Targeted Supplementation for Recovery and Performance

Netherlands’ Femke Bol in action before winning the Women’s 400m Hurdles Final REUTERS/Aleksandra Szmigiel

Collagen and creatine have long been staples in the aesthetics and bodybuilding world, frequently promoted by fitness influencers, gym enthusiasts, and celebrities alike. However, beyond the pursuit of muscle tone and youthful skin, these two supplements are gaining significant attention in the world of sports and rehabilitation.

Over the past decade, a growing body of research has begun to uncover their potential benefits not just for enhancing athletic performance, but also for supporting musculoskeletal recovery and injury rehabilitation. From tendon health and joint integrity to muscle regeneration and strength restoration, collagen and creatine may play a far more meaningful role in clinical practice than previously thought.

“Creatine enhances strength, reduces muscle damage and soreness post-exercise without adverse reactions.”

Collagen

Practitioners and athletes primarily consider hydrolyzed collagen, also known as collagen peptides (CP), for its anti-aging properties. Used as a nutraceutical to improve skin elasticity and hydration and, in turn, reduce those fine lines and wrinkles. However, the jury is still out on whether there is sufficient evidence to support ruining a morning coffee⁽¹⁾.

Excitingly, collagen is showing promise in this role in reducing chronic pain and facilitating injury recovery. With younger, athletic populations being the primary cohort represented in the literature, the findings are particularly noteworthy. In 2023, researchers from Florida State University in the USA published a study in the International Society of Sports Nutrition, showing promising results in favor of collagen peptide use in middle-aged, active individuals with either periodic or consistent chronic joint-related or musculoskeletal pain⁽²⁾.

The researchers included 86 middle-aged males and females (ages 40-65) who engaged in more than four hours of planned and consistent physical activity per week over 15 years. They conducted a double-blind, randomized controlled trial and tested three groups (placebo, 10g/day, and 20g/day) over three, six, and nine months to determine the outcomes in terms of pain, function, and physical and mental health. Naturally, not all participants made it the full nine months. The researchers used the Knee and Osteoarthritis Outcomes Score (KOOS), the Veterans Rand 12 (VR-12), and a series of questions around physical activity as their outcome measures. The participants logged their diet, and the researchers ensured there were no discrepancies in kcal or macronutrient intake across the group.  

Their findings suggest that 10g/day appears to be the optimal dosage for injury recovery, while 20g/day may be ideal for maintenance and a reduction in the risk of injury. The participants also demonstrated improved mental health scores over six to nine months with these dosages. The use of CP supplementation is most effective whilst in conjunction with moderate to high levels of activity (> 188 mins a week), suggesting that the increased blood flow and collagen production turnover during exercise, encourages the delivery of the amino acids and peptides to connective tissue, which is generally poorly vascularized.

Interestingly, the placebo group reported higher degrees of pain as activity levels increased, which aligns with the literature indicating that higher levels of activity can lead to increased pain levels. Highlighting that the use of CP can mitigate exercise-related pain. In addition, females appear to benefit more than males, suggesting a hormone link⁽²⁾.

In female athletes, high levels of circulating oestrogen are linked to a higher risk of injury. Therefore, supplementing with collagen peptides (30g) prior to exercise during this phase of menstruation may encourage exercise-induced collagen synthesis, which could reduce this risk⁽³⁾.

In 2025, researchers from the Health Science Research Center in Japan conducted a randomized controlled trial, comparing 50 participants taking 10g of CP with a placebo over 16 weeks. The researchers assessed medial gastrocnemius fibre and Achilles tendon stiffness before and after intervention and demonstrated that daily CP use increases muscle and tendon stiffness in healthy young males⁽⁴⁾. Furthermore, CP use in Achilles and Patellar tendon pathologies accelerates healing and return to sport⁽⁴⁾.