Collagen, Exercise, and Hormones: My Path to Recovery

Around your 50s, you hear the buzz about using collagen to maintain a youthful appearance. After my Achilles tendon ruptured, I was more interested in it’s ability to keep my body strong. This is a deep dive into five studies that examine the effect of collagen, exercise and hormones on our muscles and tendons.

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After fixing my ruptured Achilles tendon, the surgeon told me that he attached a Regeneten collagen patch over the repair. He said it would help healing and strengthen the tendon over the next six months. I had no idea that it was a thing, and I was happy that it now existed in my body.

The patch is the size of a postage stamp. It is usually used for rotator cuff repairs, but I suppose it can help other tendons in the body. The surgeon showed me a picture of the patch sewn onto my repaired tendon before he closed it up. That was very cool (and gross, but fascinating). I’ll refrain from sharing too much.

Basically, the patch acts as a scaffold for new tendon tissue to form, which thickens and grows over time. In six months, the patch is completely absorbed into the body. (Seaview Orthopedics, 2025)

Intrigued, I asked if taking a collagen supplement would also help with healing. He gave a qualified yes. Their absorption rate is much lower rate than the patch directly placed on the repair. Sure, but could it help? He said it couldn’t hurt.

Since then, I’ve been doing a deep dive all about collagen.

Learning about collagen

The beauty industry touts collagen as an age-defying panacea. Sure, I’d love to keep my skin looking smooth in my second act. However, I’m much more interested in using collagen to keep my body strong and functional.

While collagen doesn’t possess magical qualities like some profess, it is an integral component for our body’s strength and structure. It is important to include ample sources in our diets.

You don’t know what you don’t know until you need to know it. Since I wasn’t well-versed in the details about collagen, I dug into the research. I wanted to learn how it relates to muscle and tendon strength. This is what I wanted to know:

• What is it?
• What does it do for our bodies?
• What dietary forms does it take?
• How much do we need?
• How does it help our workout and recovery outcomes?
• How does hormone replacement therapy (HRT) affect its use in the body?

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Whenever I do a deep dive into the available research, it’s like diving into a rabbit hole. One study leads to another. They are are usually very specifically targeted, full of data and scientific jargon, so they’re not easy reads. The other issue is that the outcomes may not fully apply to me and my situation.

Despite the challenge of poring through studies, I was determined to understand why collagen is so important. Some of the basics came from Harvard’s School of Public Health’s The Nutrition Source and Cleveland Clinic’s post about collagen. Read on to see what I learned.

What is collagen?

Collagen is a structural protein used throughout our bodies. It maintains the strength and resiliency of our connective tissue, bone and skin.

Collagen is the most abundant protein in the body. It is mostly made up of three amino acids: glycine, proline, and hydroxyproline. The amino acids combine into short chains called peptides. Those are woven together in a triple helix structure (see pic above) and make up muscle and tendon fibers.

When collagen is hydrolyzed, it is broken down into smaller components (aka collagen peptides). These are soluble in cold water and easily absorbed by the body. It’s quite convenient to be able to add it to a drink.

Our tendons are made up mostly of collagen. Thus, it “plays a vital role in maintaining tendon health and mitigating potential injury-risk in sport.” (Khatri, et al. 2021) I’ll talk more about that later in this article.

How do we get collagen?

With the right amino acids, our body produces collagen every day. We can get the necessary amino acids through both food and supplement sources.

Harvard School of Public Health published a good article about collagen in The Nutrition Source. It indicates a wide variety of foods that help to support collagen production. Hint: It’s the usual variety of foods we should be eating as part of a healthy diet. The following are the details.

Foods containing collagen

These foods contain whole collagen from animal sources. They are broken down into the peptide and amino acid components that our bodies use to make our own collagen.

• Tough cuts of meat with connective tissue (pot roast, brisket)
• Fish, including bones and skin
• Bone broth (a good source, but the amino acid levels vary from batch to batch)
• Gelatin

Foods to boost collagen production in the body

These contain the amino acids and other nutrients that are necessary for collagen production. (Source: Cleveland Clinic)

• Vitamin C. Vitamin C is found in oranges, strawberries, bell peppers, broccoli, Brussels sprouts and potatoes.
• Proline. Proline is found in mushrooms, cabbage, asparagus, peanuts, wheat, fish, egg whites and meat.
• Glycine. Glycine is found in red meats, turkey, chicken and pork skin, peanuts and granola.
• Copper. Copper is found in liver, lobster, oysters, shiitake mushrooms, nuts and seeds, leafy greens, tofu and dark chocolate.
• Zinc. Zinc is found in oysters, red meat, poultry, pork, beans, chickpeas, nuts, broccoli, green leafy vegetables, whole grains and milk products.

Fortunately, I eat all of the above. If I ate a perfectly balanced diet every day, I’d likely consume everything I need to make collagen. Alas, I don’t live a perfectly balanced life every day. I do start my day with a large dose of protein with some fiber. I’ve talked in detail about that in Building Muscle Mass in Perimenopause.

Since my injury, I wanted to double down on consuming the building blocks to maximize collagen synthesis. That’s where supplementation comes in.

Using a collagen peptides supplement

Like I said, I enjoy all of the foods that contain the required amino acids. However, I may not always get them every day. You know, life sometimes gets in the way.

When I got home from the surgery, while the nerve block was still working, I looked into collagen powders. Like the doctor said, it couldn’t hurt.

I landed on a brand called Live Conscious. They were well-rated and had a chocolate flavor. I ordered it and started adding it to my existing morning protein shake recipe. It tasted good, so there’s that.

How does collagen help improve workout outcomes?

When it comes to my workouts, I’ll admit, I’m not super scientific. I often go by how I feel, progressing if it feels right. If I’m tired or too much time has gone by, I’ll back off a bit. I try to perform at least two sets of about 10 repetitions with a weight that feels heavy to me. If I’m lifting heavier than I’m used to, I’ll only do 3-5 repetitions, sometimes twice.

I hate the feeling of severe DOMS (delayed onset muscle soreness) two days after a too-strenuous workout. I’m not looking to compete or get super-cut. I’m looking for my body to be functionally strong and stable. I want to heal well from my injury and continue flipping at the gym. Any gym-related strength gain I reach is slow-and-steady.

What I am most concerned with right now, along with building muscular strength, is also building tendon strength and resilience. This Achilles tendon rupture is scary stuff.

Looking at the science of collagen

I wanted to know:

1. if collagen peptides supplements are actually effective
2. how does exercise play into that effectiveness
3. how much I’d need in a day

I found three studies that looked at these questions.

STUDY 1: Effects of specific collagen peptide supplementation combined with resistance training on Achilles tendon properties (2022)

This study looked at 40 healthy males ages 18-40. One group received 5 grams of oral specific collagen peptides, the other a placebo. They all participated in the same resistance program for 14 days. The group receiving the collagen peptides had statistically greater increases in Achilles tendon and gastrocnemius (calf) muscle thickness. The increase is associated with less tendon stress and can be useful for both prevention and rehabilitation of tendon injuries.

In Short: Collagen peptides increases thickness and reduces stress on muscles and tendons.

STUDY 2: Effects of Collagen and Exercise on Tendon Properties and Pain: A Critically Appraised Topic (2023)

This study found that tendons respond to a combination of eccentric training and concentric resistance, in combination with collagen supplements. Positive adaptations were in pain mitigation as well as an increase in tendon thickness and size. Eccentric training is when you lengthen a muscle under load (weight).

In Short: Resistance exercise and collagen supplements together help reduce tendon pain and increase tendon thickness and size.

STUDY 3: The effects of collagen peptide supplementation on body composition, collagen synthesis, and recovery from joint injury and exercise: a systematic review (2021)

This was another review of the literature to determine:

1. the impact of collagen and exercise on joint function and athletic recovery
2. appropriate dosing strategies for collagen supplementation

Out of 856 articles, 15 randomized trials were selected. For dosing of collagen (both peptides and gelatin products), they recommended taking:

• 5-15 g/day to improve joint pain and functionality
• 15 g/day to increase collagen synthesis, in conjunction with exercise and vitamin C

Also noteworthy findings about consuming collagen:

• It inhibits bone collagen breakdown and alleviates painful symptoms associated with degenerative joint conditions
• It could be used as a safe, therapeutic supplement in helping to manage symptoms associated with osteoarthritis and osteoporosis

In Short: Take 5-15 grams per day of collagen supplements and vitamin C before resistance training to maximize its benefits.

Collagen and HRT

Being an active Gen-Xer in perimenopause, I was also interested in finding studies that focused on older females. Most of the existing literature does not focus specifically on women my age and activity level. It is well-documented that estrogen and progesterone levels have a profound effect on muscle and tendon health.

Last June, I started hormone replacement therapy (HRT). Since then, I feel healthier, happier and more like myself. I thought it wise to include research that covers the effects of HRT on muscle and tendon health.

I found two studies that support the combination of hormone replacement therapy and collagen supplementation.

STUDY 4: Impact of oestrogen deficiency and aging on tendon: concise review (2014)

This paper searched numerous scholarly databases for existing studies using these keywords: ‘postmenopausal women’, ‘tendinopathy’, ‘tendon’, ‘oestrogen deficiency’, ‘aging’. It focused on the effects of estrogen replacement on tendon structure. Some notable findings:

1. Estrogen in older women seems to stimulate tendon and raise collagen synthesis.
2. There are estrogen receptors on tenocytes (tendon cells) which are influenced by estrogen levels. Reductions in blood estrogen correlates with reductions in tendon strength, diameter and density as well as collagen synthesis.
3. Including more high-intensity eccentric exercise (resistance as the muscle lengthens) can help prevent tendon disorders in post-menopausal women.

In Short: Adequate estrogen and eccentric exercise is needed to maintain tendon health.

STUDY 5: Effects of transdermal estrogen on collagen turnover at rest and in response to exercise in postmenopausal women  (2012)

This examined the effects of using an estradiol patch for five days on type I collagen synthesis in tendon and skeletal muscle. This small study included 11 healthy, post-menopausal women.

1. Estrogen replacement therapy enhances the creation of type I collagen in the skeletal muscle in response to acute exercise.
2. Combining estrogen with exercise stimulates collagen synthesis in the skeletal muscle. This may be important for repair of muscle damage or remodeling of the connective tissue after exercise.

In Short: Estrogen and exercise together improve the creation of collagen in the body.

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My takeaways

After looking at the studies, these are some of my takeaways about collagen, exercise and female hormones on tendon and muscle health:

1. Consuming collagen and peptide-rich food sources (including supplements) will provide the foundation for making stronger muscles and tendons.
2. Exercise is the mechanism for turning collagen into strong muscle and tendon. Eccentric training must be part of healing and strengthening processes.
3. Hormone replacement in older women helps facilitate collagen production for muscle and tendon strength and recovery.
4. Added Bonus: Collagen can alleviate and mitigate pain associated with degenerative joint conditions.

Since my Achilles healing journey began, I have added collagen peptides to my breakfast shake. I’ve also been trying to maximize my intake of foods that assist healing. So far, my healing process has gone exceedingly well. I haven’t lost any strength in the rest of my body, and my tendon strength is progressing nicely.

In short, I’m following this formula:

Collagen + Exercise + Appropriate Hormone Levels = Strong Body Structure.

A side observation: my hair and nails seem to be growing strong as well. Maybe that’s a direct result of the collagen, maybe not. I’ll take it either way. I suppose that’s another deep dive for another day.

There’s a lot more information to dig into. I am encouraged to look more into the effects of female hormones on muscle and tendon health. That’s another post altogether.

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Sometimes, doing a deep dive into the science helps your put the necessary actions into perspective. I hope this information was useful and encourages you to do your own research. Subscribe for notifications on all of my articles.

RESOURCES

The effects of collagen peptide supplementation on body composition, collagen synthesis, and recovery from joint injury and exercise: a systematic review. (2021)

Impact of oestrogen deficiency and aging on tendon: concise review. (2014)

Effects of specific collagen peptide supplementation combined with resistance training on Achilles tendon properties (2022)

Effects of Collagen and Exercise on Tendon Properties and Pain: A Critically Appraised Topic. (2023)

Effects of transdermal estrogen on collagen turnover at rest and in response to exercise in postmenopausal women (2012) 

Regeneten Patch: The New Treatment for Rotator Cuff Tears

Cleveland Clinic: Collagen

Collagen