When your patients deal with tendonitis or torn ligaments, they may take a long time to heal, even with proper guidance and direction from a practitioner.
The two categories of common problems with tendons and ligaments are inflammation and injury, which can occur separately or simultaneously. Some of the problems you’ve encountered in your patients probably range from tendonitis, tennis elbow, carpal tunnel syndrome, anterior cruciate ligament (ACL) injuries, ruptured Achilles’ tendon, plantar fasciitis, rotator cuff tendonitis, and (indirectly) dislocated joints. Even though they may be taking pain and inflammation relieving supplements, they may need a boost of specific nutrients to keep their ligaments and tendons strong.

Targeted Vitamins, Minerals and Herbs
Boswellia is a traditional botanical that does an excellent job relieving pain and inflammation. However, not all boswellia extracts are the same. The best is low in β-boswellic acid (which interferes with beneficial activity) and has higher levels of acetyl-11-keto-β-boswellic acid, or “AKBA”, to really boost the effectiveness of the extract.  But a good high-AKBA boswellia extract has been shown to inhibit the 5-lipoxygenase (5-LOX) enzyme, and reduce the degradation of synovial fluid in the joints.

Bromelain, an enzyme from pineapple, is well known for reducing pain and inflammation, but also has wound-healing applications, so it is excellent for muscle, ligament, and tendon repair as well. While your patients feel muscle tears as pain at first, bromelain can help relieve that pain, and shorten the duration of the “inflammatory phase” of tissue healing.  For people with blunt injuries and bruising, bromelain reduces swelling and pain whether they are at rest or on the move.

Active B Vitamins for an Active Life
Active B vitamins are in the same form that the body uses. Vitamin B6 as pyridoxal-5-phosphate (P-5-P) and vitamin B12 as methylcobalamin are two essentials for tendons, ligaments, and flexibility.

In foods or most supplements, vitamin B6 is found in one of three forms: pyridoxine hydrochloride, pyridoxal, or pyridoxamine. Inside the body, these forms of B6 have to be converted by the liver to the active form the body needs – P-5-P.  By consuming vitamin B6 in the active P-5-P form, conversion is no longer necessary, and the full benefits are available immediately after absorption. This is a form of B6 that is effective for carpal tunnel syndrome, if used consistently when symptoms first begin to appear.  It’s an excellent partner to magnesium, another must-have nutrient for tendon and ligament support.

Vitamin B12 is essential for nerve function, metabolism, energy and blood pressure health. The best form is methylcobalamin, the active form readily used by the body. Beyond its already impressive list of abilities, it has been shown to rebuild and regenerate damaged sciatic nerves. High dose methylcobalamin shows real promise in treating diabetic neuropathy and, with more research, may actually slow the progress of muscle wasting in amyotrophic lateral sclerosis as well.

Niacinamide is a form of niacin that prevents the degeneration of collagen —building block of joint tissue and cartilage—by reducing the expression of inflammatory cytokines. It may be a substrate for PARP, an enzyme that helps the body’s DNA repair tissues properly.

Vitamin C is crucial for collagen formation after bruises or wounds. As people get older, they can be deficient in vitamin C, stacking the deck against connective tissue repair because any deficiency weakens fibrous material in the body like tendons and ligaments right off the bat. After stressful exercise, or commonly recurring conditions like carpal tunnel, a vitamin C deficiency dramatically slows down the healing process, because vitamin C is essential to reconnecting the intracellular matrix.  The ascorbic acid form of vitamin C has been the most widely tested. The fact that vitamin C is a powerful antioxidant and fights reactive oxygen species (ROS) that can interfere with healthy muscle, ligament and tendon use is an additional plus to getting this ingredient on board in a patient protocol.

Manganese, Magnesium, and Zinc. The best forms of these minerals are amino acid chelated forms bound to glycine. They’re much better absorbed by the body, and in the case of magnesium, aren’t going to create the same potential intestinal issues in patients like loose stools that other forms of magnesium can.

Magnesium is an essential mineral for tendon and ligament health. First, it helps relax muscles, so patients don’t get tightness from activity or more recurring concerns like carpal tunnel syndrome. Deficiencies of magnesium, common enough in the diet because of refined foods and from vegetables and fruits grown in mineral depleted soils, can cause muscle cramps and numbness. As an extra bonus, magnesium has synergistic effects with bioactive B6 (P-5-P) and helps to facilitate its biological activities.

Zinc is a required trace mineral for protein synthesis, cell division, and proper DNA synthesis. It helps ensure that any tendon and ligament repair proceeds along the right track to help your patients become get active again, sooner, or to help them stay active in the first place. In models of wounds or tissue stress, zinc concentrations at the site peak after a few days, usually at the time you notice the strain most acutely.

Manganese may be the most important mineral your patients will ever take for their tendons and ligaments, because one of the signs of manganese deficiency in the body is weakened tendons and ligaments. Manganese activates a wide range of enzymes, and is necessary for building collagen, the major component in tendons and ligaments. Collagen is great at holding on to water, which allows connective tissues with high collagen content to remain hydrated and resilient.  Without manganese, the body cannot make any collagen or repair any connective tissue.

To keep tendons and ligaments strong, take 250 mg of boswellia, along with vitamin C, activated B vitamins (B6, B12, and niacin), magnesium, zinc, manganese, and bromelain.