Hyaluronic Acid for Tendon Health

Tendons connect your muscles to your bones and their smooth function is vital for pain-free movement. Tendons must glide smoothly while transferring the force of muscle contractions to your bones. Problems occur in athletes from overuse and begin to occur more frequently in active adults over the age of 40, as tendons start to lose elastic properties. While tendon problems can occur in any joint area, common problems occur in the knee, heel, and/or shoulder areas. A new discovery about tendon structure opens the door for more targeted nutrition to help combat tendon inflammation and pain, actually fixing the problem.

The discovery is of a layer of “skin,” epithelial cells that cover the tendons¹. This skin has never before been identified. The researchers found that when this skin is compromised then the injured area becomes sticky and starts forming adhesions with surrounding tissues, thus causing inflammation and painful movement. 

It is obvious that the integrity of this skin declines with age and a goal would be to maintain it. The problem is that various areas of the tendon have a poor blood supply so that nutrition flow to the injured area is not a fast process. 

I found this study fascinating, because I have time and again seen in clinical practice that one nutrient stands out above all others in helping this type of inflammation – low molecular weight hyaluronic acid from rooster comb. In fact, while various structure support nutrients and anti-inflammatory nutrients may be helpful, hyaluronic acid is the only nutrient I have seen work extremely well in this situation.

Up until this study I never understood why, other than that it was a basic structural repair nutrient at the most fundamental level. However, its low molecular weight appears to allow easy transport (typically by diffusion) to the inflamed area that has poor circulation. Hyaluronic acid, while a simple molecule, is the foundation molecule for the formation of any new collagen or connective tissue based structure in the human body. Its properties are also highly lubricating. Thus, it appears to have a unique ability to help tendons and the rejuvenation of this newly discovered skin. Of course, it is the primary nutrient that forms lubrication in the synovial fluid of joints as well – so it appears to be able to help joint pain in several different ways.
There are no studies with hyaluronic acid and tendon inflammation. What I am giving you is front line clinical experience. I have found for many that taking three capsules a day of hyaluronic acid is adequate, though some need up to 6 or even 9.  On doses ranging from 3-9 per day improvement should be felt within a few weeks, sometimes sooner. I suggest staying on whatever dose is helpful for at least two months, then lower to a maintenance dose based on your activity level. 

Bromelain is another nutrient that supports tendon healing, most likely by helping to dissolve the adhesions.

Being able to maintain physical activity level as you grow older is very important. Keeping your tendons in a lubricated and smoothly operating condition is vital. Most likely you will have to cut back on the intensity of what you once did, even if your muscles say you can do more. However, you don’t want to get backed into the corner of pain and injury every time you ramp up your fitness program or perform your favorite sports or physical activity. Hyaluronic acid is my personal favorite supplement in this category.