Although numerous supplements lay claim to the title of “Best Supplement for Connective Tissues“, the truth might surprise you.  As always, the best thing you can do for any health condition is not to put too much faith in much-hyped supplements, but instead, base your entire diet and way of eating around whole foods.  By the way, this is great advice even if you do not have a health “condition“!


If you have read through any of Destroy Chronic Pain, you have come to realize that although the connective tissue problems that I deal with each and every day in my clinic are not typically caused by inflammation, they definitely attract inflammation.  This is important to know, because frankly, most people (doctors included) do not understand tissue injury, nor do they understand the corresponding inflammatory process that follow it.

In a nutshell, “Inflammation” is a group of chemicals that reside naturally inside of your body’s cells.  When cells die, they rupture their contents, including these inflammatory chemicals, into the extra-cellular fluid (the fluid that is outside of the cells).  When tissue injury occurs, there are a lot of cells dying and rupturing their contents.  The greater the tissue injury, the more inflammatory chemicals get dumped into a given area.  Although these inflammatory chemicals are absolutely vital for healing; too many of them can wreak havoc, actually causing excess scarring and adhesion (not to mention pain).  And this is just the beginning!



If you want to understand the most current model for treating injuries to the ELASTIC, COLLAGEN-BASED CONNECTIVE TISSUES, you have to understand the following sentence.  The suffix “itis” means inflammation.  The suffix “osis” means degenerative or deranged. To get a better handle on this concept, listen to what one of the world’s leading tendon researchers said almost a decade ago.

Tendinosis, sometimes called tendinitis, or tendinopathy, is damage to a tendon at a cellular level (the suffix “osis” implies a pathology of chronic degeneration without inflammation). It is thought to be caused by micro-tears in the connective tissue in and around the tendon, leading to an increased number of tendon repair cells. This may lead to reduced tensile strength, thus increasing the chance of repetitive injury or even tendon rupture. Tendinosis is often misdiagnosed as tendinitis due to the limited understanding of tendinopathies by the medical community.

Tendon researcher, Dr. GA Murrell from an article called, “Understanding Tendinopathies” in the December 2002 issue of The British Journal of Sports Medicine.

As you can tell, this concept of “osis” as opposed to “itis” is nothing new.  The medical community has known since the late 1980’s that problems with the ELASTIC, COLLAGEN-BASED CONNECTIVE TISSUES are rarely caused by inflammation (itis) alone, but are instead caused by a derangement or degeneration (osis) of the tissue.  These “osis‘” are usually caused by trauma or overuse.  This is why the receipt or E.O.B. from your doctor visit will rarely have on it a diagnosis of tendon(itis), but will instead say, “tendon(osis).  If you have read our page on TENDINITIS, you already understand all of this.  If you have not read this page, go back and read it — it has pictures that are truly worth a thousand words!


If you are one of the individuals who has spent significant time suffering with chronic DEEP SOMATIC PAIN that is the result of injuries to ligaments, tendons, muscles, fascia, or bone, you already know how it affects you!  Doctors have been, and still are, knowingly treating connective tissue problems using a model that was scientifically outdated decades ago.  Instead of dealing with the “osis“, they are stuck in a time warp treating “itis“.  They typically use things like anti-inflammatory drugs, NSAIDS, and Cortico-Steroids that actually destroy collagen-based tissues!  Again, tissue injury is not caused by inflammation, it attracts it!

Is this to say that inflammation should be ignored?  In the words of the Apostle Paul in Romans 9, “God Forbid!”  But, if your doctor is treating you with drugs that attempt to control these inflammatory chemicals, you are covering symptoms (“itis“) without ever addressing the underlying cause (“osis).  

One of the many dirty little secrets of modern medicine is that anti-inflammatory drugs actually cause connective tissues to heal improperly (weaker and less elastic by 30 to 40%).  They also cause liver problems, kidney problems, cardio vascular problems, and GI bleeds as well.   Let’s not forget that at least 30,000 – 45,000 deaths per year in America can be directly traced back to these very medications.  Gulp! (See our ANTI-INFLAMMATORY MEDICATIONS PAGE).


If you are already eating an ANTI-INFLAMMATORY DIET, the single most important supplement to take for Chronic Pain of any type; and particularly those that involve DEEP SOMATIC PAIN caused by injury to the elastic, collagen-based connective tissues (ligaments, tendons, muscles, and fascia), as well as bone, is Pharmaceutical Grade Fish Oil (PGFO).  Current research shows that Joe-Average American is getting about 1/30th of the Omega Three fatty acids that are required by the body for optimum health.  Hold on.  I doubt that you picked up on that the first time, so I will repeat it.  Current research shows that the average American is getting about 1/30th of the Omega Three fatty acids needed to maintain health.

Omega Three fatty acids are incredibly anti-inflammatory.  They help people not simply with whole-body inflammation (see our SYSTEMIC INFLAMMATION web page), but they attack local inflammation as well.  Our number one selling supplement for the last decade and a half has been Pharmaceutical Grade Fish Oil (PGFO).  I would love to tell you that the majority of our patients take it because they have read the research and realize that controlling inflammation is good for everything from heart conditions, to bowel troubles, to depression, to skin problems, to mental acuity, to colitis, to diabetes, etc, etc, etc.  The truth is, PGFO is good for anything that ends with “itis” (inflammation).  Far and away, the reason that most people take our PGFO is because it helps them with the pain and dysfunction of arthritis.  ARTH (joint), ITIS (inflammation).


The next step is to get some specific nutrition into the injured area so that the tissue actually has the raw materials available to repair and regenerate injury to the elastic, collagen-based connective tissues.  Standard Process makes a wonderful product called Ligaplex (LIGAPLEX I for acute, LIGAPLEX II for chronic).  Whole Food Vitamin C (not the fake 500 or 1,000 mg per tablet stuff) is critical for healing any kind of connective tissue.  Ligaplex has this and other vitamins / minerals / nutritional complexes in it.

Because most of these tissues that we are discussing, attach or “anchor” to bones, a good calcium supplement is in order as well.  For you ladies that are being sold Bone Density Studies in order to get you started on the so-called “bone building drugs” —- drugs that actually cause osteoporosis; pay attention!  Most calcium supplements are crap! (can I really say that on my own website?)  American women get more calcium than the women of any other country in the world —- yet we have the highest rate of osteoporosis.  Do you detect a snow job taking place?

Standard Process makes a product called CALCIFOOD (wafers or powder).  It is the only product like it on the planet —- a cold-processed, whole-bone, bone meal supplement.  DO NOT WASTE YOUR TIME WITH CALCIUM ALONE! (especially if it comes from rocks or shells).   I realize that this web page is specifically for dealing with nutritional supplements for the elastic connective tissues, but ladies, please check out our OSTEOPOROSIS PAGE.  Bone is a load-bearing Connective Tissue that is important in our discussion because it provides the attachment or anchor points for the other connective tissues — particularly tendons.

As strange as it sounds, digestive enzymes can play a huge part in cleaning up scar tissue.  The part of the enzyme complex that breaks down proteins is called a Proteolytic Enzyme.  These Proteolytic Enzymes actually attack scar tissue (which is made of deranged collagen proteins).  I have a whole paper I can send you on digestive enzymes upon request.

Another great line of products consist of Glucosamine Sulfate, Chondroitin, and MSM.  Don’t waste your time (or money) buying these products separately.  We carry a product that has them all-in-one.  It also contains about a half dozen anti-inflammatory herbs.  Although Glucosamine is critical for people with cartilage problems (a load-bearing connective tissue), it is also good for the elastic connective tissues that have to deal with tensile (pulling) forces.

Still another supplement that is excellent for cartilage, as well as the ELASTIC, COLLAGEN-BASED CONNECTIVE TISSUES, is Powdered Collagen.  There are many forms of this stuff on the market that all claim to be better than the next.  You can take Knox Gelatin (pure hydrolyzed collagen) and get similar results.

Get your Vitamin D from sunlight when you can.

For more information on supplementation, go to


  1. Dian

    Thank you for the article! I’ll ask my local chiropractor who sells Standard Process for Ligaplex. Have a healthy and wonderful day! :)

  2. Ian

    I am 17 years old. I have a chronic tendon injury (6-7 months). The injury hurts in the inside hamstring tendons behind my knee. I am a competitive swimmer, and the injury was caused by repetitive up and down kicking. There is pain when I kick up towards the sky as that is when my hamstring tendon is activated. I have been to physical therapy (didn’t work) and I have been doing Active Release Therapy for about 3 weeks (6 appointments). Also, during the course of the day when I walk and sit there is mild pain.

    As the months progressed with my injury I decreased the amount of stress my hamstring underwent by not kicking sometimes. Before the injury I swam about 7,000 yards a day; (used my legs for all of it) I currently kick around 500-1000 yards a day. After that amount, the pain doesn’t become unbearable but it definitely kicks in, so I stop kicking.

    I have worked a lot on activating my glute on the up kick, and now my glutes fire perfectly. However, it is impossible not to use hamstrings on the up kick, so my hamstrings continue to hurt even though I use my glutes a lot.

    So I tried eccentric hamstring curls, where I used 2 legs concentrically, and then I eccentrically lowered with only 1 leg. I did this with a 5 pound weight for 10 reps each side every day for 5 days. My hamstring pain became worse, so I stopped. Then, two weeks later I tried the same thing with 2.5 pound weight, and it hurt more than normal again after 5 days so I stopped. The whole time through both bouts off eccentric exercise I swam between 500-1000 yards of kicking.

    I will admit, after I take a super hot shower and it seems blood flow increases to my hamstrings, they feel better. I become nearly pain free for 10 minutes and exercising them doesn’t hurt much at all.

    • Hello Ian,

      Hate that ART did not help. It is often quite effective. Could be a lot of reasons for this. Have someone video you and put the video on a program that slows it down to a frame at a time and watch for biomechanical differences / abnormalities from right to left. Sometimes these things can take a long blasted time to heal. The problem is, athletes don’t like to take the time necessary. As an athlete myself, I understand this all too well.

      Dr. Russ

  3. krislight

    Can you recommend a suitable substitute for Ligaplex II that is appropriate for a vegan?

  4. ruchi

    good …. thank you

  5. joy

    Thanks I work to keep as alkaline as possible, but not perfect….hoping the Ligaplex II will help and I just ordered a new bottle of glucosomine, have taken it off and on for years but not now, so I’ll get with it again….also read it can raise blood sugar so that kind of spooked me.

    I do all the RIGHT stuff and take Jarrow DHA max omega 3’s and cooking with olive oil and coconut oil….

    Again I’m not perfect and aging isn’t my best friend, mind is good but the body…. THanks for your assistance. joy

    • Dian

      Extra-virgin olive oil contains a great number of healthy properties, but upon cooking, it loses many of its health benefits. It oxidizes with exposure to air, light, heat, and just with time. So the best way to go is not to cook with it. For max health benefits, consume cold-pressed extra virgin olive oil on salads (makes a great dressing when mixed with lemon, salt, and pepper or other herbs), in pesto, mixed into hummus, as a replacement for butter on bread, as a condiment, or take a little bit each day as a supplement (same goes for unrefined coconut oil). It’s also good for your skin, applied topically. Choose olive oil that doesn’t smell rancid (the fresher the oil, the healthier it is). Fresh, healthy oil will have a stronger olive fruit smell, a complex zesty, bitter, or slightly peppery taste, depending on the variety — taste reflects freshness and nutrient content. It should not be yellow (which means it’s old or refined and processed, which is rancid and unhealthy oil). The bottle should be dark, not clear, to help keep it fresh longer. Store it in a cool area away from sunlight, and don’t let it get too old (you’ll be able to tell by the smell and taste when it gets rancid).

      Coconut oil is a mostly saturated fat, so it’s very stable (doesn’t oxidize easily). Good for baking and light cooking, but avoid frying, which makes it (as well as any food) unhealthy and inflammatory. For good health, use only unrefined and cold-pressed (virgin) coconut oil. Organic is best whenever you can afford it (same with olive oil, and food in general). Commercially refined coconut oil is highly processed, usually at high heat, which isn’t good for your health. The least processed (“whole” foods) are the always the best. Coconut oil contains a great many beneficial health properties, including the antifungal chemical capryllic acid, and the oil’s been studied for its role in improving brain function (as with many healthy oils), but its healthful properties are preserved only when it’s eaten cold and unrefined.

      Check out World’s Healthiest Foods at and type in “healthy fats”, omega-3, coconut oil, or olive oil in the search bar for more info or to find tasty healthy recipes.

      A few months ago I read a report from a research study that found that consuming fish oil capsules for omega-3 supplementation causes an increase in cholesterol; but when salmon and other healthy fish sources of omega-3 were eaten, it did not cause participants’ cholesterol levels to rise, and both groups (the participants taking fish oil capsules and those eating fish) attained the same level of omega-3 in their bodies.

      Conclusion: Eating whole foods for nutrition instead of depending on supplements is the best and healthiest way to go.

      Just make sure you’re digestion works properly, or you won’t get any benefit no matter what you eat. For those of us who don’t have good digestion due to health problems or age, try taking digestive enzymes. There are many digestive aids in the market; Standard Process also makes them. A holistic health professional or naturopathic medical doctor can help you determine what deficiency you may have and what digestive aid type (general broad-spectrum enzymes, specific help for breaking down fats, for proteins, etc) might suit you best, because what helps one person may not be suitable for another (even if it’s a natural supplement!), especially if you have certain health problems.

  6. Rupert Clarke

    Do you have a general recommendation to support achiiles repair (non-surgical) following a complete rupture in a 65 yo active male. A friend mentioned magnesium supplementation ?
    Many thanks.
    Rupert Clarke

    • Ligaplex by Standard Process without a doubt.

      Dr. Russ

      • joy

        I deal with bodywide OA and a pretty big mess from an anterior hip replacement in 2010, knee is worse and foot/ankle on this replacement side worse….

        I’m taking Ligaplex II over 3 weeks now and wonder if it take longer to “kick in”….it may be helping but it’s hard to tell. I don’t want to give up and I muscle test and pendulum test positive for it. I’m 76, so long old OA. Testing tells me to take 4 per day, 2 and 2.

      • Hello Joy,

        Bear in mind that Ligaplex is the kind of supplement that is going to take awhile to work. Also, with OA, you probably need something for the joint surfaces like Glucosamine. However, the most important thing you can do is to eat an ANTI-INFLAMMATORY DIET and take PFGO. Dealing with INFLAMMATION is critical if you want to effectively manage this without more drugs or surgery.

        Dr. Russ

  7. Erika

    Hi, My daughter ( 4,5 years) has connective tissue issues due to cerebral palsy. She is getting a gel capsule with fish oil, calcium and Magnesium. I know I should be adding more of what you said but have problems locating things that taste okay and that she can swallow. She can handle chewing but tablets, especially foul tasting liquids don’t go down. we live in Germany. what do you suggest I do?

  8. LeAnn Craddock

    My structure has collapsed. I have Severe Advanced Arthritis, I get chiropractic and was very blessed to have met a couple that are MST’s and are helping immensely. I take all kinds of supplements and have changed my diet. Have been at this for a long time but it took me the first 4 yrs to get off all of the medications the dr’s had me on…What can I take that will help strengthen my structure? It just seems to be taking so long. I’m still working on getting the knots (toxins) out of my body. Thank you!

  9. Charlotte Baggs


    I have Diastasis Recti and was wondering what would you recommend as a supplement for me to take that would help re build my connective tissue?

  10. Ronny Moussa

    Hi Dr i was hoping you can help me with my problems.i have mild tendinosis in my left shoulder around the rotar calf area.i also have in my left and right wristsand now in my right leg in the areas of the quads, adducter and calfs.i have been taking fish oils for maybe five years on and off and now i have started on cissus and powdered joint complex that has gucosimine, chrondrotin and msm.i have started the gym and taking protein shakes.i have been taking them for about 5 weeks now and dont see much there anything else i can take or do to help me with my 35 years old and a plumber as my job.thank you

  11. Corri

    For someone with a chronic underlying issue, such as Ehlers Danlos Syndrome (essentially defective collagen that is thin and weak), would attacking the scar tissue/deranged collagen still be benificial? I guess, I wonder if my body might attack only the scar tissue, and either help build/synthesize proper collagen, or if it would see all collagen as deranged and then try to clean it all out. A very odd question, maybe you have an idea? :) Enjoying some real answers to what supplements are truly helpful!

    • Hello Cori,

      I do not think that my Tissue Remodeling would work on most patients with hardcore EDS. The thing to do, however, would be to simply follow a healthy lifestyle (GLUTEN FREE would be huge here). The best supplement for you would be Ligaplex II.

      Dr. Russ

  12. brickjuice

    How important is it to take Ligaplex I with food? I am currently fasting yet want to begin taking this supplement again. Thanks so much!

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