Speaker A
I used to talk about it all the time. Oh, well, a tendon adapts slowly. It actually adapts faster than muscle does.
Learn how to build bulletproof tendons with Professor Keith Baar on the Doctor Yaad Podcast, focusing on training, nutrition, and injury prevention.
Key Takeaways
- Tendons adapt faster than previously thought and require specific loading protocols for optimal strength.
- High-jerk, plyometric movements pose the greatest risk for tendon injuries; static training is safer.
- Nutrition plays a crucial role in tendon health, with collagen and protein intake being important.
- Gradual progression and minimal effective dose training prevent overuse injuries in connective tissues.
- Avoid anti-inflammatory drugs during tendon adaptation phases to not hinder recovery.
Summary
- Professor Keith Baar explains that tendons adapt faster than muscles and do not produce delayed onset soreness.
- Tendons, ligaments, and cartilage lack blood flow and receive nutrients through mechanical loading and fluid exchange.
- Calisthenics disciplines like statics, street lifting, and endurance have different impacts on tendons and connective tissues.
- High jerk (rapid changes in acceleration) movements increase injury risk, especially in plyometric and dynamic exercises.
- Static holds and controlled loading are safer and beneficial for tendon health and resilience.
- Proper training protocols and minimal effective doses of load can stimulate tendon collagen synthesis and adaptation.
- Nutrition, including collagen supplementation and leucine-rich proteins, supports tendon repair and growth.
- Injury prevention focuses on gradual progression, avoiding excessive volume and high-jerk movements early on.
- Recovery protocols and avoiding anti-inflammatory medications like ibuprofen can improve tendon healing.
- The podcast offers practical advice for calisthenics athletes on building stronger connective tissue and recovering from injuries.
Chapters
Full Transcript — Download SRT & Markdown
Speaker A
Whoa. Whoa. There is no such thing as delayed onset tendon soreness. You know, your tendons don't give that signal to your brain that you're doing too much.
Speaker A
When we do things like immobilize, the tendon actually loses almost 15 to 20% of the collagen within that tendon.
Speaker A
How much volume should a casting athlete be doing when it comes to straight arm strength movements? Tendons and ligaments and cartilage, they don't have blood flow. And so the way that they get nutrients is when we pull on a tendon or
Speaker A
we squish down a cartilage. What happens is you squish out a lot of liquid and then when you relax, now any liquid that's around is going to be sucked into the cartilage, tendon, or ligament. The reason why I asked this question is as
Speaker A
we're talking, I'm already forming a protocol in my head and it sounds like for PLCH and Maltes, for example, casting athletes should do one session a day in the morning where they do. Ladies and gentlemen, welcome to the Dr.
Speaker A
The Art Podcast. Today I have with me a very special guest, someone I've wanted to have on here for a long time, Professor Keith Bar. Now, Keith Bar is a professor of physiology and membrane biology at UC Davis. He's one of the
Speaker A
world's leading researchers on how tendons, ligaments, and muscles adapt to training, nutrition, and hormones. He's famous for his pioneering work with engineered ligaments, literally growing tendons in a lab to study it, to study how it responds to load, rest, and
Speaker A
nutrients. Keith, thank you so much for taking the time to come on. Is there anything I missed in that introduction that you'd like to add?
Speaker A
No, that's way too much already. Thank you very much, Yad, for having me on here. This is going to be great.
Speaker A
Awesome. So, here's the thing I want to do in this podcast. Um, first I want to give the calisthenics community, everyone listening also, clear guidance on how to train their tendons, ligaments, and connective tissue. And I don't mean just preventing injuries. I'm
Speaker A
also talking about building stronger, more resilient tissue. And if someone does end up getting injured, I want to outline practical protocols they can use to recover as quickly and as safely as possible. But before we dive into all of that, Professor Keer, do you
Speaker A
actually know what calisthenics is? H I've seen some of your videos and they're very impressive and I know, uh, way back when when it was, um, uh, what was his name? The somebody is the king.
Speaker A
Hannibal for King. Hannibal. Hannibal the King. Yeah. So, I used to, I used to love watching Hannibal for King because, you know, there were some weird movements there, but because he had built up over time, he got big
Speaker A
mass and he got lots of resilience and strength with it. So, I know a little bit, but I'm, I'm keen to learn more.
Speaker A
Great. Well, I have some things I want to show you. It's funny you mentioned Hannibal King. You see, there's many types of calisthenics out there. Um, one of the types is the endurance type. This is the type that Hannibal King does. Doing
Speaker A
lots of reps, you know, he's doing like a bunch of pull-ups, then a bunch of muscle-ups, and just when you think he's tired, he ends up doing a little bit more. But there's so much more to calisthenics. There are different
Speaker A
disciplines. For example, we have also street lifting. Um, street lifting is very similar to powerlifting. In powerlifting, you have three major lifts. You have your, uh, deadlift, you have your back squat, and you have your bench press. Now, in street lifting,
Speaker A
they also do the back squat, but instead of the bench press and, uh, deadlift, they do weighted muscle-ups, uh, weighted pull-ups, and weighted dips.
Speaker A
And, and there's so many other types of calisthenics, but the one I really want to focus on today is statics.
Speaker A
And I can share my screen. Yeah, here we go. So, now you should be looking at a few pictures of some impressive movements. This first one here is a frequently sought-after move called the full planche.
Speaker A
And here we have it with a slightly different modification. You have, um, the hands in a supinated position putting a lot of strain on the biceps.
Speaker A
And speaking of biceps, this one is, uh, also called the bicep killer, but actually it's called the Maltese.
Speaker A
And then we have the front lever. We have the human flag, a classic, and the back lever.
Speaker A
And even though it's called statics, um, it's not only isometric contractions. These, the ones I showed you, are the foundational movements that are done in calisthenics. But in this video, for example, we have this gentleman Nathan Becher performing basically a straight
Speaker A
arm push-up throughout the planche position. Now looking at all this, I'm sure that you might have some concerns.
Speaker A
Uh, actually I have fewer concerns about this than I would if you were doing the street lifting actually because really because most of the injuries actually occur, um, because of, because of jerk and so most injuries to connective tissues
Speaker A
are jerk-based injuries. And so what that means for everybody who's not familiar is where I am right now is my location. How quickly I'm changing my location, that's my velocity. How quickly I'm changing my velocity, that's
Speaker A
my acceleration. And how quickly I change my acceleration, that is my jerk. And so what that means is if I'm going to do, say, a deadlift or I'm going to be pulling myself up with a lot of weight
Speaker A
on me, uh, what most people will do is they won't go all the way down in a nice controlled manner and then pull from a static position. What they're going to do is they're going to basically let the muscle, uh, relax at
Speaker A
about, you know, three-quarters of the way down. They're going to get a whole bunch of energy stored within the tendons of the lats and all and all of these other muscles. And then they're going to use that momentum and they're
Speaker A
going to get that change of direction really quickly and that's going to be really, really high jerk. It's a very plyometric dominant movement. And so those are the ones that are going to be the most concerning for me as somebody who
Speaker A
looks at musculoskeletal injury rate because jerk is going to be even a little jerk. So we get tennis elbow in the outside of the elbow because we're swinging a tennis racket and our backhand the ball is going the other
Speaker A
direction. Even that little bit of jerk repeated enough times is going to give me tennis elbow. If I'm doing, say, golfer, I'm going to get the inside of the elbow because I'm swinging through. I'm hitting the ball or the turf and that's
Speaker A
going to give me a little jerk going the opposite direction. That's going to give me that golfer's elbow. Jumper's knee is a classic one in the patellar tendon. So all it is is those jerk. High jerk equals high rates of injury. High jerk
Speaker A
with high volume equals high rates of injury. That's a lot of times what happened with a lot of, um, CrossFitters, for example, because CrossFit does use jerk and if you can survive the movements you will become very, very
Speaker A
strong. But many people who are just starting out get lots of injuries and they get the injuries because most of the, or many of the movements that they're doing are these high velocity, high-jerk movements. And so yes, they
Speaker A
will over time if we build into them properly make us really resilient and really strong. But too often people do too much too soon. Or, you know, I, I lived in MRI for a year, so I know that
Speaker A
uh, at the end of winter on the first sunny day of the year, everybody runs out and does like a thousand different things because, oh my god, it's sunny.
Speaker A
Oh, it's warm. Let's get out and do stuff. And so they go and they play like three hours of tennis or they go and they, they, they overdo it in that first early period. And so that's when we get
Speaker A
a lot of these injuries. And so it's really about that jerk. So when I see the static work, that's actually what we prescribe a lot of times for health of the tissues. But again, you can't start with some of th
Speaker A
those moves would be not possible for a starter. So you have to slowly ramp into them. And that's the advantage of the of those static moves. The longer you hold it, the more that's going to be beneficial for both your muscle and your
Speaker A
tendons. Okay, I see what you mean. So, you're saying that the real risk of injury comes from dynamic movements, not static ones, specifically from jerk. And if I were to simplify jerk, it's the sudden snap in a direction or load that really
Speaker A
stress stresses the tendon. So, going from zero speed to a lot of speed or going from one direction to another direction. So, when you're going down, for example, you're doing bicep core, you go down and you quickly go up, that
Speaker A
is a jerk. Okay, I see. So the thing is um this subject actually really hits home for me. About two years ago I tore the distal part of my biceps on the left side about 50% tear and it actually
Speaker A
happened on the multis move. The one where I said it's the bicep killer where it actually killed my bicep. Um I was performing the multis with about 20 kilos of assistance more than I would usually do. And at that time I could
Speaker A
hold it without any assistance. But what had happened is uh I was training it on the floor and the floor was slippery and I usually did it on bars like P bars.
Speaker A
And because the floor was slippery I was like okay you know what I'll I'll add assistance and I'll do do fat four like I'll I'll put my hands down like this which you know changes the bicep position. It puts a little bit more
Speaker A
stretch on the biceps if you supenate like that. And um so I did my first set, held it for 10 seconds with about 20 kilos of assistance, went pretty well. Then I rested enough and I did my second set
Speaker A
and about like 7 seconds or something in it just it popped. And I immediately knew I tore my biceps. And the reason why I knew this is because ironically about a year before that I had warned people on a public podcast telling
Speaker A
people hey uh um you know the multis is a high-risisk movement without any warning you can just snap your uh bicep tendon and it happened to me someone who knows all of this and who has has who has had 13 years of experience with
Speaker A
tamales. when you hear the situation as a tendon expert, can you explain why this injury happened? So, so part of it is to know a little bit if you go back before that whether you had picked up small amounts of injuries before that
Speaker A
because usually so every single so there's a really nice study done by another group where they looked at 890 people who had bicep or had tendon tears which is not bicep tendon but just any tendon tear and they took out a piece of
Speaker A
tendon associated with that tear and they looked at it under the microscope and every single one of them showed degeneration of the tendon.
Speaker A
So there was no case where you had a perfectly healthy tendon that ruptured. And so likely what's happened is that yourself and other people have overdone it at some point in the past. So you've gotten small injuries, but your body is
Speaker A
hiding those small injuries and shielding them. And so that's great. So when we do a fast movement, no problem.
Speaker A
But the longer we hold a movement, the less we can shield. And if you're also going to be fatigued because say yesterday you did some training the day and so the material itself isn't as strong as it would normally be. Now as I
Speaker A
go in to do those same moves now what's going to happen is I'm going to be at a greater risk for those types of injuries because I can't shield the injured area using the strongest part because the strongest part is already tired. It's
Speaker A
already weaker. We see this a lot in in professional sports. So, what happens in professional sports, it's not usually the first or second repetition or the first or second run that get the the Achilles or patellar tendon um injury.
Speaker A
What happens is you're training, you do your warm-up, you get in, you're playing your game, and then about halfway through the game, maybe a third of the way through the game, that's when the risk starts to come up really fast, high
Speaker A
because you're still you're mentally still sharp. You can go really quickly in your mind, but your body is starting to fatigue. Later in the game, your mind isn't going as quickly. So, we get different types of types of injuries.
Speaker A
So, so as you're going about that third, you know, maybe from about a third of of this of the game is done to a little bit longer. Now, what's happening is our brain is saying, "Oh, let's turn quickly
Speaker A
and go in the other direction." But our our body has been starting to fatigue, now that tendon that is normally shielding an injury, well, it's not shielding as well because it's just it's a little bit too fatigued. So now I
Speaker A
stick my foot in the ground. I try and go the other direction and now I rupture my Achilles. Or I land from a from a hop that I would have done thousands of times, but as I come down now I rupture
Speaker A
my patellar tendon because I've got enough fatigue in the tissue. My brain thinks I'm totally fresh. So, oh, it's having me do this. But now I land and bang, there it goes. And so that's the type of thing that we would normally see
Speaker A
where you would normally see that you get some fatigue in there. You get some of that. So it's coming on your, you know, yes, you're doing warm-up sets and you're doing this. It's probably coming, you know, 10 or 15, 20 seconds into
Speaker A
these longer hold, very highintensity isometric static holds. And now what you're getting is you're getting that maybe there's a little bit of fatigue in the in the strongest part. And again, you're externally rotating much more in that position than you were before. So
Speaker A
now the load is actually going in a different way through the tendon. So when you're when you're in on the grips, when you have the handles, now the the the load is going diff in a different direction through the through the the
Speaker A
tissue, your body has has actually become stronger in that position. Your tendon is stronger in that specific position. as you rotate out more, you don't have that ability to use that strongest part. Now, your ability to shield the injury is even lower. So,
Speaker A
it's a combination of those things. Wow. Okay. Um, let me let me unpack that. You're essentially saying um my tendon and and tendons in general have strong parts and they have weak parts. And when you're doing a move um
Speaker A
like the maltes for a short burst, the strong part is able to to carry the movement to to protect the weaker parts.
Speaker A
But as you do more and more, fatigue accumulates. This can be in days, but it could even be within a session. And when that strong part fatigues, the tension does not only go through the strong part anymore. Now it also goes
Speaker A
through the weak part and in my case that weak part wasn't strong enough and so it tore and that's why it had happened on the second set.
Speaker A
Exactly. Yep. So so that's the first thing and the second thing is to look at kind of the volume and how you how you're doing the volume and it's not just the volume of that day. It's the volume that in the
Speaker A
accumulated time because what the way that their tendon is going to adapt and we all we have heard for years I used to I used to talk about it all the time. Oh well a tenant adapts slowly so we have
Speaker A
to take these easy days and then hard days and easy days and hard days and we have to periodize. Well actually the tendon really it actually adapts faster than muscle does.
Speaker A
Whoa. Whoa. So when we see when we do things like immobilize the muscle goes down say over the first three days it'll go down about 5 to 10%. The tendon actually will lose almost 15 to 20% of the collagen within that tendon over
Speaker A
that first three days. So when you if you are sick and you're in bed for three days now you get back up now you're actually starting from a lot further back than people really realize.
Speaker A
And so you need to rebuild. So what I lose in 3 to 7 days, it's going to take me about 8 weeks to regrow.
Speaker A
We're basically already approaching one of the hardest questions that I have had regarding Cassen. But you know, it's one of the questions many coaches always wonder and it is the question of how much volume should a casten athlete be
Speaker A
doing when it comes to straight arm strength movements. Right? And so the reason why I find this difficult is when you deal with muscles, your body generally sends signals back to you, right? One of them is muscle soreness.
Speaker A
You know, delight onset muscle soreness. When you're sore, you know, oh I need to rest a little bit. I need to recover and once, you know, the pain is gone, I'll start doing my session. But there is no such thing as delayed onset
Speaker A
tendon soreness. you know, your tendons doesn't don't give that signal to your brain that you're doing too much. And that's part of why that injury happened to me. I I wasn't warned at all. It just it happened like that. Had I felt
Speaker A
anything, I would have taken my time. So, in the past, I've tried looking at the stimulus recovery adaptation curves for tendons, which is basically the uh to find out how long does it take for tendons to recover so that I can stress
Speaker A
them again. And I couldn't find a lot of information. But today I mean I have you a professor on tendons. So could you enlighten us on this golden question uh one of the hardest question in calisthenics.
Speaker A
How much volume can our tendons handle and how much do they do they need from your research?
Speaker A
How do tendons actually respond to training volume compared to muscles? Yeah. So, so it's a great question and it's one of the things that people have been looking at for a little bit of time, but we interpreted a little bit
Speaker A
too much from some of the data that was there. For example, the best data in the world came from Michael K. And he was looking at tenon adaptations to exercise. And what he had shown was that it took the peak of tenon, neoprotein
Speaker A
synthesis happened 24 to 48 hours later. And it took a long time for that to come back down. But a lot of the exercise that he was looking at was a or one of the main studies that they used to to
Speaker A
draw that conclusion was a 37 kilometer run. Well, a 37 km run is not something that you're going to go out and do every day. It's a it's almost a marathon. And of course, you're going to have a lot of
Speaker A
damage. You're going to have a lot of things that you wouldn't normally do when you exercise a tendon or a muscle for that matter. So, it wasn't necessarily, oh, this is telling us something really important about the um
Speaker A
how often or how frequently we should exercise. They did some follow-up studies that were really nice with a lot less exercise. They actually took biopsies from the patellar tendon um and they could measure how much how much collagen had been synthesized and and
Speaker A
again, they saw that it took a while for the there to be a peak in collagen synthesis. So people took that to mean that well maybe we shouldn't exercise the tenant as much but what we've what we've learned in the
Speaker A
last say 10 or 15 years. So, I had a great graduate student who's now a professor at the University of Edinburgh in Scotland. And what she did in my lab was she actually took our little engineered ligaments and she could
Speaker A
exercise them. And so she exercised them either 24 hours a day because we could do that. We put them into a little machine and we could stretch them and they're exercising 24 hours a day. Um, and what we could never do was we could
Speaker A
never make them stronger when we did that. you could sometimes get the collagen to increase especially if you did small amounts of work. So instead of straining say 10% you would strain 2 and a half%. Something that you would see
Speaker A
physiological easy physiological load when you're doing a PLCH and your arms are behind you that's not a 2 and a half% strain that's more like 10 or something really really big. That's one of the reasons that you're getting into
Speaker A
into some issues. That's one of the difficulties of holding that position. So what we found is it didn't matter how far you stretched them. So whether they did like u whether they did a with their arms out in front of them kind of their
Speaker A
hands way out their hands halfway back or their hands really far back as far as what that would do to say the say the say the pectoralis tendon. What would that do? There's not really a big difference to the tendon because the
Speaker A
tendon just knows oh I'm getting pulled on at least on the synthesis side of things. Okay, the next thing we did is we said, "Okay, well, how long should we should we go for?" And so we did a bunch
Speaker A
of different tests and what we found out was that when when we looked at the signals that we were trying to maximize to to drive collagen synthesis, when we started exercising, those signals would go up and then even
Speaker A
if we kept exercising those t those tendons, the signal would come down. And so what that was telling us is that after about 10 minutes, the cells within our tendons and ligaments have stopped needing anything more. So their maximal
Speaker A
stimulus for that specific tendon is 10 minutes. After 10 minutes, doesn't matter what you do because if you go 10 minutes, it gets this stimulus for synthesis. If you go 60 minutes, you still got the same stimulus for
Speaker A
synthesis. The difference is that over 60 minutes I got a lot of wear and tear.
Speaker A
So I've got a lot more things that are happening that are kind of that slow fatigue that's causing a little bit of breakdown, maybe a little bit of something that needs to be fixed. And so now I've got a big amount of degradation
Speaker A
side. So I've got a a catabolic signal and I've got an anabolic signal. And so what that data suggested was that if we wanted to grow the tissue and make it stronger, we wanted to maximize the anabolic signal while minimizing the
Speaker A
catabolic signal. And so what we did in that study is we just did 10 minutes of stretch and we then rested and we figured out that it took about 6 to 8 hours for the cells to become sensitive enough again
Speaker A
to hear another stimulus. And so what we did is 10 minutes on, 6 hours off, 10 minutes on, 6 hours off. So 40 minutes of stretch over 24 hours. And we compared that directly to the 24 hours of stretch. And what we found was that
Speaker A
you could go 24 hours a day, you would get a a nice increase in collagen. But if you just did 40 minutes, but you did it as these four 10-minute blocks, you actually saw double the increase in collagen.
Speaker A
And the the the next interesting thing we've recently discovered is if I do that same exercise, but I do it as dynamic moves. So I do it as 300 2% stretches or I do it as four 30 secondond stretches at 2%. Same amount
Speaker A
of work. The tendon does the exact same amount of work. The strength of the tendon goes up with a four 30 secondond isometric holds, but the dynamic one doesn't increase the strength of the tissue.
Speaker A
What that tells us is that the stretching back and forth, that's giving us jerk. That's giving us a catabolic signal. The four isometrics, that's just giving us the anabolic signal without necessarily having the catabolic signal.
Speaker A
And so what it means is for the mechanics we actually improve the mechanics better by doing four 30 secondond isometrics over 10 minute over eight minutes rather than doing say 360 dynamic moves. They're exactly the same amount of time under tension, the exact
Speaker A
same amount of work, but one of them results in a stronger tendon that's bigger, and the other results in a bigger tendon, but it's no stronger, and it's actually its stiffness actually goes down a little bit, which means that
Speaker A
it's potentially more likely to get injured. And so again, I think that's really important for your listeners to understand because basically as I'm doing a lot of things, if I do a lot of really quick movements, that's going to
Speaker A
give me both an anabolic signal and a big catabolic signal. If I do some, you know, reasonable intensity for my fitness levels of longer holds, that's going to give me more of the anabolic signal and less of the catabolic signal.
Speaker A
And so that's going to end up making the tissues stronger over time. And if I really want to maximize everything, I could do one session in the morning, one session in the afternoon or evening.
Speaker A
Uhhuh. So what scale of absolute intensity are we talking about where we see more of an anabolic signal versus a catabolic signal?
Speaker A
Yeah. So we've only compared this using the isometrics and we haven't published this, but um my PhD student Ken is is finishing up this and and we're going to get it out pretty soon. But what he's showing is that if he does 2% isometric
Speaker A
or 4% isometric, they increase about the same. The 4% as far as their strength, the 4% is a little bit less, but it's not significantly worse than it was than the 2% or the controls. If we go back to
Speaker A
the dynamic, if I did the 4% dynamic, it actually gets worse. So, it's a combination of things about what goes into the wear and tear. So the dynamicness of the movement seems to be more detrimental. The load, which is
Speaker A
what we're trying to me, we're trying to um model by doing 2% or 4% strain. What that's more like is is like a low load on the tendon versus a really high load.
Speaker A
So a physiological load on the tendon versus a super physiological load. So something where I'd be doing maybe a push-up versus doing a doing a hold where my legs are off the ground and I'm trying to maintain that same structure.
Speaker A
In order to do that, now I'm in a more I'm in a more stretched position. My tendon has been pulled more and there's more load on it. So it's going to actually strain more. And strain just means how far it moves relative to its
Speaker A
original length. So, how long it is now at that point where you're doing say your iron cross or whatever you're doing, how long is the tendon relative to where it started. That's the strain.
Speaker A
And so, normally what we would see say in an in a ACL when you walk up the stairs or you bike paddle pedal your bike, it's about a 2% strain. And that's one of the reasons why we use 2% strain
Speaker A
is because that's a physiological load on on the ACL. For some of the tendons that are that you're looking at, you're going much larger strains and so that can be a little bit more damaging to it. So, you
Speaker A
just have to be aware. So, let me ask you a question. Um, hypothetically, um, let's say we have an athlete, we have a calisthenics athlete doing their calisthenics training. They're doing a bunch of statics, dynamic stuff, you know, just their typical training. And
Speaker A
then let's say we have another athlete who does the exact same work, but now we have them do this protocol two times a day. They are doing uh the positions that they're training for, but like much lighter. For example, they lie down
Speaker A
holding dumbbells in the PLCH position like this. And um we have them do that twice a day with 6 hours between them.
Speaker A
Uh you're basically adding volume. So athlete A does their thing and athlete B does the same thing plus more volume. Um is is this going to be a problem or will the person that uh is doing this protocol be more protected?
Speaker A
Yeah, it's a great question. So, so the closest thing we've done to this is in rock climbers and there we worked with a guy named Emil Abrahamson who's a professional boulder and he's a great guy and he has a has a YouTube channel
Speaker A
and he found our research actually his brother was given our research and he had always had injuries in his finger tendons and so he couldn't climb anymore. So his physical therapist gave gave him one of our articles. It kind of
Speaker A
described how we would load optimally for tendons and ligaments and they put that into into this no hang protocol which means that they use about 40% of their body weight just so that there's enough tension so that they can feel the
Speaker A
tension through the forearm. And they do that and they do that over with a bunch of different holes. And the whole program lasts 10 minutes. They've done it two times a day. And when Emil did this as a, you know, professional
Speaker A
boulder, he basically showed just incredible off-the-charts um responses in his his ability to then do hangs. And so that's great. So, but that's an end of one as he said in the in the resulting YouTube video that like a
Speaker A
million and a quarter climbers have seen. So, everybody was getting excited about this. And so, what we did is we went back, I actually emailed him and said, "This this is great. we should do something where we actually look to see
Speaker A
if we can get this from an NF1 into a group. And so we went in and worked with Peter Kimick who's uh over at Crimped the app for climbers. And they had actually put the the Abra hangs into
Speaker A
their app. And so people have been doing the program to do the no hangs. They also had in their program max hangs, which is basically you weight yourself with 90% of your maximum weight and then hang on for for two or three or four
Speaker A
seconds versus the no hangs where you do partial body weight, little bit of hanging. And then they had group that had done both of them. So they did both the max hangs and the no hangs. And all of these people were still climbing. So
Speaker A
they're all still rock climbing. This is just supplemental training. And the people who did the supplemental training that had no hangs only, they improved their grip strength by about 3%. The ones who did the max hangs only, they
Speaker A
increased their grip strength about 3%. And the interesting thing is when you did them both together, they increased by like 5.8%. So they almost had this additive effect. And they're still doing their climbing. And when we do a lot of
Speaker A
our rehabilitation with professional athletes, they're still training for their sport. they are adding a separate se session in because remember when you're training for your sport except in your sport. Most sports are these dynamic sports where you're moving,
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jumping running sprinting changing directions. The climbers, especially the boulders, they're jumping and grabbing things and then they're hanging with one with like two fingers and their whole body weight is hanging off of them. All of those things are these hugely dynamic
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moves. yours is less dynamic. So, we don't know how it will work there. What we would suggest is that adding a session would be great, but we don't want to add more than more than one session in a day. So if you're going to
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do your your calisthenic training in the afternoon or evening now what you're going to do is in the morning you would do a very low intensity partial body weight kind of holds that would allow you to get that stimulus
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the anabolic effect with almost no catabolic effect. And now what that's going to do is going to give you a really big anabolic signal and then you're going to get a anabolic and catabolic stimulus from your training.
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But over time, because now we've got two anabolic stimuli for the same amount of catabolic stimulus, now what's going to happen over time is we're going to get better.
Speaker A
This this actually makes a lot of sense. I you know, I have anecdotal evidence of this working for the wrists. Um I remember for like the longest time in my career, of my calennis career, that wrists were a big issue. You know, we're
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standing on our hands a lot. We're doing PLCHes. We're doing one arm handstands and a bunch of stuff. And I actually made a video on this um because I came up with this wrist warm-up routine which takes and this isn't qu this is just a
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coincidence about 10 minutes. And for 10 minutes we start just statically loading the wrists in different direction.
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There's a little bit of movement but uh you know there's a little bit of dynamic movements in there too but also statics.
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And it's very light load and you know about 10% of what you would do in a real training. And I could add this volume to my overall training and it would lead to better recovery of my wrist to less
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pain. And you know wrists are basically only connective tissue. There's only tendon, ligaments, there's no muscles in there. So this is a protocol that I always follow when my wrists are aching.
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Even now my right wrist is not feeling that great. So, I just did a few of those warm-up uh routine sets that I'm doing and yeah, the anecdotal evidence seems to completely be in line with everything you just said.
Speaker A
Oh, hey, now that I've got your attention, you saw that montage, right? I want to talk about a brand that I've been using almost daily. It's called Moving Made, and all this is made by them. this brand. Well, let me just show
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Speaker A
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Speaker A
They have these straps that are super super well thought of and so much more. If you guys want to support me and Movement Made, use code yach 10. And let's get back to the video.
Speaker A
Yeah. So, so a lot of times people always think, "Oh, I got an injury. I need to shut down my volume." And if it's not a complete injury, if it's not a complete tear, what we actually do is
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we don't necessarily say, "You've got to stop what you're doing." What we do is we're going to go in and we're going to give you that second stimulus that is strictly only there to improve the function of those cells or to give them
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the signal that they need to do all the positive stuff without giving them negative stuff. It's the minimal effective dose of load is what we call it. And there it's 10 minutes of overall time. And that means that if I do five
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contractions in 10 minutes, that's fine. If I do 100 contractions in 10 minutes, that's also fine. 100 contractions over 10 minutes is going to have more jerk.
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So it's going to have a little bit more catabolic. So I'm trying to minimize that by just going and saying, okay, four 30 minute holds or 30 second holds, I should say, with two minutes of rest.
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That gives me eight minutes of total time that I've worked that tendon or that muscle. tenon unit and that's going to be enough for me to get everything.
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If I'm perfectly healthy, I can come in and do 10 seconds holds where I just do the 10-second holds. I'm going to do say 12 of them because that's going to give me the same kind of 8 to 10 minutes of
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load. And we just did a a study in rats that that basically we did exactly that.
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We exercised them for 10 minutes three times a week. We did that for three weeks and the tendon was bigger and stronger. So that's how quickly you can make those adaptations.
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You can see that there's an increase in collagen content and the mechanical strength of the tendon already within nine sessions. And if you think about that, that's that's 2 minutes of work, six three times a week. So that's six
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minutes per week for three weeks. So that's 18 minutes of total load was enough to make the tenant bigger and stronger. So again, it doesn't take a huge amount to have the positive effect on your tendons.
Speaker A
Okay. So is there any reason why we would for these anabolic sets, I'll call them that for now.
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Yeah. To progressively overload the intensity. Why would I ever want to add weight? So again, it's just something where what you're trying to do is you're trying to get to the point where you feel that, oh yeah, I can feel it going through the
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tissue. And at that point, you're good because you're like, oh yeah, there's tension there. And so part of what we have to do with these athletes that are training and doing incredible feats, you know, Olympic and world class athletes,
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the problem is they wanted, oh well, you know, when I first gave out, okay, we did this bone reacts the same way. So, we had these Olympic runners and they had all kinds of bone stress problems.
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And so, all we were doing was adding one session of jump rope that would be six minutes, just jump rope, six minutes, eight hours before you do your training.
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And that's going to And of course, I go back and I talk to them maybe three or four weeks later and they're like, "Oh, now I'm up to 30 minutes of jump rope because I really increased my jump
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rope." I'm like, "Yeah, you missed the point here." Okay. The point was to actually keep it at five minutes.
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They're so tuned to now I'm jumping with like a piano on my back and now I can do five. Okay, everywhere else you're going to do that. What we need you to do here is just stay controlled. I want you to
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do just enough of your body weight, just enough tension to give you that tension that's going to give the signal that's going to have that positive adaptation.
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And don't try and build the weight. Don't try and build the length of the contraction. Don't try and add lots of extra contractions. It's enough just to do that minimal effective dose.
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I think I think one of the reasons why athletes do this is because progressive overload is is one of the most important sports science principles. You know, making things gradually more difficult will lead to stronger tissues usually.
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Which brings me to this next question. Is there a cap to how much tendon size you can gain from this method?
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Especially because, you know, you're not progressively overloading. So, how will it ever adapt to those difficult movements? Yeah, it's a great question and it's not something that we've we've looked at because our our rat studies, you know, you have to go down there and
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exercise rats, you know, a period of time. And it's it's not necessarily something that everybody wants to go down and do. And so it's it is something where we did it as okay, we should see an effect after 3
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weeks. Let's go out to three weeks. Now, are we going to see a bigger effect at 6 weeks, 8 weeks, 12 weeks? I don't know.
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I don't know. I I do think that you are going to get to some sort of a plateau.
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Um but where that plateau is is a good is a great question. So Robert Schlepp, who was the guy who really discovered and and scientifically started addressing fascia, he he basically he's German he's a German professor and and
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at the time the the world record holder in the in the javelin was a German guy.
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And so Robert brought him in and he said, "Okay, let me look at the fascia across the pec at the shoulder of your throwing arm versus your non-throwing arm." And so he did that. In the non-throwing arm, he had about a 0.5
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millimeter thick fascia. So nice fascia there. And then on the throwing arm, he had a 3mm thick fascia.
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So yes, there is a lot of room for improvement. Um, but that's a lifetime of throwing a javelin. That's a lifetime of doing this. So we don't know whether it went up and plateaued and it just stayed there because he was training all
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the time or whether it went up really really slowly over time. All of those things are possible. We don't know yet exactly what the dynamics of the you know increase in collagen are. And again we can we can do this experimentally and
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it's a it's a cool study that you can do. You can basically have the animal doing this and you can essentially give them these specialized amino acids that you only see that are only uh we give them in the water and if I give them
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from day one I'll get the total amount that those have gone into that animal's tendons over the whole time. If I give them halfway through or with say three days to go, it'll what it'll do is it'll give me the rate at which we're turning
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over the collagen. And if if the rate goes down as we do it, so it's really high at the beginning and then it goes slower in the middle and then by the end you get almost no turnover, we should be
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able to see it there. And that's a way that we could do it without having to go out 12 or 15 or 18 weeks.
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Okay. Okay. Okay. So the reason why I asked this question is as we're talking I'm already forming a protocol in my head and it sounds like for PLCH and maltes for example um cast athletes should do one session a
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day in the morning where they do a light PLCH variant or a multis variant with dumbbells or or something very light where you feel the tension go in the biceps tendon preferably and you have them Hold that for how many seconds
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would you say? About 30 seconds. 30 seconds for about 10 minutes, right? Well, if they're perfectly healthy, they could do it for 10.
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So, so if you if everything's healthy, but if it's an athlete who's been training and trying to do this for a while, they've probably got some stuff that they're going to deal with. So, at the beginning, I would do 30 seconds for
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say the first four weeks. And then if everything's going well, you can decrease the time of each contraction to maybe 10 seconds.
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Okay. So how much rest uh would you have between sets? So basically it's 10 minutes of total time. So the rest time counts in there.
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So the reason we know that is because we did our experiments using one hertz stimulus.1 hertz stimulus or 0.01 hertz stimulus. All that means is one cycle per second, one cycle every six seconds or one cycle every 60 seconds for 10
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minutes. And they had the exact same response. So whether they did six contra six loads, 60 loads or 600 loads, there was no difference between them. And so really what we're looking for is the total time active plus the the rest in
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between the contractions. And again, the one thing that you're looking at is you've got you've got all of the tendons and muscles of the shoulder. I could do that in the front. I could do that with my thumbs up and do it as a posterior
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deltoid aspect. I could do some rotator cuff, which probably wouldn't be bad for your group to do a little bit of internal, you know, abducted internal rotation. Um, you could do four different moves holding them for 30 seconds and then you come back to the
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start again and now you're ready to go for the first one again. And you could do that as a as a move through. Each tendon is only getting 10 minutes of total time with say two minutes of active contraction. But now I've got
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four different protective moves on the one side and then I do the other side or I could do them both together, whichever you want. But that's the way that that's the way that I I do it. It's more of a a
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mobility sequence. Oh, that is super efficient. So, let me recap. one time somewhere in the day, could be in the morning, a sequence of movements that are often high risk like rotator cuffs, uh, distal biceps, proximal biceps, and
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I'll spend some more time thinking about what tendons we should cover. And you have them do that routine for 10 minutes with sets of 10 seconds if you're completely healthy and 30 seconds if you're if you need to spend more time on
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that tendon. if you've had a past injury or you feel like there could be an injury happening and they do this indefinitely for as long as they do calisthenics 4. My question is is there a reason for doing high load isometric
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contractions? Is there a reason for for doing that or is this enough work to be completely protected and safe for you know for doing the move that I was doing like the multi?
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So there's there's two different properties that are going to go into the the stiffness and the strength of a t of a tendon or a ligament and one of them is how much collagen is and that's really what we've been talking about is
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how much collagen is in that tissue. So the anabolic signal is going to give me more collagen. The catabolic signal is going to break some of that collagen down as the turnover starts increasing.
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That's going to be a bit of a problem and I'll explain why in a second. The second component that goes into how stiff and strong that tenon or ligament is is how much cross-linking there is between the collagen molecules. And that
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cross-linking is really important because that's done by an enzyme in our body called lysol oxidase. And that's really important because that's going to give us differences between male and female athletes because that enzyme is inhibited by estrogen and it's
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stimulated by testosterone. So in men, we're going to have stiffer matrices, stiffer collagen, and that's great for our power and our our ability to do powerful movements. It's bad for our blood pressure, for example, because our because the collagen in our in our
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blood vessels are more cross-length and so they don't stretch as much. And so that means that our blood pressure is higher, cardiovascular disease is higher up until a point when a woman goes through uh menopause and now she doesn't
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have the protective effect of the decreasing stiffness that happens because estrogen directly inhibits lysol oxidase and decreases cross-linking. So what that means is injury rates in the two athletes are going to be different because men have stiffer tendons and
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ligaments, women have less stiff tendons and ligaments. We get muscle pulls when our tendon is stiffer than the muscle is strong. So we do something really quickly in a long position and instead of the tendon stretching, it's actually
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stiffer than the strength of the muscle. So the muscle has to stretch while it's trying to contract. That's a really fast eentric load. That's where we get these muscle pulls.
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So women because they have less stiff tendons, yeah, they have less power, but they have 70% lower muscle poles in the same sport. So if you take professional soccer, men are going to pull their hamstrings 70 well women are going to
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pull their hamstrings 70% less than men playing that same sport. They're going to have about four to six times more ACL ruptures because they have less stiffness in the tendon ligament. The ligament being less stiff means there's more movement in the
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joint. There's more laxity in the joint. And so now that joint is a little bit less stable and actually right around ovulation. So right in the middle of the cycle you get what's called the ludial surge where there's a big increase in
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estrogen. So estrogen goes way up actually if and there's a a um a a researcher named Schultz who's done beautiful studies where she pulls on the knees of men and women every day for uh a full month and the men exactly the
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same knee laxity the whole month the women at ovulation their knee laxity goes up about a millimeter and that's going from like five to like four to four or five to like five to six and that increase in laxity there's a
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Japanese group that that in their study 72% of all the women's ACL ruptures that they measured were during the ludal during that ludal surge or right after right around ovulation. And so what that's telling us is it's telling us
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that that estrogen inhibiting lysol oxidase makes the tissue stretchier for a little bit of period of time and that's going to be protective for a lot of things. It's going to put people at risk for other things. Okay. So, but it
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also tells us that there that other component of tenon stiffness or strength is the cross-linking. And so, when we do more dynamic fast movements that stimulates lice production more than when we do slower less loaded movements.
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So, when we do lightweight isometrics, we are actually going to not get as much of an increase in lysolidase.
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And so the result is we'll have more collagen, but it won't be as tightly cross- linked. So it's not going to necessarily be as stiff if I do lots of dynamic moves or lots of really heavy or or really fast moves. Now what I'm
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getting is I'm getting more of that lysol oxidase. So that's why in the climbing study when we did the really heavy with the really light, that's one of the reasons why we got an additive effect because we got more collagen and
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then we got more stiffness because we were doing more dynamic moves and so the result was we got an additive effect. So a lot of what we and you see this all the time in athletes who are in the
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offseason, oh all they're going to do is go lift heavy weights because oh I want to be bigger next year. Then they come back and they're slower and they can't move as quickly and they actually get a few more injuries because what's
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happened is that now their muscle is bigger. They've decreased their cross links and so now they don't have as much stiffness in the tendon and so they can't develop force as quickly and if they get into a really high force
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situation they they can get more tendon ruptures. So all of that to say that the high velocity, high intensity, all of those high dynamic movements, you can bring them in as a way to to regulate the stiffness. So that explosiveness and
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how stiff the collagen is is directly proportional to its rupture rate. So if I have a stiffer tendon, it's going to rupture later.
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And does this also apply to highintensity isometric movements? Um, it should, but a high-intensity isometric movement is kind of like a a one second or lower isometric.
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So, there's a there's a guy named Alex Natraa who does a bunch of programming of isometrics for track athletes where he does explosive isometrics, which just means that for 2.3 of a second, he's going to have some somebody
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put as much force into the into a pad as they can in a specific position. that's going to build up stiffness. So the lace lock I guess I mean go ahead. I mean uh absolute intensity in terms of doing you know the the
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multis position for example these high load isometric movements right because getting in and out of that you're going to get a high jerk and like okay yeah and so that's where and the higher load is probably going to give us a little
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bit more of that kind of four 6% strain and that's going to probably give us a big bigger stimulus for lysol oxidase activation because the one thing that we see in our when our when we stretch are engineered
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ligaments 2% versus 4%. The 4% stretch gets more of the signals that are leading to more lysol oxidase.
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Okay. Which is convenient because basically what you're saying, you know, to simplify our protocol, you say do these anabolic sets.
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Yeah. And then do your regular training, your specific work, your sport specific work is going to sort you out.
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Yeah. Which is very convenient. So you just want to do it with less load. And so you can do it where instead of doing the full body off the ground with your arms back, you just push against the ground
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with your body in that same position for 30 seconds, not lifting yourself, feeling the tension through both your bicep tendons and your deltoid tendons.
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And now that's going to give you that positive anabolic signal. And then you do that for all your different moves without actually being fully into your PLC or your or whatever exact move it is, but you're just trying to mimic it
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as closely as you can without putting your whole body weight onto it. As you said, you're doing it with 20 kilos less. I would say, you know, if you have a scale, I would do shoot for about 50%
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of body weight would be kind of, you know, maximum that you would do in those types of things. And that would give you a really good stimulus, very specific stimulus to the tendons you're looking for. And that will give you the the
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positive effect with the minimal negative effects. This is awesome. We've already covered the protocol that I wanted to achieve in this podcast. Uh but this brings me to the next question.
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Is there anything that these cats athlete should be taking like on a nutritional basis? because I know you've done research on vitamin C enriched gelatine or hydrayzeed collagen. What have you found and do you think it's worth doing that for people who are
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training their tendons? Yeah. So, so again the number one thing to for everybody to understand is that the loads are going to give you about 95% of the effect. There's going to be maybe two to 5% that you can add by
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getting the nutrition right. Okay? So, it's it's a very minor thing. It's the same thing with muscle mass, right? We all know, okay, we should eat these lucine rich proteins, but if I sit on my butt all day long and I eat lucine rich
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protein, I'm still not going to get muscles. Um, so I need the load. The load is going to give me the number one thing. And then the nutrition will give me a a supportive stimulus. And so there's a lot of data that has now come
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out that shows that yes, you can get um maybe a bigger tissue from the same amount of loading if you have say hydrayzeed collagen.
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There's even better data that says that your stiffness is going to go up or your reactive energy goes up. So, we did a study with our with our uh American football team here at UC Davis, and what we did is we had them do their heavy
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strength training in the offseason where they were doing three three weeks of really heavy strength training, and then we just supplemented them afterwards with either um with either hydrayzeed collagen or a placebo control. And all of them got their normal whey based
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protein, so their their milk-based protein shakes and all of that stuff afterwards. We just gave them this extra little bit afterwards. And what we found is that it didn't change their change in it didn't alter their change in
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strength. They still got about 9% stronger over three weeks because that's their heavy strength training period. So that's their big period where they're trying to push really hard. But what we did see is that in the controls you saw
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this big rate decrease in how how quickly they could develop force. So their rate of force development went way down. When we gave them the hydrayzeed collagen, it stayed exactly the same.
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Okay. Okay. And then when we did all of this jumping analysis and all these other things, what we could find was that what we were doing is increasing leg spring stiffness and we were improving that component that allowed us
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to get rate of force development to stay high. And so there's a lot of data now that shows that when you take the hydrayzeed collagen, what tends to happen is you see performance effects first and then over if you go long
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enough, you can see size changes in your tendons. And so, so that's interesting. And so, yes, what we do, and then the other thing that's important is that it's not just, so all the collagen is doing is it's providing building blocks.
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It doesn't seem to be giving us a really specific signal to the cells within our tendons to turn on or to make more collagen themselves to produce a collagen that could go into the matrix.
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Because what I eat is broken down into amino acids and a few peptides. that's not going to increase collagen on its own. What has to happen is those amino acids have to get to the cells and those cells have to use those amino acids to
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build new collagen. So, one of the things we did while I was in Mastri on on sbatical is we did a study where we gave um whey protein together with collagen and it was the amount of collagen necessary so that we wouldn't
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go negative in how much glycine was circulating. So glycine is an essential or it's not an essential amino acid.
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It's an amino acid that our body normally makes at a low level, but it's every third amino acid in uh collagen is glycine and every third amino acid is proline. So, we've got glycine and proline that are when we're training
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really hard, when we've got athletes who are growing really quickly. Um, these are times when we actually think that glycine and proline might become a little bit of a conditional essential amino acids, which just means that they're a little bit lower
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than they need to be in order to stimulate maximal um production of collagen. And then what we were doing was giving it together with whey protein. So the whey protein gave all the amino acids and a lot of leucine.
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The the hydrayzeed collagen gave a lot of glycine and a lot of proline. And those two things together when we measured collagen synthesis in muscle when we gave the mix of whey protein and collagen together we saw an increase in
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connective tissue protein synthesis. The reason we think that happens is we've done other work that shows that like our muscle cells, our tenon cells are sensitive to this protein complex called mTor complex one. All you have to know is that that protein mtor is
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activated by the amino acid leucine and a couple of other amino acids. So what we found is that the more lucine that was circulating in the blood, the higher the collagen synthesis was. So that means that the whey protein is really
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important because there's almost no leucine in in collagen protein. Um and so if we want to build both the tendon and the muscle, if we have this leucine rich protein together with a little bit of hydrayzeed collagen, that seems to be
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a really good mix for giving us the best stimulus to increase collagen synthesis. And we've got a new uh paper that's in review where we actually took um a recombinant collagen. So this is made in bacteria and it's the bacteria produce
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the collagen. So vegetarians and vegans can eat collagen because collagen is normally only made in animal proteins.
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So it's only in our skins and our tendons, our bones, all of those structures. So by using this recominant collagen, we could test to see whether first of all is it important that the amino acids in collagen become
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hydroxilated. So there's hydroxyproline and hydroxycine that you only find in collagen. And it could have been that one of those things was signaling our cells to make more collagen. Well, what we found is we compared whey protein, malttodextrin, so a placebo control.
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Then we did normal collagen and we did the the recominant collagen. And what we found is that we only saw the hydroxilated proteins of amino acids in the in the dietary protein that was the hydroxilated uh sorry the hydrayzeed
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collagen. But when we looked at markers for collagen synthesis, there was no change in the malttodextrin between three feedings with some jump rope in between. there was no change with the whey protein and there was about a a 30% increase in both of the
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two collagens. And so what that tells us is that first of all the whey protein alone isn't enough to stimulate specifically collagen synthesis at least in the whole body level. And that we can get a small stimulation with either a
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recominant collagen or actually a collagen that's that's just a natural skin-based collagen. And so what that tells us is that there is something about having those amino acids which allows us to make more collagen.
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And it probably says that if we combine that with the whey protein, we're going to get two stimuli that are going to give us an even bigger effect. So collagen with vitamin C or gelatine with vitamin C will have impact on your
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tendon gates. Not a huge impact, but it will definitely do something. Um does timing matter at all? So, so when we're trying to target say tendons specifically because we have an injury or a ligament specifically or cartilage, we want to have it in there before just
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because tendons, ligaments, and cartilage, they get their nutrients by interacting with the fluid around them.
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They don't have a lot of blood flow in them. So, muscle has a ton of blood flow. And when we do exercise, everybody knows after you do exercise for a long period of time, there's a lot more blood
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flow to the muscle. The reason I say everybody knows it is because if you go to the gym on Friday afternoon, there's all kinds of guys working their chest, doing their shoulders, because they know that when they put on their t-shirt that
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night to go out to the bar, they're going to have bigger muscles because there's going to be more blood flow for two or three hours afterwards. And that's going to give them a little bit of extra actually fluid that stays there
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for even longer. And now they're going to have these they're going to look bigger in their t-shirt. Tendons and ligaments and cartilage, they don't have blood flow. And so the way that they get nutrients is when we pull on a tendon or
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we squish down a cartilage. What happens is you squish out a lot of liquid or you pull and that squishes out liquid from the tendon. And then when you relax now any liquid that's around is going to be
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sucked into the cartilage, tendon or ligament. And that's how we actually increase. I've got a a student right now doing this in vitro where he's just taking tendons and he's putting them into a blue dye. He's just letting him
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sit in a blue dye for a long time and then he's cutting them and seeing how far did the blue dye get in in 10 minutes. And then he's doing different loading programs and he's looking to see how far did the blue dye get in when we
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did these different loading programs. And what we're seeing is that when we do the loading, we get the blue dye from outside the tendon actually gets deeper into the tendon. And so part of what we're doing as we're doing our exercise
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is we're actually moving nutrients deeper into the tendon. And so that's important for tissues that have low blood flow. So if we want to target it for our tendons, we can take say the co the collagen beforehand 30 minutes to an
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hour beforehand and then we can give a secondary stimulus um afterwards of say whey protein or something else that's going to give us a muscle stimulus as well as a a collagen or a connective tissue uh stimulus. The other thing to
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go back to in your mind is what we started with is Michael K's work early on where he said that collagen synthesis kind of peaks around 24 hours. And so part of what we're doing when we take today's nutrients is we're affecting how
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the cells the signal that the cells got yesterday as well. And so if I want to put in a nutrient, you know, nutrient-dense solution and I'm going to train at the same time every day and I'm going to take my nutrients at the same
Speaker A
time every day, what I'm going to get is I'm going to get kind of a a buildup of the positive effect because when collagen synthesis is maximal in those cells, now I'm giving them those nutrients. So what we want to do is we
Speaker A
want to kind of be particularly, you know, regular with when we take our collagen. If we're trying to do it so that our tendons and ligaments get the best and our cartilage get the best effect, ideally we take it 30 to 30
Speaker A
minutes to an hour before. But it's more important to take it in than to get it exactly at the right time. So if you can't do it before because you got you get up early in the morning, you're
Speaker A
going to just go in and do your loading. Totally good. Understood. Take it in as soon as you can. Get as much extra blood flow into that area as you can. Yeah.
Speaker A
It's not going to give you as much into the meat of the tendon, but it'll get you the muscle into the tendon pretty well.
Speaker A
And how much collagen are we actually talking about? Yeah. So, so what we do is we do kind of a a standard for if you're going to do a combination of whey and and collagen, we would do say a standard whey protein.
Speaker A
So, that's about 0.25 grams per kilogram body weight. So, it's about 20 gramsish um for for an average person. And then we would do about 10 grams, 5 to 10 grams of of hydrayzeed collagen. And it's important that when we do the
Speaker A
hydrayzeed collagen, we want it to have vitamin C together with it because even if you get vitamin C later in the day, if especially if you're taking your supplements in the morning, in the morning when I wake up, I don't I've
Speaker A
used up all the vitamin C pretty much in my body because vitamin C is consumed in the production of collagen. So an enzyme within our within our collagen containing cells, it needs vitamin C in order to export collagen from the cell
Speaker A
into the matrix so that it can do its job. And that vitamin C is absolutely essential for that export process. So, if we have vitamin C, but it's coming 2 or 3 hours later when we're going to have, you know, orange juice, we're
Speaker A
going to eat some strawberries, whatever it is, that's not necessarily going to be targeted to the same area where we just did our loading and our nutrition earlier. So, we want to put the collagen and vitamin C in together. And we're
Speaker A
looking at between 50 and 250 milligrams of vitamin C within that. Oh, which is not super much.
Speaker A
No, it's it's very low compared to what you would have. It's like a it's a glass of orange juice. It's uh I think it's like six big, you know, nicesized strawberries. Those types of things.
Speaker A
It's easy to do. And if you're doing it as say a little bit of a shake or something, you can put six strawberries in. You can put some liquid in. You can put milk to give you the the lucine rich
Speaker A
protein. And you can put a little bit of dietary collagen in there. And that's you're good to go.
Speaker A
Okay. So, we can add this to our protocol. All you need to do is 30 minutes to 60 minutes before your anabolic sets, take your collagen with vitamin C or your gillatine with vitamin C. And if you don't want to do it in the
Speaker A
morning or if you don't want to do it before those sets, the more important part is taking your collagen or gillatine with the vitamin C consistently daily. Now, this brings me to the next question. Let's say they're doing all this. They're doing the
Speaker A
collagen. They're doing their anabolic sets, but they still end up getting injured. they get a let's say a partial tier or maybe even a full tier and they need surgery, should they rest? Should they maybe do rice or should they do
Speaker A
something else? Yeah. So, so again, one of the things that we talked about earlier was that within 3 days of immobilization, you're going to lose 15% of the collagen that's in your tendon.
Speaker A
So now if I've got that um that's not necessarily what I want to do when I've got an injury. I don't want to have a bigger decrease. So what we what we do is we load very early after any injury.
Speaker A
Whether it's a partial tear or a full tear. It's a full tear and you get a surgical repair. We're loading the same day of surgery. Again, we're doing a very different load than you guys are doing normally, but we're doing some
Speaker A
we're getting a little bit of tension through there. Okay. And the tension doesn't have to be as much because there's not as much of a connection. And so what we would tend to do is say, you know, when this happened to my wife
Speaker A
who's, you know, early 50s, uh, just a couple days, no, maybe like four weeks ago now. So she was out trail running and she popped her ankle and she did inversion sprain. And so she's got this, she does that. She comes home, she she's
Speaker A
like, "Ah, you know, this is going to be bad." And so all we have her doing is first of all we have her doing constant kind of mobility because remember what we just said about the fluid being important. So every time I load it I
Speaker A
squeeze fluid out. So now if if I have her doing alphabets which she's just tracing the capital letters of the alphabet. Now what we're doing is every time we do that we're pulling on that tendon. We're letting it go. And then I
Speaker A
have her go into a slight inversion to where she feels like oh yeah it's tight.
Speaker A
I just feel it is tight. Hold it there for a little while. That's squeezing out the fluid. And then relax. And then go back and do that again. That type of kind of pumping motion is what we use as
Speaker A
an anti-inflammatory. We don't use an anti-inflammatory. We don't we don't immobilize. We don't uh you don't have to use ice or anything like that. And you know, the next day she wakes up and she's like, "Oh, this is going to be bad." And she gets up and
Speaker A
she walks around without any pain, without any problems. She still has a purple ankle because there's nothing we can do about the fact that she tore something in there. It's just that she doesn't have the secondary injury, which
Speaker A
is the immobilization and the increase in swelling that happens because you're not actually pumping fluid out of those tissues that you've damaged. Yes, there's going to be inflammation, but I can use load as a way to to minimize the amount of fluid
Speaker A
that's that's sucked into those tissues. Okay? And so that's a good example. She keeps doing those kind of those mobility exercises. Um, and once the swelling isn't the big thing and once she's not doing the mobility just to manage the
Speaker A
swelling and we're now going to use much more of the okay, go to the point where you feel that tension where you feel like, oh yeah, that's where I hurt myself. Go to that point, hold it for 30
Speaker A
seconds. And now what we're getting is we've got the little bit of injury. If there's healthy tissue around it, normally if we're moving quickly, all the load goes through the healthy part.
Speaker A
But as we pull and hold, the healthy part relaxes and the load gets through that injured part so we can start fixing that injury. It's not enough just to just to, you know, make the healthy part stronger. We want to actually fix the
Speaker A
injury because if we don't fix the injury, she's going to take a couple of days off at some point. She's not going to be able to do this for the rest of her life. just these routine things. So,
Speaker A
what's going to happen is a couple of days where she just rests, she's on the beach, whatever it is. Now, what's going to happen is the healthy part is going to shrink back down, the injured part never went away, is still going to have
Speaker A
that problem unless we fix it. Okay? And so, the same thing would happen if we've got, say, somebody with a quad tendon rupture and they go surgically repair it. What we're going to do is we're going to start loading immediately. That
Speaker A
doesn't mean, okay, we're going to jack up some really high weights on the leg extension. What it means is we're going to have the athlete bend the leg to the point where they feel like, "Oh, yeah, that's tight. I can't really bend it
Speaker A
anymore." That's good. Let's start there. And all I want them to do is what we call a low jerk isometric. What they do there is they load it slowly over about a 3 to 5 second period because what that does is that decreases the
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jerk component. That decreases the change in acceleration and that's the thing that's damaging to the collagen network. So now they're going to hold it for they're going to slowly apply the load. They'll hold the load for as long
Speaker A
as they can up to 30 seconds. They're going to slowly let that off over 3 to 5 seconds. They're going to do that four times for 30 seconds. And they're not going to do it to a point where they
Speaker A
feel any pain at all. So we're just And that, you know, I've got I've got a nephew who's 6'6. He's like 110 kilos.
Speaker A
He's big fella. Um, but he's messed up his rotator cuff so bad that we can get him so he can do about three newtons of force in his rotator cuff before he gets pain. So, he's sitting there as this
Speaker A
massive individual and he's barely moving anything because that's what he has to do in order to not feel the pain to get the load through the tissue. And that's what he started at. Yeah, he's a big fella. What happens is now he's he
Speaker A
can increase the weight at which he can do really really quickly to the point where yeah I still don't feel pain here that's good all right we now I feel tension and now if I look at him couple
Speaker A
three weeks after we've started doing his rehabilitation now he's up to 20 30 40 kilos or newtons and that's telling me that he's getting a lot more force through there but I don't need all that force remember I just need him to get
Speaker A
tension through there okay so for our quad rupture We're going to have him again after he does the first repetition. He's just going to bend his knee again. And you can do this just you can do this with like a belt. I'm just
Speaker A
going to put the belt around my my my foot. I'm going to let my knee bend until I can't bend it anymore. Okay.
Speaker A
Now, I'm going to slowly apply the load. I'm going to slowly build tension. I'm going to hold it for 30 seconds. No pain. I'm going to let that off over over a three to five second period. Now what'll happen is that as I relax to
Speaker A
bring that back my knee actually goes further because again every time we it's like it's like PNF stretching where you pull it back you push against something and then suddenly you can pull it back more. You know all of those types of
Speaker A
things are going to be in play. But remember we don't need it to be at the longest muscle length. We just need to get tension through there. Oh yeah that I can feel it but there's no pain.
Speaker A
That's perfect. And then what'll happen is you'll get back to your full range of motion pretty quickly. And then once you're at your full range of motion, now we can do isotonic loading. So that just means say doing in that in our quad
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tendon rupture that means doing some light um leg extension for example, but we're still going to do our 30 secondond isometric holds.
Speaker A
Right? And so the biggest problem we get with people with tendon and ligament issues is that they start doing the the program and they feel great and they're like, "Oh yeah, oh yeah, I'm all better now." Two weeks into it, there's no pain
Speaker A
anymore and they're all good to go. It's a lot like antibiotics. You got a really bad bacterial infection. Oh, I feel horrible. You take your first antibiotic, oh, I feel great. But you still have to complete that course of
Speaker A
antibiotics because if you don't complete the course, you haven't actually gotten rid of the whole infection. Same thing is true for with your isometrics. You're going to feel great after one to two weeks. A lot of people feel great after the first
Speaker A
session. They're like, "Wow, I feel so much better." And then they're going to go out and they're going to do every Okay, we're still going to let you do a lot of what you're going to do, but you
Speaker A
still need to do this. And what we tell people is our course of isometrics, like your course of antibiotics, is going to last about eight weeks. We want you to do this course of an of isometrics for about eight weeks. After that, all
Speaker A
you're doing is you're doing maintenance work, maybe once to twice a week. For that eight weeks, I want to do it daily.
Speaker A
I'm going to do it once a day. I'm just going to hit it and we're just going to get in there and we're gonna go through and we're just going to get up to a point where yeah, I can I feel like
Speaker A
there's tension across there. three, four times, 30 seconds, we're good to go. Does the muscle length matter? Do you like recommend practicing different muscle length?
Speaker A
So again, it depends on what tissue we're looking at. So a lot of tissues like say the patellar tendon, there's different parts of the patellar that tendon that are active when we're in a bent position versus a straighter
Speaker A
position. So in that situation, we're going to do both straight and bent. In the Achilles tendon, the same type of thing. If I have a straight leg, I use my Achilles differently than if I have a bent knee. So we're going to do
Speaker A
different different locations that way. So but also muscle length is going to be something that we can go in a long we go as long as the muscle length allows us.
Speaker A
So so if we have a bicep tendon a lot of people have proximal bicep or proximal bicep tendon problems that's really common. So what'll happen is they'll find themselves like okay yeah we can get stretched back a little bit. We can
Speaker A
apply load from there. Long muscle length is okay. We can do these loads in a long muscle length. It's just not absolutely necessary except for you guys. If you're going to be doing that and that's your performance position,
Speaker A
you need to practice that position. I have to say the way you approach injuries, this physiological model of how tendons respond seems to resonate so well with the biocschosocial model of pain. And for the people who don't who don't know what
Speaker A
the biocsychosocial model of pain is, let me explain as short as possible. So let's take okay man I have to say this approach of injuries the the physiological model of of the tendons that you describe seems to resonate so well with the
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biocschosocial model of pain. And for the people who don't know what that is, you see pain is very complex. We used to believe that, you know, you you injure yourself, you know, there's damaged tissue and that damaged tissue sends a
Speaker A
pain signal and uh that teaches us not to move the damaged tissue. Okay. The problem with this model is sometimes the damaged tissue would heal but people would still experience pain. And the opposite would also happen. Sometimes uh
Speaker A
there would be damage but there would be no pain. So the model wasn't sufficient at explaining those situations. So then the biocschosocial model came to be. It explains the biology which is also again damage you know the injured part the
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damaged tissue. But there's also the psycho part which is the way your brain interprets signals. So the the the damaged part sends a signal to your brain and then your brain starts adding context to the signal uh which
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determines whether this should be uh uh interpreted as pain or as something else. So if you're more anxious for example, you're more likely to interpret the signal as pain. And then the social one is if you have a good social
Speaker A
environment, if you have a coach that is very positive and doesn't use certain uh language, you are less likely to experience pain. But if you have a coach who constantly tells you don't do this because you're going to get injured,
Speaker A
then you're more likely to to uh suffer from pain. And the reason why I explain all of this is people who know how the biocschosocial model of pain works treat injuries differently. We want to after an injury immediately move the damaged tissue even
Speaker A
if it's just a little bit so that the pain doesn't linger. So that we teach the person that it is okay for this tissue to move. You're not making it that much worse. right? You're teaching the body that it's okay to move and
Speaker A
you're not making the pain chronic that way. And so this seems to resonate so well with what you do when it comes to injuries. Is this something that you have thought about on on how well this resonates?
Speaker A
Yes. This is stuff that um that is more the line of Ebony Rio down in Australia who works with Jill Cook and they do a lot of isometrics and they what they look at a lot of times that goes into
Speaker A
the biosocial um model of of the pain component. They look at what's called central inhibition and central inhibition is your brain actually doesn't turn on the muscle if it's associated with an injured area. And so the central drive is actually lower if I
Speaker A
have a patellar tendon on my right leg than my left leg. my central drive to my right leg is going to be lower than that is to my left leg. And so you can do stuff like externalize the stimulus. You
Speaker A
can use a metronome. You can watch somebody else doing it and try and mimic their movement as a ways to get out of your brain. And that decreases central inhibition. You see this really really frequently in kids, the biosocial uh
Speaker A
model of of injury because kids, especially kids who are maybe a little bit shy and and maybe not the most popular, if they hurt themselves and they get a cast and they come in and everybody's like, "Oh, yay. Let's sign a
Speaker A
cast. Let's do all now." They feel like, "Oh, there's something special about being injured." And so they actually continue the injury much longer and it's very difficult for them to actually get back to health because they find themselves in a in a position where
Speaker A
their psychology is now like oh this is great this injury is great. So even after they get the cast off they won't walk normally and and they won't do stuff and they won't because that made them special. And so yes, that there is
Speaker A
a whole component of that that we often ignore that is really important for getting people healthy again that goes really closely with the actual physiological reasons that we load.
Speaker A
Remember that the the first immobilizers come from, you know, we're that if people have identified were we're in ancient Egypt and, you know, 4,500 year old, you know, pictures of people in in basically immobilizers. So, you know, we've we're we're we can't possibly
Speaker A
think that that's still state-of-the-art. And so, you know, if we're not moving on from this technique that we used 4,000 years ago, that's really doesn't say much about what either that says that we were really great as medical doctors 4,000 years ago
Speaker A
or it says that we're really bad at it today. And I'm, as much as they might have been great back in the day, I I think it's much more that we we didn't actually challenge that that type of thinking for far too long.
Speaker A
And so we got into this situation where we actually um made things a lot worse.
Speaker A
And so in in the long term it takes you a lot longer to get better, but in the you maybe you'll get better because what happened is you made the tissue so bad that it's so weak that yeah, it's going
Speaker A
to take you a long time to get back. But because it's so bad and so weak, it doesn't stress shield and it's not strong enough to shield the injured part. So maybe you do get better, but the reality is we could do that without
Speaker A
taking the 8 to 12 to 16 weeks to get you back. we can do that in a much much shorter time frame.
Speaker A
Ah that's awesome. Um I want to make one last segue and I don't know if anyone has asked this particular question. This is a very well it's still on topic but it it is a very different question is we
Speaker A
know that ice baths or medicine like ibuprofen insets you know medicine that can reduce inflammation can have effects on the adaptation of both muscles and tendons. We see that they have a stunning effect. though you are going to
Speaker A
make less gains if you're going to be on a high doses of NSAIDs or if you're doing ice baths every time after your uh hypertrophy training.
Speaker A
Now I sometimes prescribe turmeric to my patients who have osteoarthritis. In fact, I take it myself and I've always wanted to find out whether this has impact on muscle growth and tendon adaptation and I've never been able to make that
Speaker A
connection. Is this something that that you think also happens with uh anti-inflammatory herbs such as turmeric? So what we can see so we've done this and I have a a postoc who did his PhD on inflammation in our
Speaker A
engineered ligament model and so what he can do is he can produce basically an inflammatory response in our engineered ligaments and he can optimize the inflammatory signals so that he gets 50% decrease in the function of the tenant.
Speaker A
So if I just put in the things that your inflammatory cells produce, these chemicals called cytoines, those cytoines will decrease the function of our ligaments by about half and they'll decrease the collagen content as well.
Speaker A
And so he thought, okay, what we're going to do is we're going to put in these um anti-inflammatories essentially, these things that are going to decrease inflammatory signals and that's going to make everything better.
Speaker A
And so there's two really big pathways for that. One is uh through a protein called NFCappa B and the other is through these proteins like Jackstat proteins. And so so what he did was he used the NFCappa B ones because that's
Speaker A
the biggest one. Oh, this is going to work. I'm going to inhibit NFCAPPA B and we're going to have these tendons back to normal. And what he actually did is by inhibiting NFCappa B, he made them so that they almost didn't have any
Speaker A
mechanical strength at all. and they were barely functional and they had barely any collagen in them because NFCappa B seems to be important and that's one of the things that we get when we get inflammation. The interesting thing is when he used the
Speaker A
jack stat inhibitor and these are things that you use for rheumatoid arthritis and for um ser psoriis so these skin problems that are also collagen related issues is what he saw was that he actually made the tendons stronger at
Speaker A
rest but then when he gave the inflam the inflammatory signal he actually still made them stronger and so what we have to do with our with our anti-inflammatories we have to be specific with And so turmeric is a problematic one to
Speaker A
some degree because most people will go get a bunch of spice and they'll try and use that. That's really poorly absorbed by the human body in the first place. So you don't really get much turmeric in.
Speaker A
The second thing is you have to know how broad of a an inhibitor it is. So we see that it can improve slightly the ligament um function, but it's not as good as other things that we found. And
Speaker A
so there's other natural products that are better. um we just haven't published about them yet and that's stuff that's going to be coming out. So, so the tumeric may be a little bit it's not going to be huge. It's going to be better than a lot
Speaker A
of other things because it's not going to have as much of the effect on the other pathway. So, if we look at stuff like um anti-inflammatories like NSAs or ibuprofen as an example, ibuprofen does make our ligaments worse. Um but usually
Speaker A
ibuprofen doesn't really get to the tendons or cartilage or coll or or collagen containing things as well just because of the blood flow issue. Um again so so there is there's much less that we know but that's again why we
Speaker A
wouldn't necessarily use ice or or any like really broad anti-inflammatories because inflammation is some is necessary for our tendons and ligaments to actually produce a strong tissue.
Speaker A
Some inflammation is bad. Some inflammation is actually really important. And so, um, as we get more specific with these things, we're going to have better products that are going to be better designed for improving outcomes.
Speaker A
That's a huge cliffhanger. I think a lot of people want to know what these better products are.
Speaker A
Professor Keith Bar, I want to thank you so much for coming on, for covering so many things. We've, you know, covered the protocol that I wanted to talk about. We've covered what we should be doing once we get injured. We we talked
Speaker A
about nutrition. We covered all of it. Is there anything else you think that we should still cover before we end this podcast?
Speaker A
No, it's mostly about what you guys already know, which is the biggest thing that's going to keep your injuries away is your slow progression to into your calisthenic holds. your your static work is going to it's going to be one of
Speaker A
those things where there are progress the moves progress for a reason and don't try and skip the moves. Um as much as somebody who's coming along wants to jump on top of you. Yeah, those are the things where those big changes in are
Speaker A
when you're going to be at most risk for injury. So, as the more you can make that into smooth transitions from one kind of progressive move to another, the better off you're going to be. And just remember that the goal isn't necessarily
Speaker A
to spend hours and hours doing these things. The goal is to give enough of us uh to do enough of it to get a stimulus so that you can learn how to do the movement so that you can progress your
Speaker A
muscle strength, but not so much of it that you turn on breakdown and you get all of this negative components of it because that will not necessar that won't be as as effective for you as if you get the loading just right. Um and
Speaker A
it doesn't mean you only do 10 minutes. It just means that realize that there are some times where you should only do 10 minutes. And then there are other times where you can train for your muscle strength and you can train for
Speaker A
your heart and you can train for all these other tissues because those tissues, your skeletal muscle, your heart, they will continue to adapt for hours.
Speaker A
But the your tendons, ligaments, and cartilage and bone, they they only respond to a short bout of load. So just realize that those protective sessions, those those anabolic sessions for our connective tissues, those can be nice and short, tidy, something we do in the
Speaker A
morning. We could call it a mobility routine, whatever it is. That's what's going to allow you to have the good elasticity and the good the good function that you're looking for from your um from your calisthenic work.
Speaker A
Well, thank you guys. If you want to see more of Keith Bar, there's apparently more research coming out, including stuff on anti-inflammatories. You can look him up. His research is out there.
Speaker A
And if you're excited for more podcasts, uh, comment, like, subscribe, do the whole thing. Uh, and see you guys later.
Speaker A
Bye now. Take care.
Topics:tendon trainingcalisthenicsconnective tissueinjury preventioncollagen synthesisstatic holdsjerk injuryProfessor Keith BaarDoctor Yaad Podcastmusculoskeletal health
