Oral Supplementation of Specific Collagen Peptides Combined with Calf-Strengthening Exercises Enhances Function and Reduces Pain in Achilles Tendinopathy Patients.

Stephan F.E Praet,Jamie E Gaida,Craig R Purdam,Silvia Manzanero,Marijke Welvaert,Gregg Lovell,Nicole Vlahovich,Louise M Burke,Gordon Waddington,David Hughes

doi:10.3390/nu11010076

Abstract

The current pilot study investigates whether oral supplementation of specific collagen peptides improves symptoms and tendon vascularisation in patients with chronic mid-portion Achilles tendinopathy in combination with structured exercise. Participants were given a placebo or specific collagen peptides (TENDOFORTE®) in combination with a bi-daily calf-strengthening program for 6 months. Group AB received specific collagen peptides for the first 3 months before crossing over to placebo. Group BA received placebo first before crossing over to specific collagen peptides. At baseline (T1), 3 (T2) and 6 (T3) months, Victorian Institute of Sports Assessment–Achilles (VISA-A) questionnaires and microvascularity measurements through contrast-enhanced ultrasound were obtained in 20 patients. Linear mixed modeling statistics showed that after 3 months, VISA-A increased significantly for group AB with 12.6 (9.7; 15.5), while in group BA VISA-A increased only by 5.3 (2.3; 8.3) points. After crossing over group AB and BA showed subsequently a significant increase in VISA-A of, respectively, 5.9 (2.8; 9.0) and 17.7 (14.6; 20.7). No adverse advents were reported. Microvascularity decreased in both groups to a similar extent and was moderately associated with VISA-A (Rc2:0.68). We conclude that oral supplementation of specific collagen peptides may accelerate the clinical benefits of a well-structured calf-strengthening and return-to-running program in Achilles tendinopathy patients.

Highlights

The treatment of chronic Achilles tendinopathy remains challenging with a relatively high percentage of non-responders
As a change invascularity might be a hinge for improved tendon architecture, our aim was to check whether the oral intake of collagen peptides influence microvascular changes in tendinopathic areas of the Achilles tendon using real-time contrast-enhanced ultrasonography (CEUS) [17]
Bilateral (n = 13) mid-portion Achilles tendinopathy were formally included in the study following a detailed medical history and physical examination by a sport and exercise physician (Figure 1)

Summary

Introduction

The treatment of chronic Achilles tendinopathy remains challenging with a relatively high percentage of non-responders. There are many proposed treatment options, of which an eccentric. Nutrients 2019, 11, 76 exercise program is currently the first treatment of choice. Despite the good results on pain scores after eccentric exercises, a 5-year follow-up study showed that only ~40% of the patients were completely pain free and 48% had received one or more alternative treatments [1]. There is still a need for treatments that would improve the benefits of a structured eccentric exercise program. Recent studies indicate that both cardiometabolic [2,3], as well as nutritional factors [4,5] can modulate local tendon healing. Clinical studies are still scarce, a recent International Olympic

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