What deficiencies cause tendon stiffness and pain?

From the Guidelines

Magnesium and calcium deficiencies are the primary nutritional shortfalls that can cause tendon stiffness and pain, with magnesium playing a crucial role in energy production, muscle function, bone health, immune function, and pain modulation. According to a recent study 1, athletes with a history of Achilles or patella tendon pain had significantly lower magnesium levels than average, highlighting the importance of magnesium in tendon health. The recommended daily intake of magnesium is 310-420mg for adults, which can be achieved through foods like nuts, seeds, and leafy greens, or supplements if needed. Calcium is also essential for maintaining bone tissues, skeletal muscle, and cardiac contraction, with a recommended daily intake of 1000-1500mg for adults 1.

Some key food sources of calcium include:

• Whole or skimmed cow's milk (200 mL): 240mg
• Calcium-enriched soy milk (200 mL): 240mg
• Hard cheese (30g): 220mg
• Yoghurt (120g): 200mg
• Sardines with bones (½ tin): 258mg
• Broccoli (2 spears): 34mg
• Kale (67g): 100mg
• Orange (1 medium size): 75mg

In addition to magnesium and calcium, other nutrients like vitamin D, potassium, and collagen can also impact tendon health. However, the most recent and highest quality study 1 emphasizes the importance of magnesium in tendon health, particularly in athletes. Therefore, ensuring adequate magnesium intake is crucial for maintaining healthy tendons and preventing stiffness and pain.

From the Research

Tendon Stiffness and Pain Deficiencies

• Vitamin C deficiency is associated with a decrease in procollagen synthesis and reduced hydroxylation of proline and lysine residues, hindering the tendon repair process 2
• Collagen deficiency may also contribute to tendon stiffness and pain, as collagen is the main molecular component of tendons (60-85%) 2
• Glycosaminoglycans-proteoglycans, glycoproteins, and other collagen subtypes deficiencies may also play a role in tendon stiffness and pain, although the exact mechanisms are not fully understood 2

Nutritional Supplementation

• Vitamin C supplementation has been shown to increase collagen synthesis and improve tendon repair 2, 3
• Collagen supplementation, alone or in combination with exercise, may also improve tendon properties and reduce pain 4, 5
• Combination of collagen peptide type-1, low molecular weight chondroitin sulphate, sodium hyaluronate, and vitamin C may be more effective than oral diclofenac in controlling pain in Achilles tendinopathy 5

Biomechanical Properties

• Vitamin C supplementation may not significantly improve ultimate tendon tensile strength or stiffness 6
• Collagen supplementation, alone or in combination with exercise, may not significantly improve tendon stiffness, but may improve cross-sectional area and tendon thickness 4