[RESEARCH] Improving Tendon Health | Modern Manual Therapy Blog - Manual Therapy, Videos, Neurodynamics, Podcasts, Research Reviews

[RESEARCH] Improving Tendon Health

[RESEARCH] Improving Tendon Health - themanualtherapist.com

Improving Tendon Health

Recently, engineered ligaments have been developed using cells from human ACL or hamstring tendons. This research used this technology to learn how to best improve performance, prevent injury, and accelerate return to play in injured tendon/ligaments.


Loading Effects:
  • Tendons, like other forms of fibrous connective tissue such as bone and ligaments, adapt to their loading state.
  • Molecular adaptation to loading was independent of the frequency and intensity.
  • Time however DID alter the cellular response; Within 10 min of starting the activity, the molecular response peaks.

Hormonal Effects:

  • 48 h of high estrogen level was enough to decrease the stiffness of ligaments without change in collagen content.
  • Exercise produces global hormonal signals, which improves connective tissue function.
Nutrition Effects:
  • Amino acids enriched in collagen & added together with vitamin C can improve collagen synthesis.

Connective tissue can be trained:

  • 10 min of activity, targeted to a tendon/ligament.
  • Exercises performed with a light weight either 6 h before or after any other training.

Following Injury:
  • Begin training as soon as possible.
  • Simple range-of-motion and light exercises (amplitude of the load is not important for stimulating collagen production).
  • Ideally performed 3x/day. Ex. Jump-rope for Achilles Tendon.

Best Nutritional Support:
  • Consume leucine-rich protein as part of training to benefit from added muscle mass, strength and mTORC1 activation.
  • Glucose uptake into tendons increases during exercise.
  • 30-60min before training, consume 15 g of gelatin.


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Injury & Performance Lessons from Engineered Ligaments. Barr 2017. Sports Med (2017) 47 (Suppl 1):S5–S11.

Dalton Urrutia, MSc PT

Dalton is a Physical Therapist from Oregon, currently living and running the performance physiotherapy clinic he founded in London for Grapplers and Strength & Conditioning athletes. Dalton runs the popular instagram account @physicaltherapyresearch, where he posts easy summaries of current and relevant research on health, fitness, and rehab topics. 
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