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cofactor · 3
Joint cartilage has no blood vessels and tendons have very little blood supply, so both depend heavily on load for nourishment and repair: cartilage exchanges nutrients as it is squeezed and released, and tendons need load to stimulate collagen synthesis. For them, long rest is not protection but decline; the signal that triggers repair is the load itself.
Vitamin C is an essential cofactor for making collagen: both prolyl and lysyl hydroxylase depend on it, and without it hydroxyproline cannot be made, so collagen's triple helix will not hold together. The reopening wounds and fragile connective tissue of scurvy follow exactly this path.
Making collagen needs a good supply of amino acids, especially glycine and proline, and that comes first from eating enough protein each day. In a small trial of 8 people, a gelatin supplement only raised a blood marker of collagen synthesis; whether injuries healed faster was not measured.
regulates · 2
Tendons repair under load: mechanical loading stimulates collagen synthesis and tissue remodeling, while keeping them still works against recovery. That is why advice on soft-tissue injury has moved from RICE, centered on rest and ice, to PEACE & LOVE, which calls for early, gradually increasing load.
Gluteal tendinopathy is a primary local source of lateral hip pain, and it follows the same rule as other tendon problems: mechanical load drives the biology inside a tendon, and left unused, the force it can bear only shrinks. What differs is that moving the thigh toward the midline presses these two tendons against bone, so the exercise has to load them in tension while avoiding that compression; in one randomized trial, education plus exercise brought more overall improvement than a steroid injection at one year, with similar pain.