Simple Exercises That Can Repair Tendons, Isometrics vs. Eccentrics, and More — Dr. Keith Baar

This episode explores the science behind tendon and ligament strength, injury, and rehabilitation, challenging conventional wisdom on treatments like rest, ice, compression, and elevation (RICE). Dr. Keith Baar discusses how mechanical stress shielding, often induced by boots and immobilization, can worsen tissue scarring by preventing load. He introduces the concept of a minimal effective dose of exercise, suggesting that short, optimized loading periods of around 10 minutes, separated by six to eight hours, can maximize connective tissue adaptation. More significantly, the conversation pivots to isometrics versus eccentrics, with Dr. Baar explaining that the benefits of eccentric loading often attributed to the movement itself are actually due to the reduced velocity, which is maximized in isometric exercises. For instance, overcoming isometrics, where force is gradually developed against a stable resistance, are presented as a safer initial approach for chronic injuries due to minimized jerk. The discussion further covers collagen synthesis, the potential drawbacks of BPC-157, and the impact of estrogen and testosterone on connective tissue stiffness, highlighting the importance of individualized training approaches. Emerging industry patterns reflected in this episode include a shift towards early loading post-surgery and a more nuanced understanding of inflammation's role in tissue adaptation.