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I can confirm many tendon supplements do actually work through a little known secondary side effect of making you spend so much time on the toilet you give your tendons extra time to heal while you sit around doing nothing in the bathrrom all day. Otherwise you would be out, active, and irritating the injury so it can't heal.
It would in theory only possibly help someone with an actual injury (tear or degeneration or short term tendonitis caused by micro tears) and there has to be some healing process going on. So, someone with a degenerated tendon will see no result from using supplement unless 1) they are somehow able to trigger a process where the degenerated tendon changes shape to become more like normal tendon fibers or 2) the supplement helps pain or inflammation (so there's no healing but it provides pain relief). If adhesions are the cause of your pain - and therefore there is no healing process going on - no supplement will help the painful tissue to '' heal '', but enzymes who help with excess fibrin in the body can help remove some of that. Supplements to help inflammation can help people with adhesions for their pain, but you'll never get rid of the pain by not treating the adhesions themselves. Good video btw!
Actually it may help degenerated tendons because some of the supplements were shown to enhance the effects of the rehab exercises and tendon growth - so you get more bang for your buck - however, those were the studies with super small sample sizes and funding from drug companies, so not trusting it 100% at this point.
@@SportsInjuryPhysio I agree but only if strength training can trigger changes in the structure of degenerated tendons. It's not a fact that has been established, at least not for every case of degenerated tendons
You're right but if it helps to strengthen the rest of the tendon, then that is also useful since the one theory is that it is due to the rest getting stronger that function improves despite the degenerated part being present.
@@SportsInjuryPhysio this is a question I wonder about : does the tendon actually get stronger or does it just become less sensitive (from a nervous system perspective essentially)? Because I feel like tendons are already so strong naturally that even if you do slow heavy resistance training, I'm not so sure about how much you can change the '' strength '' of a tendon. I'm aware though that some people get hypertrophied tendons from climbing for years for example. So I'm willing to believe that a degenerated tendon could change its shape when you train it, but I can't with confidence say that it does happen since we don't have much evidence in that regard. Again, on the other hand, the healthy part of the tendon, I feel like it could change shape but only in specific cases (the climbers example I gave earlier). I also wonder if the people who get hypertrophied tendons have extra tendon cells BECAUSE they degenerated part of their tendons and that was the body's response to tendons being overused.
@@DonaldGaron Excellent analysis. Millions of people every year fall for this kind of huckstering snake oil where shady podiatrists, chiropractors, etc are telling people with severe degenerative tendinosis that supplements, injections of dextrose (sugar water - WTF!), creams, orthotics, or a freaking red light will help them. It's all nonsense. The tissue is necrotic. Meaning dead. And you need a more aggressive, radical intervention of some sort that is going to stimulate the tendon to change shape, as you said. So there is of course physical therapy, but it is a long and painful process. And many people are in so much pain (even at rest) they don't even want to walk to the bathroom.) There is decent (though not great) evidence for something like shockwave for achilles tendonitis or plantar fasciitis, whereby the machine introduces micro trauma, thereby making a chronic injury acute again and giving you a second chance to heal. And then unfortunately for more severe tendinopathies that do not respond within 6-12 months (depending on your patience), surgery is usually a good choice. They have gotten much less invasive over the years, with severe injuries treated by Tenex/Tenjet and seeing a full recovery in 6-8 weeks instead of 6-8 months. If those are not possible, grafting or donor tissue can give you virtually a brand new tendon that you can strengthen to 80-90% of original tensile strength. Arthroscopic procedures have gotten much better with tools like Arthrex for joint/cartilage issues, where the incision used to be the size of a pencil eraser and now is the size of a pencil tip. Some of these things can actually be done in office although rare. I hate seeing people struggling with tendon or ligament injuries for years and still begging for answers while falling for every scam in the book.
A brilliant specialist, without any esoteric bullshit or sales. Everything is said clearly and to the point. Regarding the topic, I am saddened by the fact that in 2024 there is still no clear evidence of the effectiveness of many supplements and substances that are so actively sold and advertised, including by doctors. There are literally hundreds of them! It's terribly annoying. For example, I have a partial rupture of the cruciate ligament (ACL) and my traumatologist prescribed Tendisulfure Forte to me, however I did not find a single high-quality study or research that confirmed the results of its use. And I couldn't find any reviews on the Internet too
You have to consider the injury process here - inflammation doesn't really play a roll in tendonitis. There may be a bit present in the first few days but research shows that in ongoing cases there really isn't any inflammation present. So, like with any treatments, there is a time and a place for it but there is no treatment that is appropriate for all situations always.
I have tendonitis for about 6 years now. It only comes back when Im active in sports like climbing, arm wrestling. Does that mean my tendon are degenerating?
It likely just means that you increase your exercise intensity too quickly for what you tendon can currently do. So you need to likely change up your strength training and general workout regime to build the strength the tendon needs for wrestling and climbing. If you want help with your rehab and an exercise plan, this is something that our team of physios can assess and help you with via video call. You can read more about how the online consultations work here: www.sports-injury-physio.com
I'm not a fan of it - I feel it is an overcomplicated thing and not convinced it holds that much benefit. Most people will get better results if they just do the basics right.
I have added it to the list but it will unfortunately not be done any time soon. But most complete patellar tendon tears usually require surgery - partial thickness usually don't require surgery and can be managed concervatively.
