MGD’s

Injury / Tendon Strain

  • Tim Ferriss Show: Ep. 797: Dr. Keith Baar, UC Davis – Simple Exercises That Can Repair Tendons (Tennis Elbow, etc.), Collagen Facts, vs. Fiction, isometric vs. Eccentrics, etc.

In Episode 797 of The Tim Ferriss Show, aired February 24, 2025, Dr. Keith Baar, a tendon expert from UC Davis, outlines a simple exercise protocol for repairing tendons, emphasizing the effectiveness of isometric exercises. Here’s a summary of the protocol and how it could be applied to a strained tendon behind the knee:

Summary of Dr. Keith Baar’s Tendon Repair Protocol

Dr. Baar’s protocol leverages isometric exercises—static holds where the muscle contracts without moving the joint—to stimulate tendon healing. Key points include:

  1. Isometric Holds: Perform isometric contractions targeting the affected tendon, holding each for 10-30 seconds. The duration depends on injury severity—shorter (10 seconds) for acute injuries, longer (up to 30 seconds) for chronic ones. Aim for 4-6 reps per session with 1-2 minute rest periods between reps to allow for “stress relaxation” in the tendon.
  2. Frequency and Rest: Conduct 2-3 sessions daily, spacing them 6-8 hours apart. Tendons become refractory to loading after about 10 minutes, requiring this rest period to maximize collagen synthesis and adaptation.
  3. Load Level: Use a moderate load—around 70% of maximum voluntary contraction—where you feel tension but not pain. For chronic injuries, “overcoming isometrics” (pushing against an immovable object) are preferred over “yielding isometrics” (holding a weight) to ensure even load distribution.
  4. Nutritional Support: Take 15g of collagen (from skin sources like bovine hide or fish skin) with 200-250mg of vitamin C, 30-60 minutes before exercise. This boosts collagen production, enhancing tendon repair.
  5. Consistency: Perform the protocol consistently over weeks to months, as tendon remodeling is fast but requires sustained effort to rebuild strength and stiffness.

Dr. Baar emphasizes that isometrics outperform eccentrics for tendon healing because they evenly distribute load, avoiding stress concentrations that could worsen injury. He debunks the RICE (Rest, Ice, Compression, Elevation) approach, advocating early loading to reduce inflammation and promote recovery.