Supplements for Tendinosis
Vitamin C enriched dietary gelatin is the most effective supplement for tendinosis, as it has been identified as a novel strategy to support tendon repair. 1
First-Line Supplements
- Collagen Peptides: Support tendon healing and have been shown to augment tendon hypertrophy during training 1, 2
- Vitamin C: Essential for collagen synthesis and tendon repair, especially when combined with gelatin 1, 3
- Turmeric/Curcumin: Provides significant anti-inflammatory, antialgic, and antioxidant effects for tendinopathies 1, 4
- Ginger Extract: May help reduce pain and improve function in mild-to-moderate tendinopathies 1
Second-Line Supplements
- Glucosamine and Chondroitin: May be helpful in reducing pain and improving function, though evidence is limited 1, 2
- Vitamin D: May support tendon healing, though evidence is inconsistent 1
- Omega-3 Fatty Acids: Emerging data indicate potential roles in retaining/restoring tissue during rehabilitation 1, 2
Proprietary Blends with Evidence
Several commercial proprietary blends have shown promise in clinical studies:
- TendoActive: Contains mucopolysaccharides, type I collagen, and vitamin C 2
- TENDISULFUR: Contains methylsulfonylmethane, hydrolyzed collagen, L-arginine, L-lysine, vitamin C, bromelain, chondroitin, glucosamine, Boswellia, and myrrh 2
- Tenosan: Contains arginine-L-alpha ketoglutarate, hydrolyzed collagen type I, methylsulfonylmethane, vitamin C, bromelain, and vinitrox 2
Mechanism of Action
- Supplements primarily work through anti-inflammatory pathways and by supporting tendon healing processes 2, 5
- Many supplements modulate multiple cellular targets, including NF-κB, p38/MAPK, JNK/STAT3, and PI3K/Akt signaling pathways 5
- Collagen peptides combined with vitamin C provide building blocks for tendon repair while reducing inflammation 3
- Curcumin decreases cell infiltration, activation, and maturation of leukocytes at the site of inflammation 4
Optimal Supplementation Strategy
- Multi-nutrient approach: Because many nutrients are required for tendon health, interventions involving multiple nutrients are likely more effective than single-nutrient strategies 6
- Timing: Supplements should be taken consistently throughout the rehabilitation period 1
- Combination with Exercise: Nutritional supplements work best as an adjunct to proper exercise therapy, particularly eccentric strengthening exercises 7, 2
Important Considerations
- Supplements should complement, not replace, first-line treatments such as relative rest, ice therapy, and eccentric strengthening exercises 8
- Most patients with tendinopathies (about 80%) fully recover within 3-6 months with appropriate conservative treatment 8
- Maintain adequate protein intake (≥1.6 g/kg body mass) during rehabilitation to prevent muscle loss and support tendon healing 1
- Avoid drastic reductions in energy intake during rehabilitation, as the metabolic demand of tissue recovery processes is high 1
Remember that while supplements may help, they should be part of a comprehensive approach that includes proper loading through eccentric exercises, which stimulate collagen production and guide normal alignment of newly formed collagen fibers 7.