissue repair, sleep debt lowers the hormonal environment repair runs in, and an under-fed body in a hard deficit has less protein and energy to build with, so a reader dieting hard through a tendon injury has a brake on they may not have noticed.

Releasing the brakes, pressing the only accelerator, and adding the adjunct

Releasing the brakes is the speeding up a reader can actually do, and it is a list to work through rather than a product to buy. Stop smoking, or at least do not start a tendon rehab while continuing. Decline a steroid injection unless a specialist has a specific reason for it and has explained the trade. Mention an active tendon problem to any prescriber considering a fluoroquinolone. Eat enough, with complete protein at around 1.6 to 2.2g per kilogram and no aggressive deficit while the tendon heals, and sleep. And stop resting: with a physiotherapist's assessment in hand, replace rest with a progressive loading programme, which is the only thing in the whole picture that resembles an accelerator, not because it shortens the stages but because it is the signal that drives the remodelling stage to produce aligned type I collagen rather than disorganised scar, and because a tendon that is loaded heals towards strength while a tendon that is rested heals towards weakness. The programme typically begins with heavy isometric holds, five holds of around forty-five seconds at roughly seventy percent of maximum in the patellar tendon research, which reduce tendon pain for around forty-five minutes afterwards and let the heavier work begin, then progresses through slow heavy resistance and eccentric loading to the energy-storage work the tendon will be asked to do in sport, with a criteria-based return rather than a calendar one. The adjunct, if a reader wants it, is collagen with vitamin C taken about an hour before the loading session: 15g of gelatin or hydrolysed collagen with vitamin C doubled a blood marker of collagen synthesis in the Baar trial when timed to a loading bout, and 2.5g a day of collagen peptides beside a six-month calf-strengthening programme improved Achilles function and return to running against placebo in one small manufacturer-funded trial, so the adjunct has a marker trial and one small outcome trial, both beside loading and neither in a rested tendon, which is why it is listed after the brakes and the programme rather than before them. No tendon claim is authorised for collagen in the UK and the honest tub does not print one. The worked example is a habit dose and is stated as such: two capsules, 1200mg hydrolysed type 1 marine collagen with 12mg vitamin C plus zinc, 120 for £16.99 at 28p a day, lab tested and UK made, below the 15g protocol dose, with vitamin C's contribution to normal collagen formation for the normal function of cartilage and bones as its lawful sentence. How can I speed up tendon healing: you cannot, but you can stop slowing it, load it properly, and take the adjunct beside the session if you want the small evidence it has.

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