Summary
Dr. Keith Baar is a Professor at UC Davis specializing in tendon and muscle physiology. His research revealed that mechanical strain activates mTOR signaling, a key regulator of muscle growth. He studied under Dr. John Holloszy, the father of modern exercise biochemistry. This episode covers tendon repair, collagen supplementation facts vs fiction, isometric vs eccentric exercises, and why the traditional RICE protocol may be outdated.
Key Points
- Tendons can be repaired with specific loading protocols - isometric holds are particularly effective for tendinopathy
- Collagen supplementation (15g with vitamin C) 30-60 minutes before exercise may enhance tendon repair
- The traditional RICE protocol (Rest, Ice, Compression, Elevation) is being replaced by MEAT (Movement, Exercise, Analgesics, Treatment)
- Load itself acts as an anti-inflammatory - complete rest can be counterproductive for tendon healing
- Growth hormone vs IGF-1: IGF-1 is what actually stimulates collagen synthesis in tendons
- Eccentrics work but isometrics may be better for acute tendon pain
- JAK inhibitors show promise for treating tendinopathy by blocking inflammatory pathways
- Tennis elbow and similar overuse injuries respond well to progressive loading protocols
Key Moments
Isometric holds cause tendon creep: why 30-second holds beat dynamic reps for tendon health
Baar explains that holding isometric positions causes tendons to relax and creep, forcing muscles to contract more. This loading pattern is key for tendon rehabilitation. Several baseball teams found rotator cuff isometrics unexpectedly improved ulnar collateral ligament health too.
"As I hold that position, my tendons start to relax. And as my tendon starts to relax, in order for me to stay there, my muscle has to contract more."
Take collagen + vitamin C before exercise, not after: tendons need nutrients during loading
Tendons and ligaments have poor blood supply and get nutrients through compression during exercise. Taking collagen with vitamin C before training delivers amino acids when the tissue needs them most. Growth hormone does nothing for engineered ligaments, but IGF-1 produces a beautiful dose response.
"If we take our engineered ligaments and we add growth hormone, it doesn't change their mechanics. But if we add IGF-1, we get this beautiful dose response."
Skip the ice and anti-inflammatories: light loading after injury beats compression protocols
Baar argues against using ice, compression, and anti-inflammatories after injury. Instead, light isometric loading like side lunges squeezes fluid from connective tissue and promotes natural recovery. Loading replaces everything these passive interventions try to do, without shutting down the healing response.
"I don't use the anti-inflammatories. I just add a little bit of minor load that's going to squeeze the liquids out of the connective tissues."
