Author(s): LEPETIT THOMSEN, L., OLSEN, A.E., SCHJERLING, P., BRÜGGEBUSCH SVENSSON, R., BISGAARD, M.S., DIDERIKSEN, K., BACH, J., HANSEN, E.P., TRAMMELL, S.A.J., VESTERGAARD, M.S., KARLSSON, M.M., BRUSHØJ, C., HOLM, L., HANSEN, M., MAGNUSSON, S.P., KJAER, M., COUPPÉ, C., Institution: BISPEBJERG HOSPITAL, Country: DENMARK, Abstract-ID: 1659

INTRODUCTION:
Tendinopathy is a significant problem in elite athletes. Traning-based rehabilitation is effective at reducing symptoms, but complete recovery is rare. Collagen supplementation has been shown to increase collagen synthesis and tendon cross-sectional area in healthy tendons, but it remains unknown whether collagen supplementation could serve as an effective add-on treatment to heavy slow resistance (HSR) training in the treatment of tendinopathy in elite athletes.
The purpose of this study was to investigate whether daily ingestion of hydrolyzed collagen, compared with placebo, in addition to HSR training had any beneficial effect on patellar, Achilles, and plantar fascia tendinopathy in male elite athletes. We hypothesized that 12 weeks of collagen ingestion would have superior effects to placebo ingestion on the primary outcome, pain during sport (Numerical Rating Scale [(NRS]), and secondary outcomes after 12 (primary endpoint) and 38 weeks.
METHODS:
Thirty-six male elite athletes with chronic patellar, Achilles or plantar fascia tendinopathy underwent 12 weeks of thrice-weekly (one supervised) HSR training, and were randomized to daily ingestion of either 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 Sports Assessment questionnaires [VISA]) and ultrasound morphology (thickness, echogenicity and hypervascularity [power Doppler area, PDA]). All outcomes were assessed at baseline, and after 12 and 38 weeks.
RESULTS:
After 12 weeks, both groups demonstrated comparable clinically relevant improvements in the primary outcome NRS during sport (mean ± SEM) with sustained effects after 38 weeks (Collagen: baseline 3.90 ± 0.59; 12 weeks 2.20 ± 0.45; 38 weeks 1.50 ± 0.34) (Placebo: baseline 5.00 ± 0.45; 12 weeks 2.20 ± 0.28; 38 2.30 ± 0.57). Secondary outcomes: After 12 weeks, both groups showed comparable clinical improvements in NRS scores (after activity, in the morning, maximum during the week, during provocation), and in the VISA-Patella and VISA-Achilles. These improvements were sustained after 38 weeks for the NRS-scores and VISA-Patella, but not for the VISA-Achilles. Ultrasound PDA improved after 12 weeks. There were no significant differences between groups.
CONCLUSION:
This study found no superior clinical effect of daily collagen supplementation as an add-on to 12 weeks of HSR training on patient-reported or structural outcomes, compared with placebo, in elite athletes with tendinopathy (Achilles, Patellar or plantaris).