Author(s): COUPPÉ, C., OLSEN, A.E., THOMSEN, L.L., SCHJERLING, P., SVENSSON, R.B., BISGAARD, M.S., DIDERIKSEN, K., BACH, J., HAN-SEN, E.P., TRAMMEL, S.A.J., VESTERGAARD, M.S., KARLSSON, M.M., BRUSHØJ, C., HOLM, L., HANSEN, M., MAG-NUSSON, S.P., KJAER, M., Institution: UNIVERSITY OF COPENHAGEN, Country: DENMARK, Abstract-ID: 1328

INTRODUCTION:
Tendinopathy is a considerable problem in elite athletes. Collagen supplementation has been shown to increase collagen synthesis and tendon mechanics in healthy female elite athletes. However, it remains unknown if collagen supplementation could serve as an effective add-on treatment to heavy slow resistance (HSR) training for the treatment of tendinopathy in females.
Purpose/hypothesis
The purpose of this study was to examine whether daily ingestion of hydrolyzed collagen, compared with placebo, on top of HSR had any beneficial effect upon patellar, Achilles, and plantar fascia tendinopathy in female elite athletes. We hypothesized that 12 weeks of collagen supplementation would have greater improvements than placebo on the primary outcome, pain during sport (Numeric Rating Scale [NRS]), and secondary outcomes after both 12 weeks (primary end-point) and 38 weeks.

METHODS:
Thirty-six female elite athletes with chronic patellar, Achilles, or plantar fascia tendinopathy completed 12 weeks of thrice-weekly (one supervised) HSR, and were randomized to daily ingestion of 10 grams of hydrolyzed collagen (intervention) or maltodextrin (placebo). The primary outcome was NRS during sport. Secondary outcomes included NRS scores (after sport, in the morning, maximum during the week, during tendon provocation), function and symptoms (Victorian Institute of Sport Assessment [VISA], Foot function index [FFI] questionnaires), tendon ultrasound morphology (thickness, echogenicity, and hypervascularity [power Doppler area, PDA]). All outcomes were assessed at baseline, 12 weeks, and 38 weeks.
RESULTS:
After 12 weeks, both groups demonstrated comparable and clinically meaningful improvements in the primary outcome, the NRS during sport (mean ± SEM), with sustained effects observed at 38 weeks (Collagen group: 0 weeks, 4.53 ± 0.46; 12 weeks, 1.86 ± 0.46; 38 weeks, 1.17 ± 0.50. Placebo: 0 weeks, 4.71 ± 0.43; 12 weeks, 1.38 ± 0.43; 38 weeks, 1.91 ± 0.47).
Secondary outcomes: After 12 weeks, both groups exhibited comparable clinically relevant improvements weeks in NRS scores (after activity, in the morning, at maximum during the week, and during provocation), and VISA-A including FFI scores and these were maintained after 38 weeks; however, no improvement was observed for VISA-P. Ultrasound power Doppler findings improved 12 weeks in both groups, with changes favoring the placebo group. There were no significant differences between groups.

CONCLUSION:
This study did not confer any additional clinical effect of daily collagen supplementation as an adjunct to 12 weeks of HSR on clinical or structural outcomes compared with placebo in female elite athletes with tendinopathy (Achilles, Patellar or plantaris).

Registration: ClinicalTrials.gov (NCT04578418)