Does Collagen Supplementation Support Musculoskeletal Recovery? A Narrative Review of Tendom, Ligament and Muscle Adaptation
DOI:
https://doi.org/10.12775/JEHS.2026.95.74233Keywords
collagen supplementation, musculoskeletal health, tendons, ligaments, muscle recovery, exercise-induced muscle damage, connective tissue, extracellular matrix, collagen peptidesAbstract
Introduction and aim: Collagen accounts for ~1/3 of body protein and forms the structural core of tendons, ligaments, and skeletal muscle extracellular matrix (ECM). Oral hydrolyzed collagen or collagen peptide (CP) supplementation has gained popularity, yet clinical evidence lags marketing claims. Results vary, several trials report null effects, and key questions on dosing, tissue specificity, and cofactors such as vitamin C remain open. This review critically appraises CP effects on tendon morphology and mechanics, ligament remodeling, and post-exercise muscle recovery.
Material and method: Searches (April 2026) covered PubMed, Scopus, Web of Science, and Google Scholar. Terms included: collagen peptides, hydrolyzed collagen, tendon remodeling, ligament, exercise-induced muscle damage, DOMS, ECM, and musculoskeletal health. English-language RCTs, systematic reviews, and meta-analyses were prioritized.
Results: For tendons, trials report increased cross-sectional area (CSA) and stiffness with 15–30 g/day CP combined with resistance or plyometric training. However, at least two RCTs found no effect on mechanical properties and certainty of evidence is low-to-moderate. Human ligament data are lacking as the field relies on in vitro and biomarker studies. Muscle recovery data are contradictory: some trials show attenuated creatine kinase release and improved neuromuscular function while stable isotope tracer studies found no rise in intramuscular connective protein synthesis after CP ingestion, undermining the proposed mechanism.
Conclusions: Evidence for collagen supplementation in musculoskeletal health is weaker than its commercial prominence suggests. A modest signal for tendon CSA exists, but mechanical effects are inconsistent. For ligament repair and muscle recovery, evidence is indirect or negative. Broad recommendations are premature. Future RCTs need longer interventions, female populations, active protein controls, and clinically meaningful endpoints.
References
1. Wu M, Cronin K, Crane JS. Biochemistry, Collagen Synthesis. [Updated 2023 Sep 4]. Treasure Island (FL): StatPearls Publishing, https://www.ncbi.nlm.nih.gov/books/NBK507709
2. Mienaltowski, M. J., Haddox, N. L., Beall, J. M., & Pechanec, M. Y. (2021). Basic Structure, Physiology, and Biochemistry of Connective Tissues and Extracellular Matrix Collagens. Advances in experimental medicine and biology, 1348, 5–43. https://doi.org/10.1007/978-3-030-80614-9_2
3. Ricard-Blum S. (2011). The collagen family. Cold Spring Harbor perspectives in biology, 3(1), a004978. https://doi.org/10.1101/cshperspect.a004978
4. Selvaraj, V., Sekaran, S., Dhanasekaran, A., & Warrier, S. (2024). Type 1 collagen: Synthesis, structure and key functions in bone mineralization. Differentiation; research in biological diversity, 136, 100757. https://doi.org/10.1016/j.diff.2024.100757
5. Kjaer M. (2004). Role of extracellular matrix in adaptation of tendon and skeletal muscle to mechanical loading. Physiological reviews, 84(2), 649–698. https://doi.org/10.1152/physrev.00031.2003
6. Wohlgemuth, R. P., Brashear, S. E., & Smith, L. R. (2023). Alignment, cross linking, and beyond: a collagen architect's guide to the skeletal muscle extracellular matrix. American journal of physiology. Cell physiology, 325(4), C1017–C1030. https://doi.org/10.1152/ajpcell.00287.2023
7. Csapo, R., Gumpenberger, M., & Wessner, B. (2020). Skeletal Muscle Extracellular Matrix - What Do We Know About Its Composition, Regulation, and Physiological Roles? A Narrative Review. Frontiers in physiology, 11, 253. https://doi.org/10.3389/fphys.2020.00253
8. Brueckheimer, P. J., Costa Silva, T., Rodrigues, L., Zague, V., & Isaia Filho, C. (2025). The Effects of Type I Collagen Hydrolysate Supplementation on Bones, Muscles, and Joints: A Systematic Review. Orthopedic reviews, 17, 129086. https://doi.org/10.52965/001c.129086
9. Holwerda, A. M., & van Loon, L. J. C. (2022). The impact of collagen protein ingestion on musculoskeletal connective tissue remodeling: a narrative review. Nutrition reviews, 80(6), 1497–1514. https://doi.org/10.1093/nutrit/nuab083
10. Iwai, K., Hasegawa, T., Taguchi, Y., Morimatsu, F., Sato, K., Nakamura, Y., Higashi, A., Kido, Y., Nakabo, Y., & Ohtsuki, K. (2005). Identification of food-derived collagen peptides in human blood after oral ingestion of gelatin hydrolysates. Journal of agricultural and food chemistry, 53(16), 6531–6536. https://doi.org/10.1021/jf050206p
11. Shaw, G., Lee-Barthel, A., Ross, M. L., Wang, B., & Baar, K. (2017). Vitamin C-enriched gelatin supplementation before intermittent activity augments collagen synthesis. The American journal of clinical nutrition, 105(1), 136–143. https://doi.org/10.3945/ajcn.116.138594
12. Martínez-Puig, D., Costa-Larrión, E., Rubio-Rodríguez, N., & Gálvez-Martín, P. (2023). Collagen Supplementation for Joint Health: The Link between Composition and Scientific Knowledge. Nutrients, 15(6), 1332. https://doi.org/10.3390/nu15061332
13. León-López, A., Morales-Peñaloza, A., Martínez-Juárez, V. M., Vargas-Torres, A., Zeugolis, D. I., & Aguirre-Álvarez, G. (2019). Hydrolyzed Collagen-Sources and Applications. Molecules (Basel, Switzerland), 24(22), 4031. https://doi.org/10.3390/molecules24224031
14. Balshaw, T. G., Funnell, M. P., McDermott, E. J., Maden-Wilkinson, T. M., Massey, G. J., Abela, S., Quteishat, B., Edsey, M., James, L. J., & Folland, J. P. (2023). The Effect of Specific Bioactive Collagen Peptides on Tendon Remodeling during 15 wk of Lower Body Resistance Training. Medicine and science in sports and exercise, 55(11), 2083–2095. https://doi.org/10.1249/MSS.0000000000003242
15. Balshaw, T. G., Funnell, M. P., McDermott, E., Maden-Wilkinson, T. M., Abela, S., Quteishat, B., Edsey, M., James, L. J., & Folland, J. P. (2023). The effect of specific bioactive collagen peptides on function and muscle remodeling during human resistance training. Acta physiologica (Oxford, England), 237(2), e13903. https://doi.org/10.1111/apha.13903
16. Aussieker, T., Hilkens, L., Holwerda, A. M., Fuchs, C. J., Houben, L. H. P., Senden, J. M., VAN Dijk, J. W., Snijders, T., & VAN Loon, L. J. C. (2023). Collagen Protein Ingestion during Recovery from Exercise Does Not Increase Muscle Connective Protein Synthesis Rates. Medicine and science in sports and exercise, 55(10), 1792–1802. https://doi.org/10.1249/MSS.0000000000003214
17. Siemiątkowski, R., Haber, M., Czachor, A., Kula, P., Juśkiewicz, A., Grelewicz, O., … Kotula, A. (2024). Comparative Analysis of Collagen Supplementation Forms and Their Effects on Multiple Health Parameters. Journal of Education, Health and Sport, 65, 55474. https://doi.org/10.12775/JEHS.2024.65.55474
18. Jerger, S., Centner, C., Lauber, B., Seynnes, O., Sohnius, T., Jendricke, P., Oesser, S., Gollhofer, A., & König, D. (2022). Effects of specific collagen peptide supplementation combined with resistance training on Achilles tendon properties. Scandinavian journal of medicine & science in sports, 32(7), 1131–1141. https://doi.org/10.1111/sms.14164
19. Jerger, S., Centner, C., Lauber, B., Seynnes, O., Friedrich, T., Lolli, D., Gollhofer, A., & König, D. (2023). Specific collagen peptides increase adaptions of patellar tendon morphology following 14-weeks of high-load resistance training: A randomized-controlled trial. European journal of sport science, 23(12), 2329–2339. https://doi.org/10.1080/17461391.2023.2232758
20. Lee, J., Bridge, J. E., Clark, D. R., Stewart, C. E., & Erskine, R. M. (2023). Collagen supplementation augments changes in patellar tendon properties in female soccer players. Frontiers in physiology, 14, 1089971. https://doi.org/10.3389/fphys.2023.1089971
21. Buchalski, A., Jeanfavre, M., Altorelli, C., & Leff, G. (2026). Collagen Supplementation on Tendon-Related Structural and Performance Outcomes: A Systematic Review. Journal of Functional Morphology and Kinesiology, 11(1), 130. https://doi.org/10.3390/jfmk11010130
22. Bischof, K., Moitzi, A. M., Stafilidis, S., & König, D. (2024). Impact of Collagen Peptide Supplementation in Combination with Long-Term Physical Training on Strength, Musculotendinous Remodeling, Functional Recovery, and Body Composition in Healthy Adults: A Systematic Review with Meta-analysis. Sports medicine (Auckland, N.Z.), 54(11), 2865–2888. https://doi.org/10.1007/s40279-024-02079-0
23. Frahs, S. M., Oxford, J. T., Neumann, E. E., Brown, R. J., Keller-Peck, C. R., Pu, X., & Lujan, T. J. (2018). Extracellular Matrix Expression and Production in Fibroblast-Collagen Gels: Towards an In Vitro Model for Ligament Wound Healing. Annals of biomedical engineering, 46(11), 1882–1895. https://doi.org/10.1007/s10439-018-2064-0
24. Lohmander, L. S., Englund, P. M., Dahl, L. L., & Roos, E. M. (2007). The long-term consequence of anterior cruciate ligament and meniscus injuries: osteoarthritis. The American journal of sports medicine, 35(10), 1756–1769. https://doi.org/10.1177/0363546507307396
25. Nyland, J., Pyle, B., Krupp, R., Kittle, G., Richards, J., & Brey, J. (2022). ACL microtrauma: healing through nutrition, modified sports training, and increased recovery time. Journal of experimental orthopaedics, 9(1), 121. https://doi.org/10.1186/s40634-022-00561-0
26. Kang, L., Li, J. & Li, F. (2025). Effect of platelet-rich plasma combined with hyaluronic acid and collagen supplementation on tissue healing after anterior cruciate ligament reconstruction. Postępy Higieny i Medycyny Doświadczalnej, 79(1), 195-206. https://doi.org/10.2478/ahem-2025-0022
27. Smeets, J. S. J., Horstman, A. M. H., Vles, G. F., Emans, P. J., Goessens, J. P. B., Gijsen, A. P., van Kranenburg, J. M. X., & van Loon, L. J. C. (2019). Protein synthesis rates of muscle, tendon, ligament, cartilage, and bone tissue in vivo in humans. PloS one, 14(11), e0224745. https://doi.org/10.1371/journal.pone.0224745
28. Bischof, K., Stafilidis, S., Bundschuh, L., Oesser, S., Baca, A., & König, D. (2023). Influence of specific collagen peptides and 12-week concurrent training on recovery-related biomechanical characteristics following exercise-induced muscle damage-A randomized controlled trial. Frontiers in nutrition, 10, 1266056. https://doi.org/10.3389/fnut.2023.1266056
29. Bischof, K., Stafilidis, S., Bundschuh, L., Oesser, S., Baca, A., & König, D. (2024). Reduction in systemic muscle stress markers after exercise-induced muscle damage following concurrent training and supplementation with specific collagen peptides - a randomized controlled trial. Frontiers in nutrition, 11, 1384112. https://doi.org/10.3389/fnut.2024.1384112
30. Robberechts, R., Poffé, C., Ampe, N., Bogaerts, S., & Hespel, P. (2023). Partly Substituting Whey for Collagen Peptide Supplementation Improves Neither Indices of Muscle Damage Nor Recovery of Functional Capacity During Eccentric Exercise Training in Fit Males. International journal of sport nutrition and exercise metabolism, 34(2), 69–78. https://doi.org/10.1123/ijsnem.2023-0070
31. Ravindran, R., Pizzol, D., López-Gil, J. F., Rahmati, M., Boyer, L., Fond, G., Butler, L., Stellato, A., Gawronska, J., Barnett, Y., Keyes, H., Soysal, P., Eren, R., Onal, B., Yon, D. K., & Smith, L. (2026). Collagen Supplementation for Skin and Musculoskeletal Health: An Umbrella Review of Meta-Analyses on Elasticity, Hydration, and Structural Outcomes. Aesthetic surgery journal. Open forum, 8, ojag018. https://doi.org/10.1093/asjof/ojag018
32. Zdzieblik, D., Oesser, S., Baumstark, M. W., Gollhofer, A., & König, D. (2015). Collagen peptide supplementation in combination with resistance training improves body composition and increases muscle strength in elderly sarcopenic men: a randomised controlled trial. The British journal of nutrition, 114(8), 1237–1245. https://doi.org/10.1017/S0007114515002810
33. Kirmse, M., Oertzen-Hagemann, V., de Marées, M., Bloch, W., & Platen, P. (2019). Prolonged Collagen Peptide Supplementation and Resistance Exercise Training Affects Body Composition in Recreationally Active Men. Nutrients, 11(5), 1154. https://doi.org/10.3390/nu11051154
34. Baglietto, N., Vaquero-Cristóbal, R., Albaladejo-Saura, M., Mecherques-Carini, M., & Esparza-Ros, F. (2024). Assessing skeletal muscle mass and lean body mass: an analysis of the agreement among dual X-ray absorptiometry, anthropometry, and bioelectrical impedance. Frontiers in nutrition, 11, 1445892. https://doi.org/10.3389/fnut.2024.1445892
35. Tavoian, D., Ampomah, K., Amano, S., Law, T. D., & Clark, B. C. (2019). Changes in DXA-derived lean mass and MRI-derived cross-sectional area of the thigh are modestly associated. Scientific reports, 9(1), 10028. https://doi.org/10.1038/s41598-019-46428-w
36. Wang H. (2021). A Review of the Effects of Collagen Treatment in Clinical Studies. Polymers, 13(22), 3868. https://doi.org/10.3390/polym13223868
37. Abrahams, M., O'Grady, R., & Prawitt, J. (2022). Effect of a Daily Collagen Peptide Supplement on Digestive Symptoms in Healthy Women: 2-Phase Mixed Methods Study. JMIR formative research, 6(5), e36339. https://doi.org/10.2196/36339
38. Cohen P. A. (2016). The Supplement Paradox: Negligible Benefits, Robust Consumption. JAMA, 316(14), 1453–1454. https://doi.org/10.1001/jama.2016.14252
39. Cammilleri, G., Tortorici, M., Pantano, L., Galluzzo, F. G., Pulvirenti, A., Buscemi, M. D., Lo Dico, G. M., Macaluso, A., Calabrese, V., Jacob, U. M., & Ferrantelli, V. (2025). Toxic metals and metalloids in collagen supplements of fish and jellyfish origin: Risk assessment for daily intake. Open medicine (Warsaw, Poland), 20(1), 20251141. https://doi.org/10.1515/med-2025-1141
40. Augustsson, A., Qvarforth, A., Engström, E., Paulukat, C., & Rodushkin, I. (2021). Trace and major elements in food supplements of different origin: Implications for daily intake levels and health risks. Toxicology reports, 8, 1067–1080. https://doi.org/10.1016/j.toxrep.2021.04.012
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Martin Zeigner, Joanna Błaszczyk , Kacper Godyń-Müller, Mateusz Kasprzak, Michał Grześkowiak, Hanna Pelant, Bartosz Kulak, Michał Brzeziński, Zuzanna Majchrzak, Klaudia Pierzyńska

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
The periodical offers access to content in the Open Access system under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0
Stats
Number of views and downloads: 100
Number of citations: 0