Serious athletes under heavy training schedules are prone to experiencing overuse injuries. Whether it's swinging a golf club five hundred times per day or crushing heavy weights for as many reps or rounds as possible, athletes can develop an acute or chronic inflammation of the tendons, commonly referred to as Tendonitis.

In this article, you will learn the following 

• What Causes Tendonitis
• Common Types Of Tendonitis
• Treatment Options For Tendonitis
• Best Supplements For Tendonitis
• Should I Train or Exercise With Tendonitis?

What Causes Tendonitis? 

Often hard to evaluate and diagnose, it’s estimated that 30-50% of all musculoskeletal sporting injuries involve tendinopathies [R].

Diagnosis is usually performed clinically, through ultrasound and MRI. Tendonitis is caused by overuse of a specific muscle group, through repeated trauma and stress. This can commonly occur from constantly and respectively using and training the same muscle groups over and over again.

Let’s use high-intensity functional training (HIFT) or CrossFit for example. HIFT is defined as utilizing constantly varied movements, incorporating different types of workouts at assorted durations, with or without active rest periods. HIFT often involves multi-jointed movements, for time (meaning how fast you can complete a set of movements) for as many reps and rounds as possible. Heavy loads, combined with Olympic movements conducted for as many reps and rounds, in the fastest amount of time, will unquestionably create severe physical stress on connective tissues such as the joints, ligaments, and tendons which can lead to tendinopathies.

Therefore, the biggest causes and risk factors associated with tendonitis are 

• Overuse training
• Compromised training form
• Lack of mobility
• Age
• Genetics  

Common Types Of Tendonitis

Tendonitis can occur in any tendon, however there are more common areas, which are prone to tendonitis than others. 

• Lateral epicondylitis - Commonly known as tennis elbow. This area of tendonitis causes pain in the backside of the elbow and forearm, along the thumb side when the arm is alongside the body with the thumb turned away. The pain is caused by damage to the tendons that bend the wrist back and away from the palm.

• Medial epicondylitis - Also known as golfer's or baseball elbow. Medial tendon pain from the elbow to the wrist on the palm side of the forearm. is caused by damage to the tendons that bend the wrist toward the palm.

• Rotator cuff tendonitis - A common form of tendonitis known as biceps tendonitis. It’s a shoulder disorder. It causes inflammation of the shoulder capsule and related tendons.

• DeQuervain's tenosynovitis - This is the most common type of tenosynovitis disorder which causes swelling in the tendon sheath of the tendons of the thumb.

• Trigger finger or trigger thumb - Another very common type of tendonitis also referred to as a type of tenosynovitis. The tendon sheath becomes inflamed and thickened. This makes it hard to extend or flex the finger or thumb. The finger or thumb may lock or "trigger" hence its name trigger finger. 

What Are The Best Treatment Options For Tendonitis?

Conventional treatment options for tendonitis typically involve ways to fight joint pain and inflammation, yet do not modify the physical structure of the tendon through surgical procedure or intervention. Initial treatment often involves

• Resting
• Icing the area
• Compression
• Supplementation

In addition to ample rest, anti-inflammatories, and supplements, oftentimes eccentric training is also used for tendonitis repair. Eccentric training, also known as negative training, is a technique that allows the contraction of the muscle in the lengthening phase of an exercise, while under load (I.e. on the negative descent of an exercise, such as the descent or lengthening motion of a bicep curl) [R]

Best Supplements For Tendonitis: Tendon and Ligament Repair

Supplements are commonly used as a treatment or conventional therapy for chronic and acute inflammation associated with tendinopathies. Clinical studies investigating the effects of supplements such as collagen, curcumin, and omega-3 have shown promising results in reducing joint pain and inflammation for tendonitis. 

Pre-clinical studies specifically addressing tendonitis have shown promising results, yet more research needs to be conducted through human clinical trials to ensure these are the best supplements for healing tendons and ligaments.  

1. Collagen

Collagen is a structural protein, specifically a polypeptide containing a mixture of the amino acids glycine, proline, and lysine. As one of the most abundant proteins in the human body, Collagen consists of nearly one-third or 30% of total human protein [R]. Collagen is engrained within connective tissue specifically in the cartilage, tendons, muscles, and bones. Collagen is essentially the glue that holds everything together, also making it a great ligament healing supplement.

Clinical evidence has shown that Collagen, specifically hydrolyzed collagen promotes an anabolic or building effect on cartilage tissue, which may help in tendon health. In a prospective, randomized, placebo-controlled, double-blind study conducted at Penn State University 147 collegiate athletes, (72 male, 75 female) were randomly administered 10g of hydrolyzed collagen or a placebo. After 24 weeks, the results showed a significant improvement in joint pain, joint strength, and resilience in athletes who were treated with collagen hydrolysate [R]. Joint pain and tendon pain can have a dramatic impact on athletic performance.

RELATED ARTICLE The Ultimate Guide To Collagen  

If you’re experiencing joint pain and discomfort from high-impact functional training, or endurance training, we recommend supplementation of 10g of Collagen peptides per day. This can have a positive effect on joint health, mobility, and tendon health.

Swolverine’s Grass-Fed Collagen peptides are unflavored and virtually tasteless with 10g of collagen per serving. You can add a scoop to your smoothies, post-workout shakes, oatmeal, or baked goods to get the extra boost of protein and supplements you need to protect your ligaments and joints. For additional ways of supporting your tendon health, try our collagen soup recipes.

RECOMMENDED PRODUCT: Collagen (35 Servings, Unflavored)

2. Turmeric (Curcumin)

Turmeric specifically the active ingredient curcumin, has been proven to be a powerful anti-inflammatory agent. Research has shown that curcumin is a highly active molecule that modulates the inflammatory response by inhibiting the production of inflammatory cytokines. This is especially beneficial to those athletes who experience chronic or acute inflammation from overuse and overtraining. Efficiently reducing inflammation can promote faster recovery, and reduce post-workout pain and inflammation, which translates into more training and better performance. Tendonitis is associated with inflammation due to repetitive actives, therefore Turmeric could be one of the best supplements for tendonitis and in the prevention of inflammation.    

In a randomized controlled study on knee osteoarthritis published in the Journal Of Evidence-Based Complementary and Alternative Medicine 367 collective patients were administered 1,500mg of turmeric or 1,200mg of Ibuprofen per day for four weeks. The results indicated that 1,500 mg of turmeric supplement consumption daily was shown to have anti-inflammatory and analgesic properties comparable to 1,200 mg of ibuprofen [R, R]

The outcomes measured were joint pain, joint stiffness, and functional movement scores. The results indicated that Turmeric curcumin extracts were non-inferior to ibuprofen. Both groups showed significant improvement in pain, inflammation, and functional scores when compared to baseline. Improvements in functionality have a direct correlation with better joint health and mobility.

The study concluded that curcumin is just as effective as ibuprofen on knee osteoarthritis inflammation and pain. Additionally, the turmeric group showed lower adverse effects on gastrointestinal health than the ibuprofen group [R, R]. This study shows that turmeric is one of the best supplements for tendonitis and it is just as effective if not more than ibuprofen with fewer adverse effects

RELATED ARTICLE Turmeric Vs. Ibuprofen: Which One Is More Effective For Post-Workout Inflammation & Pain?

In another randomized, double-blind trial 107 patients with knee osteoarthritis were administered either 800 mg of Ibuprofen per day, or 2g of curcumin for a period of 6 weeks. Outcomes were measured at weeks 0, 2, 4, and 6 and showed a significant improvement when compared with the baseline values in both groups. The study concluded that Turmeric vs Ibuprofen provides similar outcomes in efficacy on arthritic pain [R].

It’s important to note that if you’re considering adding Turmeric to help with joint and ligament health, you purchase a supplement that contains black pepper, piper nigrum, or Bioperine. Turmeric alone has terrible bioavailability and is poorly absorbed. Black pepper enhances the absorption of Turmeric by up to 2,000%. Swolverine’s turmeric curcumin capsules contain 750mg of Curcuma Longa with 5mg of Bioperine, for optimal absorption.

RECOMMENDED PRODUCT: Turmeric (750mg 60 Servings)

3. Krill Oil (Omega-3)

Krill oil contains essential fatty acids (EFAs) specifically omega-3 polyunsaturated fatty acids eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA). EFAs have been found to have positive effects on inflammation, decreasing oxidative stress, and enhancing post-workout recovery [R]. Additionally, Krill oil is unique as it contains the world’s most powerful antioxidant Astaxanthin.

Several studies have shown that Astaxanthin has powerful anti-inflammatory properties, which can reduce systemic inflammation and promote healthier joints and mobility [R, R].

In a study conducted at the University of Pittsburgh Medical Center, 125 patients who were diagnosed with nonsurgical neck or back pain were administered 1200-2500mg of Omega-3 fatty acids per day. After 75 days, fifty-nine percent discontinued taking their prescription NSAID medications for pain. Sixty percent stated that their overall pain had improved, and 60% stated that their joint pain had improved. Eighty percent stated they were satisfied with their improvement, and 88% stated they would continue with Omega-3 supplementation. This study concluded that Omega-3 supplementation demonstrated an equivalent effect in reducing arthritic pain, as does Ibuprofen [R].

Krill oil helps reduce joint pain and arthritic symptoms by directly reducing the amount of C-reactive protein in the blood; a protein made by the liver in response to inflammation. Therefore, if you’re experiencing post-workout joint pain, or exhibit mild arthritic symptoms, krill oil can potentially help reduce pain and joint discomfort [R]. 

RELATED ARTICLE 14 Studies That Prove Krill Oil Is Better Than Fish Oil For Athletes

When looking for an Omega-3 supplement, the best omega supplement is Krill Oil. Krill Oil naturally contains Astaxanthin and when compared to Fish Oil, Krill Oil has a much faster absorption rate. Krill oil has been shown to be absorbed 68% better than fish oil [R] It can be broken down in only 2-3 hours, whereas Fish Oil is utilized between 48-72 hours. Swolverine’s Krill Oil contains 500mg per serving, to help with joint pain and improve overall health and wellness.

RECOMMENDED PRODUCT: Krill Oil (500mg, 60 Servings)

Should I Train Or Exercise With Tendonitis? 

endonitis can affect several different parts of the joints and ligaments. The most common overuse areas are the elbows, wrists, ankles, hips, and knees. Training or exercising while you have tendonitis is okay so long as you are not training the affected areas and/or exacerbating symptoms.

How Do I Prevent Tendonitis?

Preventative action and care are the best measures to take for any type of injury prevention.  Daily supplementation with Turmeric, Omega-3, and Collagen will help keep your joints, ligaments, and tendons healthy and strong, to perform and keep performing at your highest potential, by relieving post-workout inflammation and joint pain. Additionally, focus should be placed on mobility training, while upholding proper form and technique. Emphasis on recovery is also vital to ensure optimized performance for the following training sessions.

Looking for the best supplement to help with your tendonitis?

 

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References 

• Kaux JF, Forthomme B, Goff CL, Crielaard JM, Croisier JLJ Sports Sci Med. 2011 Jun 1; 10(2):238-53.
• Lipman, Kelsey et al. “Tendinopathy: injury, repair, and current exploration.” Drug design, development and therapy vol. 12 591-603. 20 Mar. 2018, doi:10.2147/DDDT.S154660
• Kaux, Jean-François et al. “Current opinions on tendinopathy.” Journal of sports science & medicine vol. 10,2 238-53. 1 Jun. 2011
• Fusini, Federico et al. “Nutraceutical supplement in the management of tendinopathies: a systematic review.” Muscles, ligaments and tendons journal vol. 6,1 48-57. 19 May. 2016, doi:10.11138/mltj/2016.6.1.048
• Daily, James W et al. “Efficacy of Turmeric Extracts and Curcumin for Alleviating the Symptoms of Joint Arthritis: A Systematic Review and Meta-Analysis of Randomized Clinical Trials” Journal of medicinal food vol. 19,8 (2016): 717-29.
• Kuptniratsaikul V, Dajpratham P, Taechaarpornkul W, et al. Efficacy and safety of Curcuma domestic extracts compared with ibuprofen in patients with knee osteoarthritis: a multicenter study. Clin Interv Aging. 2014;9:451–458. 
• Perkins, Kimberly et al. “Efficacy of Curcuma for Treatment of Osteoarthritis”Journal of evidence-based complementary & alternative medicine vol. 22,1 (2016): 156-165.
• Suokas AK, Sagar DR, Mapp PI, Chapman V, Walsh DA: Design, study quality and evidence of analgesic efficacy in studies of drugs in models of OA pain: A systematic review and a meta-analysis. Osteoarthritis Cartilage 2014;22:1207–1223  
• Schnitzer TJ: Update on guidelines for the treatment of chronic musculoskeletal pain. Clin Rheumatol2006;25 Suppl 1:S22–S29
• Kuptniratsaikul V, Thanakhumtorn S, Chinswangwatanakul P, Wattanamongkonsil L, Thamlikitkul V.Efficacy and safety of Curcuma domestica extracts in patients with knee osteoarthritis. J Altern Complement Med. 2009;15:891–897.
• Miyachi, Masashiro et al. “Anti-Inflammatory Effects of Astaxanthin in the Human Gingival Keratinocyte Line NDUSD-1.” Journal of Clinical Biochemistry and Nutrition3 (2015): 171–178. PMC. Web. 21 Aug. 2017.