The Mechanisms of Tendon Weakness and Strengthening Techniques: A Systematic Literature Review

Abstract

Background

Tendon weakness contributes to musculoskeletal injuries, especially in athletes and active individuals. Understanding tendon damage mechanisms and strengthening strategies is important for prevention and rehabilitation.

Objectives

This systematic review aims to evaluate factors causing tendon laxity as well as strengthening strategies through mechanical loading, exercise, and nutrition.

Methods

Following PRISMA guidelines, a literature search was conducted across databases from Scopus, PubMed, WOS, and ScienceDirect.

Results

Results suggest that excessive mechanical strain, poor tendon adaptation, and muscle-tendon imbalance contribute to tendon weakening and increase the risk of injury. Eccentric training, isometric loading, and personalized tendon loading are effective in increasing tendon endurance. Collagen supplementation with vitamin C also supports tendon adaptation.

Conclusion

However, variability in study methodology and limitations of long-term analysis hinder standardized protocols. An approach that combines mechanical loading, targeted training, and optimal nutrition is necessary to improve tendon health. Further research is needed to refine the intervention protocol and evaluate its long-term impact.