Effects of Collagen and Exercise on Tendon Properties and Pain: A Critically Appraised Topic.

Clinical scenario: Achilles tendon ruptures are prevalent and devastating injuries that require the need for extensive rehabilitation. The methods for preventing these injuries vary between different exercise methods and nutritional supplementation. Although proven effective for decreasing pain and increasing tendon properties, the influence of these 2 methods in combination has not yet been evaluated.

Clinical question: Does exercise combined with collagen supplementation improve Achilles tendon structural and mechanical properties and diminish subsequent patient-reported pain compared with exercise alone in adults?

Summary of key findings: Exercise training, including eccentric training protocols and concentric resistance training protocols, combined with collagen supplementation influence Achilles tendon properties and subsequent patient-reported pain compared with exercise alone.

Clinical bottom line: Evidence supports that collagen along with exercise training has a significant influence on pain mitigation, augmented cross-sectional area, and tendon thickness, but may have little to no influence on tendon stiffness and microvascularity compared with exercise alone. Further research is needed to determine the effects of combined methods on various populations.

Strength of recommendation: Collectively, the body of evidence included to answer the clinical question aligns with the strength of recommendation of A.