Collagen for Strong Tendons and Ligaments

collagen for stronger tendons and ligamentsCollagen (or gelatin) + a good source of vitamin C can make your tendons and ligaments stronger. This may help you return to play faster. Take this combination 60 minutes before activity. It takes 30 – 60 minutes for the amino acids in collagen (namely proline, glycine, lysine, hydroxyproline, and hydroxylysine, which are building blocks of collagen, the primary protein in ligaments, tendons and bone) to peak in your bloodstream. This way they will peak right when the pumping action of joints (from physical activity or physical therapy) delivers blood and therefore nutrients including these amino acids and vitamin C to your tissue. You need vitamin C to build collagen. A glass of juice or an orange delivers plenty of vitamin C. You don’t need a supplement. Large doses of vitamin C are not beneficial for muscle and can delay the process of building new proteins in muscle after resistance training.

Building Healthy Tendons

Training with fast, explosive movements builds stiffer tendons. Stiff tendons make athletes explosive (I think of it like a pogo stick; anyone else play on these when they were kids?). Tendons connect a soft tissue, muscle, to a hard tissue, bone. Therefore, tendons must be more pliable near the muscle and stiffer as they get closer to the bone. Stiffer tendons have more molecular crosslinks connecting collagen to fibrils. This ability to stretch near the muscle helps protect the muscle from injury by absorbing shock. Tendons that are too stiff are more likely to be injured (think of an old rubber band that is stiff, pull it too much and it may break).

If you have a tendon injury, your physical therapist or strength coach might have you do slow movements (eccentric movements – lengthening the muscle, like the downward phase of a biceps curl; isometric holds). These movements increase collagen content but decrease collagen crosslinking in the part of the tendon closest to the muscle making it more pliable and therefore less prone to injury. Take collagen / gelatin + a source of vitamin C beforehand to further benefit collagen production in tendons.

Building Healthy Ligaments

Ligaments connect bone to bone. They need to be stiff to resist injury. Collagen synthesis in ligaments (and bone) is maximized by intermittent bouts of up to 10 minutes of activity separated by 6 or more hours of rest. Your physical therapist or rehab specialist may have you performing < 10-minute bouts of activity targeting the injured tendon or ligament separated by 6 hours before another bout. Be sure to take collagen or gelatin + a source of vitamin C 30 minutes to 1 hour beforehand to improve collagen synthesis even more.

There are huge differences in a person’s response to collagen hydrolysate and gelatin. Expect more coming out soon from Keith Barr about this.

Heating destroys vitamin C so, jello won’t do the trick (unless you already have a sufficient amount of vitamin C in your body).

Vegan? Try soy but, you need a lot more to get higher doses of these amino acids (around 58 grams of soy protein has the same proline and glycine as 15 grams of gelatin).

Interesting tidbits: Lack of physical activity makes tendons stiff. An athlete with a boot on his leg may feel very explosive once that boot comes off. In women, when estrogen is high during the menstrual cycle there is decreased crosslinking of collagen in ligaments leading to decreased stiffness of ligaments and greater chance of ligament rupture (ACLs etc.).

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NSAIDs Can Help Decrease Inflammation and Pain but Impact Muscle Gains

NSAIDs (non-steroidal anti-inflammatory drugs) including ibuprofen, naproxen, diclofenac, celecoxib and indomethacin can decrease pain. Take them for the shortest possible time as they can be harmful.

Should you use NSAIDs? If you must get back to work ASAP then consider the risks vs. benefits. Talk to your pharmacist and physician (MD).

NSAIDs can help decrease inflammation and pain

NSAIDs can Help Decrease Pain from:

  • Acute ligament sprain – use for < 5 days. NSAIDs reduce pain and swelling so you can return to activity faster.
  • Osteoarthritis (cartilage wear and tear)
  • Delayed onset muscle soreness. When taken for several days before muscle damaging exercise, NSAIDs may reduce soreness. Take with caution as they can wreck your strength gains (see below).
  • Muscle bruise (contusion). Short term use can decrease inflammation with no adverse effects on healing.
  • Tendonitis – reduces inflammation and helps recovery. NSAIDs may do more harm than good for chronic tendon issues.

How NSAIDs Impact your Strength Gains

  • Short-term low dose (400 mg ibuprofen) use may have no real impact on muscle strength or size.
  • Longer term, higher doses (1,200 mg ibuprofen) may compromise muscle growth and, when training was preformed with all-out max reps, strength gains were also compromised.
  • The elderly may benefit due to a decrease in inflammation from taking NSAIDs. Chronic inflammation, which is not uncommon in the elderly, impairs strength gains. NSAIDs help tame inflammation.
  • After muscle injuries, NSAIDs can help reduce strength loss, soreness and muscle markers of inflammation, particularly when lower body muscles are injured.

Why do NSAIDs Impact Training (Strength) Gains?

NSAIDs work by blocking COX enzymes. COX enzymes alter prostaglandin synthesis, mediators of inflammation and pain. Prostaglandins have other actions in the body including regulation of muscle protein metabolism. Decreases in the prostaglandin PGFare associated with decreased protein synthesis and reduced muscle fiber size. In one study, 1200 mg ibuprofen blocked protein synthesis after resistance training. Other studies show signaling responses in muscle are decreased for hours or days after resistance training when NSAIDs are used.

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Got Knee Pain? Creatine May Improve Your Pain & Stiffness

If you have knee pain, chances are you may have osteoarthritis. Osteoarthritis is the most common joint disorder and it’s the medical term for “wear and tear” on a joint.  Over time, the cushioning between your joints, your cartilage, can break down causing pain, swelling, stiffness and a limited range of motion.

The initial treatment regimen for osteoarthritis often involves over the counter pain relievers, physical therapy, glucosamine and chondroitin sulfate. But, a recent study shed light on the effectiveness of a popular sports supplement – creatine, for osteoarthritis.

In a randomized, double-blind, placebo-controlled study in postmenopausal women with osteoarthritis, the women were given either creatine (in a typical dosing pattern used with creatine – 20 grams per day for one week followed by 5 grams per day thereafter) or a placebo for 12 weeks. After the 12-week study finished, physical functioning and stiffness significantly improved in the creatine group. In addition, the group taking creatine significantly improved the muscle mass in their legs.

If you are in physical therapy and working on leg and glute (butt) strength to stabilize your knee and help minimize the pain of osteoarthritis, try creatine with your program. By adding creatine, you should see greater gains in muscle tissue and see them more rapidly. And, better functioning muscle means stronger knees and less knee pain. And, you don’t need to be a postmenopausal woman to reap the benefits from creatine. In fact, you’ve got a leg up if you are under 40, especially if you are a man (because your muscle tissue is primed for growth when you are younger and men have the hormonal profile to make great gains from strength training whereas women do not have the hormones necessary to “get big”).

If you want to try creatine, take the initial loading dose in 5 gram increments four times per day or 10 grams twice a day. Take more than that at one time and you may experience some stomach distress. Is creatine safe? You bet. Check out my article here about the safety of creatine.

Get Rid of Muscle Knots and Tendonitis with Dry Needling

I’ve spent my fair share of time at PT offices, in training rooms during my college years and at various orthopedic offices. And there’s one common thread I’ve noticed through the years – many practitioners want to put a Band-Aid on the issue and send you out the door. Foot pain? We’ll just assume it is plantar facititis, give you some exercises and send you out the door. Oh, and stay off your feet so you can get better. If you’re competing, we’ll just shoot you up with cortizone to mask the pain, tape the area and send you on your way.

Frustrated, but with no other real options, I went with the Band-Aid approach. So I’ve intermittently given up running countless times while faithfully doing PT exercises only to end up with knee pain, plantar facititis for the millionth time or something else.

But, through a twist of pure luck (thanks to CBS Better Mornings Atlanta), I found a PT practice that operates differently. One that spends time going through the biomechanical issues that actually cause the problem in the first place and then uses a systematic approach to treating areas that are tight, muscles that aren’t firing and more. And, they also incorporate a technique called dry needling. A technique that alone has made an immediate difference!

With dry needling, small needles are placed within within those muscle knots that are so tender. The needles hit the specific area within muscle tissue that is locked, causes it to twitch, cramp and release. For 2 seconds of pain you get amazing results! Sure, deep tissue massage feels great and it works but in my experience, dry needling is an instant relief – especially if you have painful tendonitis – you’ll feel better right away.

So what’s my take home message here? There are practices out there that take the time you need to thoroughly evaluate and then treat the actual cause of your joint and muscle pain. You may pay more, or pay out of pocket but, in the long run you’ll pay a lot less if you fix the problem on the first try instead of paying a bunch of copays and money on ineffective treatment modalities (remember, spending $20 to “try something” that has no validity, is likely a waste of $20).

In Atlanta, GA or the surrounding areas, my choice is One Therapy.
In Bethesda, MD or surrounding areas, go with Bethesda Physiocare.

Disclosure: because my treatment philosophies line up with One Therapy’s, I have aligned my business with theirs but, I’m also a patient. And, for the first time, my biomechanical issues (poor running gait, muscles not firing when they need to so I’m overcompensating with other muscles and overloading my knees) are being addressed.