Painful joints is a common condition, affecting 1 in 3 people between the ages 18-64.¹ In the 29 to 49-year age group, nearly 1 in 4 has persistent knee and/or hip pain.² Among former professional athletes, up to 80-95% suffer from joint pain and discomfort.^3,4

The most frequent cause of painful joints is osteoarthritis, also known as wear-and-tear arthritis, age-related arthritis, primary osteoarthritis or degenerative joint disease.⁵ Osteoarthritis is a disorder involving deterioration of articular cartilage and underlying bone and is associated with symptoms of pain and disability. Risk factors for osteoarthritis include age, obesity and excessive joint loading.^6,7 Athletes from all types of sports are at increased risk of osteoarthritis of the knee, hip, and ankle.^4,8-10 However, a sedentary lifestyle is also a risk factor for joint deterioration and pain.⁷

Regular physical activity and mechanical joint loading – to a degree – is important for maintaining healthy joints and reduces the risk of osteoarthritis.^11-13 Exercise prevents weakening of the joints and supporting musculature, as well as deleterious alterations in the articular cartilage.^14,15 Some data also suggest that in damaged or old joints physical activity can improve the lubricative properties of articular cartilage.¹⁶

Your cartilage thickens in response to moderate loading (such as exercise) ^17-19 and gets thinner in response to unloading (such as living a sedentary lifestyle).¹⁹ However, too much overloading can cause cartilage destruction.¹⁹ That’s why you see some older athletes who abused their bodies needing joint replacement surgery.

What is Collagen Peptide (Collagen Hydrolysate)?
Collagen is a type of protein that occurs in high concentrations in connective tissues such as cartilage, tendons, and skin, and contains the unique amino acid hydroxyproline (which is not part of muscle protein).^20,21 Collagen peptide, also known as collagen hydrolysate, gelatin hydrolysate or hydrolyzed collagen, is derived from gelatin which has undergone enzymatically degradation in order to increase absorption.^21-23

The active ingredient in collagen supplements seems to be hydroxyproline-containing peptides.^20,24-27  In the past, it was believed that proteins and peptides (shorter chains of amino acids) are split up into their individual amino acids in the gastrointestinal tract prior to being absorbed into the blood circulation. However, increasing evidence indicates that peptides are absorbed intact.^20,23 It has been shown in human subjects that hydroxyproline-containing peptides derived from ingested collagen are absorbed efficiently by the body.^24-30 Dose-dependent increases of hydroxyproline-containing peptides have been demonstrated in the bloodstream after ingestion of collagen hydrolysate ^22,28,31-33, which then accumulate in the joints ^34,35 and skin.^28,35 Collagen peptides that contain hydroxyproline and glycine seem to be particularly beneficial for the joints and skin.^33,36,37 The accumulation of hydroxyproline-containing peptides in the joints and skin – and hence the beneficial effects – may be increased by daily long-term ingestion of collagen hydrolysate.²⁷

How does it work?
Collagen peptide supplementation has been shown to reduce joint inflammation ³⁸, as well as increase synthesis of hyaluronic acid (which lubricates joints)²⁶, collagen and proteoglycans.³⁹ This may help prevent injuries and joint degeneration, and/or accelerate tissue repair.^30,40 In the skin, increased production of collagen, elastin as well as glycosaminoglycan has been documented as mechanisms underlying the reduction in wrinkling and improvement in skin elasticity.^41-44

Effect of collagen peptide supplementation on joint pain, mobility and exercise recovery.
Since 2000, numerous studies have shown that supplementation with collagen peptides significantly reduces joint pain and improves physical mobility in people with diagnosed osteoarthritis.^40,45-50 A meta-analysis found that collagen peptide supplementation provides significant effects for pain reduction and physical function improvement in patients with osteoarthritis.⁵¹ Some studies suggest that collagen peptide confers greater benefits than glucosamine or chondroitin.^48,51

More recently, a growing number of studies have examined the effect of collagen peptide supplementation on joint pain associated with athletic activities in people who have not been diagnosed with osteoarthritis (or any other form of arthritis), that is, had no signs of degenerative joint disease. One of the earliest studies, published in 2005, was conducted at an Olympic training site (for German Olympic Games qualifiers) in Germany.⁵² The aim of the study was to determine if treatment with 10 g/day of collagen hydrolysate would reduce joint pain in these athletes.⁵² One hundred athletes with exercise-related joint pain received 10 g/day of collagen hydrolysate. After 12 weeks, 78% of the subjects reported a reduction of movement pain, as well as reduced pain when climbing stairs or carrying objects.⁵²

In 2008, the first placebo-controlled clinical trial of collagen peptides in athletes was conducted. 147 subjects who competed on a varsity team or engaged in club sports (72 male, 75 female) were randomly assigned to receive 10 g collagen peptides or placebo for 24 weeks. Results showed that six parameters statistically significant improved in the collagen peptide group compared to the placebo group; joint pain at rest, joint pain when walking, joint pain when standing, joint pain at rest, joint pain when carrying objects and joint pain when lifting.⁵³ A subgroup analysis showed that those with worse joint pain at baseline achieved greater reductions in pain. The results of this study have implications for the use of collagen peptide supplementation to support joint health and possibly reduce the risk of joint deterioration in athletes and fitness enthusiasts.⁵³

A more recent study showed that collagen peptide supplementation in young adults led to a significant reduction in activity-related joint pain after 12 weeks.⁵⁴ In addition, more subjects in the collagen peptide group were able to reduce the use of ice packs, pain medications and/or physical therapy, which further supports the efficacy of collagen peptides.

Emerging research suggests that collagen peptide supplementation may play a beneficial role in injury prevention and tissue repair ³⁰ and speed up recover after intense workouts.³⁰ In a new study published in February 2019, 24 recreationally active men were randomized to receive either a supplement of 20 g collagen peptide per day (one serving of 10 g in the morning with breakfast and another 10 g serving with their evening meal) for 7 days. On the 8th day, subjects performed exercise tests (drop jumps to induce muscle damage, countermovement jumps as an indirect measure of muscle power, and maximal isometric contractions). 40 min before and immediately after the exercise testing, subjects consumed 10 g collagen peptide or placebo. Results showed that collagen peptide supplementation accelerated the recovery of countermovement jumps performance and tended to reduce muscle soreness at 24 and 48 hours following a bout of muscle-damaging exercise. This is the first study to suggest that collagen peptide supplementation seems to speed up the recovery from strenuous physical exercise.⁵⁵ The underlying mechanisms remain unclear, but the study scientists speculate that the effects are related to an increase in collagen synthesis in the connective tissues surrounding the muscle and/or modulation of the inflammatory response to the exercise bout, which could accelerate the recovery process.⁵⁵

Effect of collagen peptide supplementation on athletic injuries
One of the most common sports injuries among athletes and fitness enthusiasts is ankle sprains.⁵⁶ Recurrent ankle sprains and residual symptoms known as chronic ankle instability, is common among athletes. The affected target tissue of the ankle joint is comprised of approximately 70% collagen, which is responsible for the elasticity and firmness of tendons, ligaments and connective tissues. One study specifically aimed to investigate if collagen peptide supplementation could improve ankle stability in athletes with chronic ankle instability.⁵⁷ 50 male and female athletes were randomized to receive either 5 g collagen peptides or 5 g placebo for 6 months. The Cumberland Ankle Instability Tool (CAIT) and the Foot and Ankle Ability Measure (FAAM) were used to measure subjective perceived function of the ankle. Results showed that athletes who had been given collagen peptides reported a significant improvement in ankle stability and ankle function, and a 3-month follow-up revealed a significant decline in the number of ankle joint injuries. The reduction in ankle sprains re-injuries during the follow-up period suggests that collagen peptide supplementation in these athletes can provide notable benefits.⁵⁷

Achilles tendinopathy is another common injury in competitive as well as recreational athletes.⁵⁸ Achilles tendon ruptures can be insidious; although ruptured Achilles tendons tend to have degenerative changes giving rise to symptoms before rupture, many Achilles tendon ruptures take place suddenly without any preceding signs or symptoms.⁵⁸ One study found that collagen peptide supplementation for 6 months in people with chronic Achilles tendon symptoms who used to actively participate in sports activities may enhance the benefits of physical therapy and enable a faster return to sports training.⁵⁹

A third common type of sports injury is osteochondral lesions, which are small fractures of the cartilage surface in joints, primarily knees and ankles.⁶⁰ One study reported on a series of athletes engaged in a wide range of sports practice, who sought medical treatment due to painful exercise-related osteochondral lesions.⁶¹ Addition of collagen peptide supplementation to their physical therapy program for 17 months resulted in both symptomatic and structural improvement, as documented with magnetic resonance imaging (MRI) scans.

Effect of collagen peptide supplementation on facial skin
A second large area of collagen research is skin health. Experimental studies have shown that collagen peptides reduce aging-related changes of the skin by increasing collagen production and preventing its degradation, resulting in increased skin collagen content.⁶² Reparation of collagen fibers and reduction of skin sagginess has also been reported.⁶³

Several human studies have confirmed the skin benefits of collage peptide supplementation, such as improve skin hydration and skin elasticity.^41-44,64-66 For example, supplementing with collagen peptides vs. placebo for 8 weeks in women 40-59 years old has been shown to significantly increase skin hydration and collagen density, and reduce skin collagen fragmentation.⁴¹ These are all parameters that commonly deteriorate in aging skin.⁶⁷ Further analysis of the skin samples showed that subjects in the collage peptide group had increased collagen as well as glycosaminoglycan production.⁴¹

Another study in 114 women aged 45-65 years old found that collage peptide supplementation for 8 weeks resulted in a significant reduction in eye wrinkle volume (which was measured objectively) and increase in skin elastin content, compared to placebo.⁴² Reduced wrinkling was also seen in other studies.^43,44

Effect of collagen peptide supplementation on nails
Emerging research shows that supplementation with collage peptides can have a beneficial effects on brittle nails.⁶⁸ Brittle nail syndrome is a disorder characterized by increased nail surface roughness, raggedness (fraying of the edges), and peeling.^69,70 Affected people – about 20% of the population, women more so than men – usually complain that their nails are soft, dry, weak, easily breakable, and incapable of growing long.⁷⁰

In one study, 24 subjects (18-50 years old) were supplemented with collagen peptides for 6 months.⁶⁸  Results showed pronounced improvement in nail quality, a significant increase in nail growth rate by 15%, and a decrease in the frequency of broken, cracked or chipped nails. Most participants perceived their nails as stronger and were satisfied with the collagen peptide supplement.

Summary

A growing number of studies are supporting the beneficial effects of collagen peptide supplementation for joint function and mobility in various populations, including patients with osteoarthritis, athletes, fitness enthusiasts, and weekend warriors.

Fitness enthusiasts and athletes supplementing with collagen peptide can potentially improve their joint mobility and reduce joint pain experienced during and/or after intense workouts. It is notable that a recent International Olympic Committee (IOC) consensus statement on nutrition supplements for high-performance athletes acknowledges that collagen peptide supplementation, by resulting in increased collagen production, thickened cartilage and decreased joint pain, could potentially be useful for athletic populations.⁷¹

A second main effect of collagen peptide supplementation is an improvement in hallmarks of skin aging, such as skin hydration, elasticity, and wrinkling. While less studied, emerging data suggest that collagen peptides also can beneficially impact brittle nails.

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