By Morgan King, MSc, RD
In sports, a large percent of musculoskeletal injuries are tendons and ligaments. It is common due to pivoting, repetitive stress, or high loaded stress on fingers, knees, and elbows to name a few1. When injuries occur, rebuilding strength is required to repair the damaged ligaments and tendons. Recently, there has been a particular interest in nutrition, specifically collagen supplementation, and how it may aid in the recovery from injuries and or build ligament strength.
As an avid climber, I have taken an interest in this supplement as a climber as I am constantly placing strain on my finger ligaments due to the small painful little hold known as crimps that can induce injuries to finger ligaments.
What is collagen and how does it build tendons and ligaments?
Collagen is a structural protein that builds bone, tendons, ligaments, and cartilage. Collagen is also the most abundant protein found in the body2. For proteins to be created, protein blocks (amino acids) to be ingested through ingesting collagen, gelatin, or collagen-containing foods. These structural proteins are then combined in a helix form (a matrix) with the help of vitamin C to create tissues1,2. Asker J. provides a detailed article on collage synthesis and its role in soft tissue building about the matrix.
Article found here: https://www.mysportscience.com/post/gelatin-and-injury.
So, what about collagen supplements?
Taking collagen supplements is thought to enhance ligament/tendon strength by supplying nutrients that can aid in the building of the tendon/ligament matrix. A study by Shaw et al. 2017 showed enhanced tendon strength with ingestion of 15g of collagen enriched with vitamin C 1 hour before a high intensity workout. In a more recent research article, Lis D & Baar (2019) who investigated vitamin C and collagen supplementation before exercise ALSO reported an increase in biomarkers during exercise that suggest the building for tendon and ligament matrix when the participants ingested vitamin C and collagen before exercise.
That being said, to counter the above-mentioned studies, a study by Clifford et al (2018) reported no effects on collagen synthesis with collagen supplement ingestion.
Although promising for the use of collagen supplement increase ligament and tendon strength further studies are needed to conclude the use of collagen supplementation as it is only a “B” grade supplementation in the Australian Sports Commission (AIS) has a grading system. This system is based on scientific evidence to support sports supplements and highlights the risks and benefits of taking supplements read more here: https://www.ais.gov.au/nutrition/supplements
Important factors to consider when using collagen supplementation is that 1) the individual needs to be going to do exercise 2) vitamin C needs to be taken with the collagen supplement to be effective. Scenarios in which an athlete is injured and told to refrain from exercise, taking a collagen supplement [currently based on the literature] will not help increase tendon strength, however, if the athlete is in the rehabilitation phase (doing physiotherapy strength exercises or training), the use of a collagen supplement may be helpful. Food, in my opinion, should always come first before running to powders as they can be more expensive than eating food.
References
1. Clifford T, Ventress M, Allerton DM, Stansfield S, Tang JCY, Fraser WD, Vanhoecke B, Prawitt J, Stevenson E. The effects of collagen peptides on muscle damage, inflammation and bone turnover following exercise: a randomized, controlled trial. Amino Acids. 2019 Apr;51(4):691-704. doi: 10.1007/s00726-019-02706-5. Epub 2019 Feb 19. PMID: 30783776.
2. AIS (2021). AIS Sport Supplement Framework: Collagen. https://www.ais.gov.au/__data/assets/pdf_file/0009/999954/36194_Sport-supplement-fact-sheets-Collagen-v3.pdf
3. Lis DM, Baar K. Effects of Different Vitamin C-Enriched Collagen Derivatives on Collagen Synthesis. Int J Sport Nutr Exerc Metab. 2019 Sep 1;29(5):526-531. doi: 10.1123/ijsnem.2018-0385. PMID: 30859848.
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