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Understanding Your Tendon Health and the COL5A1 Gene

Tendons connect muscle to bone and play a key role in joint stability, movement, and injury prevention. The COL5A1 gene helps control how collagen fibrils form and organize inside tendons. Collagen quality and structure influence tendon strength, flexibility, and how well tissues recover from stress. Variations in a common COL5A1 genetic marker, rs12722, are linked to different risks for tendon and ligament injuries.

How this gene affects your tendons

  • COL5A1 influences collagen fibril size and alignment. Strong, well-organized fibrils make tendons more resilient to load and strain.
  • Different rs12722 genotypes correlate with variable tendon properties and injury risk.
  • Genetics is only one part of the picture. Training, nutrition, hydration, movement patterns, and recovery practices matter a great deal.

General recommendations to support tendon health

  • Exercise: Combine progressive strength training for surrounding muscles with targeted tendon loading exercises (slow eccentric work for tendinopathy prevention and rehabilitation).
  • Flexibility and mobility: Regular controlled stretching and dynamic mobility to maintain joint range without overstretching tendons.
  • Progression and load management: Increase intensity and volume gradually. Avoid sudden jumps in loading or repetitive overuse.
  • Nutrition: Prioritize adequate protein to supply amino acids for tissue repair, and vitamin C to support collagen synthesis. Consider collagen or hydrolyzed collagen supplementation if appropriate.
  • Hydration: Maintain good hydration to support tissue health and recovery.
  • Recovery: Prioritize sleep, active recovery, and appropriate off-days to allow tendon remodeling.
  • When to consult a provider: Seek assessment for persistent tendon pain, swelling, or functional loss. Your healthcare professional can tailor testing, imaging, and treatment.

Genetic Interpretation: rs12722 (COL5A1)

Use the sections below to see what your genotype may mean for tendon resilience and practical steps to protect and optimize tendon health.

2 effect alleles — CC genotype

What this means

If you have the CC genotype for rs12722, you carry two copies of the effect allele. This genotype is associated with more favorable tendon characteristics and a lower relative risk of tendon and ligament injuries compared to other genotypes. Your COL5A1 variation likely supports better collagen fibril formation, which can improve tendon resilience and stress tolerance.

Actionable tips

  • Maintain a balanced routine of strength training and flexibility work to protect this genetic advantage.
  • Include tendon-specific loading sessions 2 to 3 times per week, using slow eccentric or heavy slow resistance protocols when appropriate.
  • Keep protein intake adequate for repair — aim for regular high-quality protein servings across the day.
  • Consume vitamin C daily through food (citrus, berries, peppers) or a supplement if dietary intake is low.
  • Consider collagen peptides around training sessions to support collagen synthesis, paired with vitamin C.
  • Monitor training load and avoid sudden increases that can outpace tissue adaptation.
1 effect allele — CT genotype

What this means

If you have the CT genotype, you carry one copy of the effect allele. This indicates a moderate genetic predisposition: your tendon properties may be intermediate, neither as protective as CC nor as elevated risk as TT. Your tendons may require more attention to preventive care, especially if you take part in high-load or repetitive sports.

Actionable tips

  • Prioritize preventive tendon care: incorporate both strength and mobility work into your weekly routine.
  • Include progressive tendon-loading exercises, emphasizing controlled tempo and gradual increases in load.
  • Optimize nutrition with sufficient protein and daily vitamin C to promote collagen production.
  • Consider low-dose collagen supplementation if you have high training loads or are recovering from minor tendon discomfort.
  • Limit repetitive overload: vary activities, cross-train, and build in rest periods to reduce cumulative tendon stress.
  • Pay attention to early signs of tendon irritation — soreness that worsens with use or does not recover with short rest warrants evaluation.
0 effect alleles — TT genotype

What this means

If you have the TT genotype, you carry two copies of the non-effect allele. Research links this genotype with higher susceptibility to tendon and ligament problems, such as Achilles tendinopathy, tennis elbow, and ACL injuries. This variation may influence collagen fibril formation in a way that reduces load tolerance and recovery efficiency.

Actionable tips

  • Adopt a conservative and structured training approach: prioritize gradual load progression and technique to reduce injury risk.
  • Emphasize tendon-specific strengthening using eccentric and isometric exercises that are proven to improve tendon capacity.
  • Ensure daily vitamin C and adequate protein intake to support collagen repair and remodeling.
  • Consider collagen peptide supplementation, particularly around training sessions, to support collagen synthesis when combined with vitamin C.
  • Increase warm-ups and implement movement screening to correct biomechanical factors that load tendons unevenly.
  • Limit repetitive high-volume or high-impact activities when possible, and plan recovery days and cross-training options.
  • Consult a physical therapist or sports medicine provider for personalized programs if you have recurring tendon symptoms or a history of tendon injury.

Diet, supplements, and lifestyle — practical guidance

  • Protein: Aim for regular servings of protein (eggs, fish, poultry, legumes, dairy, or plant-based alternatives). Typical targets vary by activity level, but spreading protein across meals supports tissue repair.
  • Vitamin C: Consume fruits and vegetables rich in vitamin C daily, or use a supplement if dietary intake is low. Vitamin C is a key cofactor for collagen formation.
  • Collagen supplements: Hydrolyzed collagen or collagen peptides may help provide amino acids that support collagen synthesis. Best when taken with vitamin C and timed near training sessions.
  • Omega-3s: Anti-inflammatory omega-3 fatty acids from fatty fish or supplements can support recovery, especially after intense training.
  • Hydration and sleep: Both are essential for tissue repair and overall recovery. Aim for consistent good sleep and adequate daily fluids.

When to get further testing or clinical care

  • Persistent tendon pain, swelling, or reduced function despite rest and basic care.
  • Recurrent tendon injuries or a family history of connective tissue disorders.
  • Before beginning an intense training program if you have prior tendon injuries — a professional assessment can reduce risk.
  • Your healthcare provider may recommend imaging, blood tests for inflammatory or metabolic contributors, or a tailored rehabilitation plan.

PlexusDx provides genetic education to help you understand predispositions and possible preventive strategies. This information is educational only and does not replace medical advice. Always consult your healthcare provider before starting new supplements, making significant changes to exercise, or pursuing medical testing or treatment.