Synergistic Effects of Collagen Peptides and Vitamin C Supplementation in Tendinopathy Rehabilitation: A Critical Review
DOI:
https://doi.org/10.12775/QS.2026.59.72790Keywords
Collagen, Vitamin C, tendinopathy, nutrient timing, mechanotransductionAbstract
Background: Tendinopathies present significant treatment challenges due to the slow healing and low metabolic activity of tendons. While mechanical loading remains the primary intervention, patients progress frequently plateaus.
Objective: To critically evaluate the efficacy and optimal timing of hydrolyzed collagen and Vitamin C supplementation in conjunction with mechanical loading during tendinopathy rehabilitation.
Methods: Laboratory studies, pharmacokinetic research, and clinical trials were systematically reviewed to assess the impact of these supplements on tendon structure and function.
Results: Ascorbic acid is essential for collagen synthesis and tissue repair, with timing proving critical. Administration of 15-30 g of hydrolyzed collagen and 40-50 mg of Vitamin C one hour prior to exercise yields superior outcomes compared to placebo. This protocol results in a doubling of PINP levels, increased tendon stiffness, and greater improvements in clinical scores (VISA-A) relative to standard care or general nutrition, thereby enhancing collagen production and recovery.
Conclusion: Collagen and Vitamin C supplementation is most effective when administered exactly 60 minutes prior to exercise, facilitating tendon healing and strengthening.
References
1. Andarawis-Puri N, Flatow EL, Soslowsky LJ. Tendon basic science: Development, repair, regeneration, and healing. J Orthop Res. 2015;33(6):780-784.
2. Tempfer H, Traweger A. Tendon Vasculature in Health and Disease. Front Physiol. 2015;6:330.
3. Scott A, Nordin C. Do Dietary Factors Influence Tendon Metabolism? Adv Exp Med Biol. 2016;920:283-289.
4. Piersma B, Wouters OY, de Rond S, Boersema M, Gjaltema RAF, Bank RA. Ascorbic acid promotes a TGFβ1-induced myofibroblast phenotype switch. Physiol Rep. 2017;5(17):e13324.
5. Marzagalli M, Battaglia S, Raimondi M, Fontana F, Cozzi M, Ranieri FR, et al. Anti-Inflammatory and Antioxidant Properties of a New Mixture of Vitamin C, Collagen Peptides, Resveratrol, and Astaxanthin in Tenocytes: Molecular Basis for Future Applications in Tendinopathies. Mediators Inflamm. 2024;2024:5273198.
6. Savini I, Rossi A, Pierro C, Avigliano L, Catani MV. SVCT1 and SVCT2: key proteins for vitamin C uptake. Amino Acids. 2008;34(3):347-355.
7. Mandl J, Szarka A, Bánhegyi G. Vitamin C: update on physiology and pharmacology. Br J Pharmacol. 2009;157(7):1097-1110.
8. Denis A, Brambati N, Dessauvages B, Guedj S, Ridoux C, Meffre N, et al. Molecular weight determination of hydrolyzed collagens. Food Hydrocoll. 2008;22(6):989-994.
9. Walrand S, Chiotelli E, Noirt F, Mwewa S, Lassel T. Consumption of a functional fermented milk containing collagen hydrolysate improves the concentration of collagen-specific amino acids in plasma. J Agric Food Chem. 2008;56(17):7790-7795.
10. Alcock RD, Shaw GC, Burke LM. Bone broth unlikely to provide reliable concentrations of collagen precursors compared with supplemental sources of collagen used in collagen research. Int J Sport Nutr Exerc Metab. 2019;29(3):265-272.
11. EFSA NDA Panel. Scientific Opinion on Dietary Reference Values for vitamin C. EFSA J. 2013;11(11):3418.
12. Doseděl M, Jirkovský E, Macáková K, Krčmová LK, Javorská L, Pourová J, et al. Vitamin C-Sources, Physiological Role, Kinetics, Deficiency, Use, Toxicity, and Determination. Nutrients. 2021;13(2):615.
13. Valkering KP, Aufwerber S, Ranuccio F, Lunini E, Edman G, Ackermann PW. Functional weight-bearing mobilization after Achilles tendon rupture enhances early healing response: a single-blinded randomized controlled trial. Knee Surg Sports Traumatol Arthrosc. 2017;25(6):1807-1816.
14. Shaw G, Lee-Barthel A, Ross ML, Wang B, Baar K. Vitamin C-enriched gelatin supplementation before intermittent activity augments collagen synthesis. Am J Clin Nutr. 2017;105(1):136-143.
15. Khatri M, Naughton RJ, Clifford T, Harper LD, Corr L. The effects of collagen peptide supplementation on body composition, collagen synthesis, and recovery from joint injury and exercise: a systematic review. Amino Acids. 2021;53(10):1493-1506.
16. Lee J, Tang JCY, Dutton J, Dunn R, Fraser WD, Enright K, et al. The Collagen Synthesis Response to an Acute Bout of Resistance Exercise Is Greater when Ingesting 30 g Hydrolyzed Collagen Compared with 15 g and 0 g in Resistance-Trained Young Men. J Nutr. 2024;154(7):2076-2086.
17. Praet SFE, Purdam CR, Welvaert M, Vlahovich N, Lovell G, Burke LM, et al. Oral Supplementation of Specific Collagen Peptides Combined with Calf-Strengthening Exercises Enhances Function and Reduces Pain in Achilles Tendinopathy Patients. Nutrients. 2019;11(1):76.
18. Nulty CD, Phelan K, Erskine RM. Hydrolysed Collagen Supplementation Enhances Patellar Tendon Adaptations to 12 Weeks' Resistance Training in Middle-Aged Men. Eur J Sport Sci. 2025;25(4):e12281.
19. Nulty CD, Erskine RM. Collagen Supplementation Augments Strength Training-Induced Gains in Tendon Size and Rate of Force Development in Elite Female Master Field Hockey Athletes. Int J Sport Nutr Exerc Metab. 2025;35(6):510-519.
20. Lis DM, Jordan M, Lipuma T, Smith T, Schaal K, Baar K. Collagen and Vitamin C Supplementation Increases Lower Limb Rate of Force Development. Int J Sport Nutr Exerc Metab. 2022;32(2):65-73.
21. López-Vidriero E, Olivé-Vilas R, López-Capapé D, Varela-Sende L, López-Vidriero R, Til-Pérez L. Efficacy and Tolerability of Progen, a Nutritional Supplement Based on Innovative Plasma Proteins, in ACL Reconstruction: A Multicenter Randomized Controlled Trial. Orthop J Sports Med. 2019;7(2):2325967119827237.
22. DePhillipo NN, Aman ZS, Kennedy MI, Begley JP, Moatshe G, LaPrade RF. Efficacy of Vitamin C Supplementation on Collagen Synthesis and Oxidative Stress After Musculoskeletal Injuries: A Systematic Review. Orthop J Sports Med. 2018;6(10):2325967118804544.
23. Turkmen HO, Kalender AM, Tekin SB. Retendo (mucopolygen complex) effects on achille tendon healing. J Orthop. 2020;20:190-194.
24. Hijlkema A, Roozenboom C, Mensink M, Zwerver J. The impact of nutrition on tendon health and tendinopathy: a systematic review. J Int Soc Sports Nutr. 2022;19(1):474-504.
25. Bischof K, Moitzi AM, Stafilidis S, König D. 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 Med. 2024;54(11):2865-2888.
26. Burton I, McCormack A. Nutritional Supplements in the Clinical Management of Tendinopathy: A Scoping Review. J Sport Rehabil. 2023;32(5):493-504.
27. Alberts A, Moldoveanu ET, Niculescu AG, Grumezescu AM. Vitamin C: A Comprehensive Review of Its Role in Health, Disease Prevention, and Therapeutic Potential. Molecules. 2025;30(3):748.
28. Nyland J, Pyle B, Krupp R, Kittle G, Richards J, Brey J. ACL microtrauma: healing through nutrition, modified sports training, and increased recovery time. J Exp Orthop. 2022;9(1):121.
29. van Dam L, Terink R, Mensink M, de Vos RJ, Zwerver J. The JUMPFOOD study: additional effect of hydrolyzed collagen and vitamin C to exercise treatment for patellar tendinopathy (jumper's knee) in athletes-study protocol for a double-blind randomized controlled trial. Trials. 2023;24(1):768.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Alicja Rogozińska , Wiktor Beśka, Michał Kalisiak, Michał Kasznicki, Małgorzata Czechowska, Natalia Micek, Jakub Łącki, Emilia Skrzypek, Mikołaj Kamela, Karol Jackowiak

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Stats
Number of views and downloads: 66
Number of citations: 0