The Definitive Guide to Collagen Synthesis: What It Is, Why It Matters, and How to Increase It Naturally

Collagen synthesis is a blanket term that describes the process in which your body produces and forms collagen structures.

It’s like muscle protein synthesis, but for your joints.

And just like you can exercise, eat, and supplement to increase protein synthesis (and muscle strength), you can do the same for your connective tissue. To be clear, this is not an article about collagen supplements.

They have a place in this conversation. But the topic of collagen synthesis deserves a much broader discussion that includes the fitness, lifestyle and environmental factors that affect it.

And how that relates to the healing process from injuries, tissue damage, and day-to-day exercise-induced stress.

Though knowledge of the collagen synthesis process provides insight into skin aging, vision and even lung health — we’re going to focus exclusively on connective tissue (e.g. cartilage, tendons, ligaments).

Our goal is to uncover what you can do to boost collagen production and prevent collagen degradation for strong, injury-proof joints.

This article provides a broad-strokes view of the collagen synthesis process and arms you with tactical knowledge of how to leverage it for recovery, injury prevention, and optimal pain-free performance.

Why should you care about collagen synthesis?

Because the degree to which your body produces, forms, and degrades collagen directly impacts:

•  injury recovery time
•  tissue repair quality
•  future injury risk
•  mobility and overall joint function

Collagen synthesis doesn’t just matter during the 6-12 weeks you’re recovering from a sprain, strain, or tendinopathy. It dictates the strength and resilience of your joint tissues for a lifetime.

Interestingly, much of what we know about collagen synthesis comes from in-vitro studies (performed on cells in test tubes) and the meat industry, believe it or not.

This is good and bad.

Good because our friends in the meat industry have no vested interest in which supplements you do or don’t buy. They’re simply trying to understand the science behind collagen — and what that means for tissue quality.

On the other hand, animal studies are not as reliable as placebo-controlled human studies.

Luckily for us, the science has advanced leaps and bounds in the last 20 years.

But common knowledge, exercise programming recommendations, and nutrition strategies for optimizing collagen health hasn’t caught up yet.

There's a lot more to collagen synthesis than just taking supplements.

Collagen Synthesis and Soft Tissue Injuries

In high-contact sports like football, soft tissue injuries (muscle, tendon, ligaments, etc.) account for about 70% of visits to physical therapists. Most of those involve connective tissue rather than just muscle, with at least half coming from overuse injuries rather than sudden acute injuries.

According to the Centers for Disease Control (CDC), these figures roughly apply to youth and weekend-warrior adults as well as serious athletes:

• Overuse injuries account for about half of all sports injuries in middle school and high school age students
• Since 2000, there’s been a fivefold increase in the number of shoulder and elbow injuries among youth baseball and softball players
• The parts of the body most frequently injured while engaging in sports and recreation activities were lower extremity (42.0%), upper extremity (30.3%), and head and neck (16.4%)
• More than half of all sports injuries are preventable

Bottom line: improvements in the knowledge and application of joint health management lags behind muscular strength, endurance and performance advancements.

As I’ll explain, this is a big part of the problem.

We’re building bigger, stronger muscles. Faster, more powerful athletes. But we’re doing it on the scaffolding of stiff, injury-prone joint structures.

Soft tissue injuries account for the vast majority of sports, fitness, and lifestyle related injuries. With at least half of those coming from overuse injuries (and likely much more when you consider traumatic injuries that were preceded by gradual breakdown from overuse).

They’re the #1 cause of athletes missing playing time, fitness enthusiasts sitting on the sidelines, and general joint pain in the general population.

While many sports medicine doctors and physical therapists still cling tightly to the dogmatic approach of anti-inflammatory drugs, rest and ice — the science of collagen synthesis provides insight into how we can do better.

And just in case you’re thinking that you would have heard about this by now if it really mattered, here are a few examples of what you can do to optimize joint health via collagen synthesis:

• A study published in the Scandinavian Journal of Medicine and Science in Sports demonstrated that eccentric exercise (focused on the lowering portion of the movement) increased collagen synthesis rates in soccer players with chronically injured Achilles tendons, and that there is a direct relationship between collagen synthesis and injury recovery in human tendons. This means that people with chronic injuries can use a specific exercise technique to speed up tissue repair.

• Studies show supplementing with Vitamin C after an injury (or when chronic tendinopathy is present) can reduce oxidative stress, help manage inflammation levels, increase bone healing rates, and increase type I collagen synthesis. Vitamin C deficiency leads to collagen structure malformation — suboptimal connective tissue patterns that are weak, stiff and prone to injury.

• In a small placebo-controlled study, 5-15 grams of collagen protein enriched with Vitamin C doubled collagen synthesis versus the placebo group, indicating that this supplement combination coupled with exercises that target at-risk joints has the ability to improve connective tissue strength and prevent injury.

There’s real potential here.

Not just in terms of what supplements to take, but also how (and when) to exercise in a way that bolsters collagen synthesis in injury prone joints, and what lifestyle variables hinder the repair process.

Researchers from respected institutions like The American Journal of Clinical Nutrition and The Gatorade Sports Science Institute have encouraged the leveraging of collagen synthesis for injury repair and joint health maintenance.

If you’re battling through an injury right now, you feel like you’re “injury prone”, or are suffering from joint pain and tendinopathy — understanding and applying the principles behind collagen synthesis can be the difference between getting back to full function, and staying on the sidelines.

In order to understand the collagen production and formation process, we first have to understand what collagen is.

What is collagen?

Despite the typical oversimplified explanations of what collagen is, it’s actually quite a bizarre molecule.

In its natural form, collagen consists of three coiled subunits containing exactly 1050 amino acids. These coils are wound together into a characteristic triple helix structure. 

Collagen is the second most abundant substance in the human body (behind water), accounting for about 30% of the total protein in your body.

Its function is to form an extracellular matrix that provides structural support and a mechanism for transmitting force for virtually all organs and soft tissue (including joints).

As you age, your body produces less and less collagen.

By age 60, your ability to produce collagen has decreased by 50%.

This leads to aging joints, saggy skin, and loss of lean muscle tissue.

This is why the collagen supplement industry is booming (despite whether the claims being made by the supplement marketers are substantiated), and why preserving collagen mass in joints and skin is an important part of healthy aging.

What’s the difference between Collagen Type I, II, III, and the rest of them?

There are several types of collagen, but upwards of 90% of the body’s collagen is made up of Types I, II and III.

Most collagen protein supplements are also made up primarily of Types I and III.

Type II collagen (CII) is the primary component of joint cartilage, and the most bioavailable version when taken orally, requiring a much smaller dosage than Types I and III to be effective for improving joint health. Upwards of 90% of your body's extracellular matrix (mix of compounds that provide structural support to joints) is made of Type II collagen.

Is collagen the Holy Grail of Anti-Aging, Fountain of Youth, or Tree of Never-ending Life?

No.

Collagen supplements are not any of those things.

In fact, collagen is an incomplete protein — meaning it doesn’t possess all the amino acids your body needs to maintain health. It should not replace dietary protein.

Plus, most are cheap and not readily absorbed by the body.

Collagen has been grossly over-marketed. It’s popularity is largely based on the fact that low-quality sources are cheap to manufacture, making it a cash cow for supplement companies.

But, there is solid research behind it for supporting joint health and skin elasticity.

Certain types, taken at certain times, do appear to optimize collagen synthesis — especially when combined with other components that allow it retain its natural structure (undenatured). More on this in a second.

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Now that we have the obligatory “Collagen 101” lesson out of the way, let’s briefly look at the four steps of collagen synthesis.

Each one plays a vital role in the growth, remodeling, and accumulation of collagen.

This is important not just to impress your friends with some esoteric biochemistry knowledge — but also because understanding how different environmental factors affect these four steps gives you insight into building healthy joints.

It provides context into the specific recommendations we make below, and why they work.

What is collagen synthesis?

Collagen synthesis is a blanket term that describes how your body produces, aggregates and forms collagen structures.

It has four distinct processes. Without getting lost in the weeds, here is a quick overview:

How is collagen synthesis measured?

In animal studies and in-vitro (petri dish) studies, collagen synthesis is often measured by amino acid labeling techniques.

For example, animals are given amino acids with distinct signatures that researchers can track, then the total amount of those amino acids that is assimilated into joint structures is used as a measure of collagen synthesis.

Methods like this are problematic, because they don’t take into account collagen degradation rates, and don’t always translate to human joint function.

However, in placebo-controlled environments, methods like this can tell us whether or not an experimental variable (e.g. exercise or a supplement) made a significant impact. And lead us into more relevant human research.

Researchers also measure specific collagen propeptides in human skin before and after wound treatments to determine rates of collagen synthesis.

Blood tests that track collagen propeptides have been used in studies on exercising athletes to measure collagen synthesis as well.

What decreases collagen production and synthesis?

Before worrying about how to boost collagen synthesis, first make sure that you aren’t doing anything to hinder it.

There’s a long list of factors here. Some are out of your control, but you can influence most:

1. NSAID Usage

NSAIDs like ibuprofen and naproxen reduce collagen mass at injury sites, increasing injury rates later by up to 25%.

A study published in the Annals of Physical and Rehabilitation Medicine demonstrated that though NSAIDs effectively relieve joint pain and reduce inflammation in the short term (7 to 14 days), they also delay healing times, increase re-injury rates by up to 25%, and reduce collagen mass at injury sites.

Sports medicine physicians often treat athletes in pain with non-steroidal anti-inflammatory drugs (NSAIDs). However, there is lack of high-quality evidence to guide NSAID use. Their adverse effects have clinical relevance, and their possible negative consequences on the long-term healing process are slowly becoming more obvious....

If you take nothing else from this article, remember this:

NSAIDs are not good for your joints long-term.

Especially if you take them regularly.

There are natural alternatives that are just as effective without the side effects.

2. Steroid Hormones (Glucocorticoids, Corticosteroids)

The use of steroid hormones (taken orally) and cortisone injections is a common first line of defense recommendation from doctors and therapists.

While they may help relieve pain and inflammation in the short-term, they have  inhibitory effects on collagen synthesis.

Interestingly, this effect has been observed in connective tissue, but not muscles. Indicating that steroid hormones may not be as bad for muscle health, but have long-term negative effects on joint integrity.

Unfortunately the people who benefit most from steroid hormone usage in the short-term (pain relief) are the same individuals who are hurt most in the long-term (failure to repair damaged tissue optimally).

3. Lopsided Exercise Habits

An exercise routine that emphasizes explosive movements like plyometrics and dynamic effort strength training provide a more potent adaptation for muscle than tendons. This results in an imbalance between muscular force potential and tendon resilience, which leads to tendon injuries and tendinopathy.

Young volleyball players, for example, are prone to tendon disorders largely due to the explosive nature of training and competition, and comparatively little amount of movements that are known to trigger tendon adaptations (like isometric exercise and slow movement resistance training).

Simply put, muscles and tendons differ in the types of training they respond to and their timelines for recovery. Understanding these differences is key to establishing balance between muscular force potential and tendon strength and reducing risk of tendon (or muscle) injury. While neglecting to train in ways that boost tendon strength doesn’t necessarily reduce collagen synthesis, it does put you at risk of injury.

4. Disuse (Sedentary Lifestyle)

Disuse leads to a decrease in total collagen in your body, while resistance-focused exercise increases the rate of collagen deposition (formation).

During injury recovery periods, a reduction in activity leads to a reduction in collagen.

Which further increases injury risk. And so the cycle continues.

5. Disease and Genetic Disorders

There are over 200 connective tissue disorders that impact collagen synthesis.

Autoimmune disorders also negatively impact it. Many of these conditions cause the body to attack its own tissues, speeding up collagen degradation.

6. Ultraviolet Radiation (UV Ray) Overexposure

UV rays pertain more to skin health than joint health, but it’s worth mentioning because of the staggering effect on collagen metabolism. According to an article published in the journal Amino Acids, even a one-time exposure decreases collagen in skin. The take home? Avoid tanning beds and get natural sunlight (but don't allow yourself to become sunburnt).

7. Age

Collagen production decreases with age. By age 60, your ability to produce collagen has dropped by around 50%.

8. Hormonal Imbalances

An imbalance of testosterone and estrogen can inhibit collagen synthesis.

Though the research on how estrogen impacts collagen synthesis is conflicting, it appears that low levels of estrogen (especially in aging populations) do inhibit collagen synthesis in joints and skin.

However, too much estrogen also has a detrimental effect on collagen health because it decreases collagen stiffness too much, making it easier for connective tissue to bend and tear.

In sum, just about everything decreases collagen synthesis, right?

Low carb diets do, but so does excess sugar consumption.

NSAIDs and anti-inflammatories decrease collagen synthesis, but then again so does chronic inflammation.

Could I have just summed this article up by saying “all things in moderation..”?

Not exactly. Like most sensible solutions, the answer lies somewhere in the middle of two extremes.

But science also shows us some specific tactics you can employ to beef up your collagen synthesis for strong, supple, injury-proof joints.

7 Ways to Increase Collagen Synthesis

1. Let your body do its job 

In response to injury and tissue damage, your body naturally triggers collagen biosynthesis.

You don’t have to do anything to make that happen. Other than get hurt, of course.

In fact, suppressing inflammation too much during the first week after an injury could hinder collagen biosynthesis and nutrient delivery to the tissues that need it most.

Only use ice and pain meds during the first week after injury for pain management or to control excess swelling.

Don’t try to quash inflammation just for the sake of quashing it.

After the first week, keeping inflammation in the healthy range becomes more important for aiding the healing process — especially as you return to normal activities and exercises that could trigger ongoing inflammatory flair ups.

2. Use Heavy Slow Resistance Training (HSR) to boost connective tissue remodeling.

Think about the last time you did a belly flop into a swimming pool.

It didn’t feel good, did it? Belly flops feel more like being smacked with a giant plastic sheet than falling into a liquid pool.

That’s because in response to sudden force water molecules strengthen the tension that connects them, creating a massive surface area capable of knocking the wind out of you.

Now picture yourself standing in the shallow end of the pool.

With one hand, you slowly drag your arm horizontally through the water.

This time, the water acts more like water.

The slow velocity of your hand movement allows the water molecules to move individually, rather than joining forces into a belly-smacking sheet of liquid pain.

This is exactly how collagen fibers in your joints work.

If you lift weights forcefully or move explosively, your connective tissue tenses up into a rigid sheet. And thankfully so. Or your joints would disintegrate every time you move quickly.

This why using slow, deliberate motions while lifting weights helps activate collagen remodeling — breaking apart old junky cross-links, increasing collagen turnover, and allowing your body to rebuild stronger connective tissue structures.

You can put this into your current training schedule by performing 2-3 sets per week of an HSR exercise that targets a weak, or hyper-stiff, joint.

We’ll use the example of performing barbell squats to help support connective tissue remodeling in the hips, knees, and ankles.

At the end of your normal leg workout routine, perform 2 sets of 6-10 repetitions with the following tempo (5/1/5/1):

• Eccentric Phase (lowering the weight): 5 seconds
• Pause in bottom of squat: 1 second
• Concentric Phase (lifting the weight): 5 seconds
• Repeat

Use a weight that’s light enough to control and that doesn’t cause joint pain. Remember, your initial goal with HSR isn’t to build muscle size or strength  — it’s to realign and renew connective tissue fibers.

Whether you have a nagging joint that just won't recover, you feel like your connective tissue can’t keep up, or maybe you are just plagued by overall joint discomfort — optimizing collagen synthesis can help you build and maintain strong, resilient joints.