Healing Chronic Scar Tissue in Tendons with Keith Barr

Feb 16, 2025

Keith Barr is a researcher at UC Davis, focusing on tendon health and rehabilitation. He discusses groundbreaking techniques for reversing chronic scar tissue in tendons through specialized loading strategies. Barr explains the importance of isometric exercises for recovery and enhances performance while navigating the complexities of tendinopathy. Insights on how hormones affect tendon health and effective training strategies for runners to prevent injuries are also covered, providing valuable information for athletes and coaches alike.

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INSIGHT

From Muscles to Tendons

Keith Barr transitioned from muscle physiology to tendon research after encountering robotic failures at muscle-machine interfaces.
This led him to explore force transfer and how tendons adapt to various stimuli.

ANECDOTE

Tissue Engineering

Barr's team engineers ligaments outside the body using donated ACL cells in a fibrin gel.
They attach these to calcium phosphate cements and mechanically test their strength.

INSIGHT

Perceived vs. Actual Stiffness

Perceived tendon stiffness during pain is different from actual tissue stiffness.
Perceived stiffness often stems from fluid pressure stimulating Golgi tendon organs, creating a sensation of tightness.

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In this episode of the Run Smarter Podcast, I sit down with Dr. Keith Barr from the University of California, Davis, to uncover groundbreaking research on tendon health, rehabilitation, and performance. Dr. Barr shares his expertise on tendon tissue engineering, the role of mechanical loading in healing tendinopathies, and how to reverse chronic scar tissue formation. Whether you're a runner struggling with tendon pain or a coach looking to optimize performance, this episode is packed with game-changing insights.

What You'll Learn in This Episode

🔹 Why tendons develop scar tissue – and how stress shielding plays a role in tendinopathy
🔹 How to reverse chronic tendon damage – with the right type of loading strategy
🔹 The difference between tendon stiffness and perceived stiffness – and how it impacts performance and injury risk
🔹 Why isometric exercises are a game-changer – and how to use them effectively in rehab and injury prevention
🔹 The role of hormones in tendon injuries – including how menopause and testosterone affect tendon health
🔹 How to train smarter to avoid tendon injuries – including the optimal way to structure your running volume

Key Takeaways & Actionable Strategies

✅ Target the scar tissue with load – Use isometric holds after a workout to gradually reintroduce load to the weak areas
✅ Don’t rush into plyometrics – Start with long-duration isometric exercises before progressing to slow, heavy strength training
✅ Train twice a day for better tendon adaptation – Splitting your runs into two sessions improves tendon recovery and adaptation
✅ Respect the first few sessions of new training – The first track session, spikes workout, or hill session introduces high jerk forces, increasing injury risk
✅ Consider hormonal factors – Women going through menopause may need to adjust their training due to changes in tendon stiffness and collagen synthesis

Dr. Keith Barr’s Research & Resources

🔹 Follow Keith Barr on BlueSky: Muscle Science
🔹 Read his research paper: Using Load to Improve Tendon Ligament Tissue Engineering and Develop Novel Treatments for Tendinopathy

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