Tendon Strength

Tendon is dense collagen with low vascularity and slow turnover, which is why adaptation takes months and injuries are slow to heal. Mechanical loading is the primary anabolic stimulus, and heavy slow resistance and isometric protocols have the best clinical trial evidence for tendinopathy. Tendon collagen synthesis rises for roughly 6-24 hours after loading, and the strategy of taking gelatin or collagen with vitamin C about an hour before loading is designed to exploit that window. Fluoroquinolone antibiotics and corticosteroid injections both weaken tendon and increase rupture risk. Progressing load too quickly is the most common cause of tendinopathy.

1) Use heavy slow resistance training, the best-evidenced treatment and prevention strategy for tendinopathy. 2) Progress load gradually, since tendon adapts far more slowly than muscle and rapid jumps cause most injuries. 3) Add isometric holds, which reduce pain and allow loading to continue during painful phases. 4) Take 15g collagen or gelatin with 50mg vitamin C about an hour before loading, targeting the post-load synthesis window. 5) Allow 24-48 hours between heavy tendon sessions, given the slow synthesis cycle. 6) Avoid corticosteroid injections where possible; they give short-term relief with worse long-term outcomes. 7) Be cautious with fluoroquinolone antibiotics, which carry a documented tendon rupture risk. 8) Judge progress by pain the following morning rather than pain during the session.

• •Heavy slow resistance training
• •Gradual load progression
• •Isometric holds for pain
• •Pre-load collagen with vitamin C
• •Adequate rest between sessions
• •Avoiding corticosteroid injections
• •Caution with fluoroquinolones