Dr. Keith Baar, UC Davis — Simple Exercises That Can Repair Tendons (Tennis Elbow, etc.), Collagen Fact vs. Fiction, Isometrics vs. Eccentrics, JAK Inhibitors, Growth Hormone vs. IGF-1, The Anti-RICE Protocol, and How to Us

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Interview with Dr. Keith Baar on The Tim Ferriss Show podcast! The post Dr. Keith Baar, UC Davis — Simple Exercises That Can Repair Tendons (Tennis Elbow, etc.), Collagen Fact vs. Fiction, Isometrics vs. Eccentrics, JAK Inhibitors, Growth Hormone vs. IGF-1, The Anti-RICE Protocol, and How to Use Load as an Anti-Inflammatory (#797) appeared first on The Blog of Author Tim Ferriss.

Dr. Keith Baar is a professor at the University of California, Davis, in the Department of Physiology and Membrane Biology.

During his PhD studies, his research revealed that mechanical strain on muscle fibers activates the mammalian target of rapamycin (mTOR) signaling pathway, a crucial regulator of muscular hypertrophy.

Subsequently, he studied the molecular dynamics of skeletal muscle adaptation to endurance training under the guidance of Dr. John Holloszy, a legend in the field of exercise physiology, considered the father of modern exercise biochemistry.

Building on all of this experience, he conducted research into tendon health and the potential for engineering ligaments, which could have implications for treatment and recovery from injuries.

Dr. Baar now runs the Functional Molecular Biology Lab at UC Davis. His lab’s work ranges from studying molecular changes in our cells to conducting studies to effect real-world improvements in people’s health, longevity, and quality of life.

Please enjoy!

Listen to the episode on Apple Podcasts, Spotify, Overcast, Podcast Addict, Pocket Casts, Castbox, YouTube Music, Amazon Music, Audible, or on your favorite podcast platform. The transcript of this episode can be found here. Transcripts of all episodes can be found here.

This episode is brought to you by Cresset prestigious family office for CEOs, founders, and entrepreneurs; AG1 all-in-one nutritional supplement; and Shopify global commerce platform, providing tools to start, grow, market, and manage a retail business.

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Dr. Keith Baar, UC Davis — Simple Exercises That Can Repair Tendons (Tennis Elbow, etc.), Collagen Fact vs. Fiction, Isometrics vs. Eccentrics, JAK Inhibitors, Growth Hormone vs. IGF-1, The Anti-RICE Protocol, and How to Use Load as an Anti-Inflammatory

This episode is brought to you by Cresset Family Office! Listeners have heard me talk about “making before you manage” for years. And for me—as a writer and entrepreneur—I definitely gravitate toward making. So it’s important that I find the right people who are great at managing. That’s why I trust this episode’s sponsor, Cresset Family Office.

Cresset is a prestigious family office for CEOs, founders, and entrepreneurs. They handle the complex financial planning, uncertain tax strategies, timely exit planning, bill pay and wires, and all the other parts of wealth management that would otherwise pull me away from doing what I love most: making things, mastering skills, and spending time with the people I care about. Experience the freedom of focusing on what matters to you with the support of a top wealth management team. Schedule a call today at cressetcapital.com/Tim to see how Cresset can help streamline your financial plans and grow your wealth.

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Want to hear another episode that explores the possibilities of rapamycin? Have a listen to the conversation I had with Peter Attia, David M. Sabatini, and Navdeep S. Chandel at the source of this miraculous compound: Easter Island. Here, we discuss how one of the most important discoveries of medical science was almost lost, why metabolism (along with longevity) research is key to treating a long list of diseases, intermittent dosing of rapamycin, parenting advice from scientists on confidence and conflict, the necessary failures of good science, good fonts versus bad fonts, “non-potato” relationships, and much more.

What was your favorite quote or lesson from this episode? Please let me know in the comments.

SELECTED LINKS FROM THE EPISODE

Connect with Dr. Keith Baar:

Website | Bluesky | LinkedIn

The transcript of this episode can be found here. Transcripts of all episodes can be found here.

Physiology & Biology
Strength Physiology

Molecular Biology

Exercise Physiology

Injury & Recovery

Training & Rehabilitation Methods

Substances & Interventions

Supplements

Pharmaceuticals

Rapamycin
Metformin
JAK-STAT Inhibitors (ending in -NIB, e.g., Itacitinib, Vorasidenib)
Fluoroquinolone Antibiotics (e.g., Ciprofloxacin)
AT1 Receptor Drugs (Sartan drugs)
Resorbable vs. Non-Resorbable Sutures
Testosterone
Estrogen
Nandrolone
Liothyronine (Cytomel)
Relaxin

Orthobiologics (Critiqued)

BPC-157
PRP (Platelet-Rich Plasma)
Prolotherapy
Stem Cells

Diets

Institutions & Places

Movies

Lorenzo’s Oil

Research

Minimizing Injury and Maximizing Return to Play: Lessons from Engineered Ligaments | Sports Medicine
Acute Resistance Exercise Activates Rapamycin-Sensitive and -Insensitive Mechanisms That Control Translational Activity and Capacity in Skeletal Muscle | Journal of Physiology
Effects of Stress Shielding on the Mechanical Properties of Rabbit Patellar Tendon | Journal of Biomechanical Engineering
A 1-Month Ketogenic Diet Increased Mitochondrial Mass in Red Gastrocnemius Muscle, but Not in the Brain or Liver of Middle-Aged Mice | Nutrients
Ingestion of a Whey Plus Collagen Protein Blend Increases Myofibrillar and Muscle Connective Protein Synthesis Rates | Medicine & Science in Sports & Exercise
Pentadecapeptide BPC 157 Enhances the Growth Hormone Receptor Expression in Tendon Fibroblasts | Molecules
ACE-II Receptor Antagonists Are Associated with Achilles Tendon Rupture | University of Eastern Finland
Effect of Estrogen on Musculoskeletal Performance and Injury Risk | Frontiers in Physiology
Ketogenic Diets and Mitochondrial Function: Benefits for Aging But Not for Athletes | Exercise and Sport Sciences Reviews
Do Inflammatory Cells Influence Skeletal Muscle Hypertrophy? | Frontiers in Bioscience-Elite

Relevant Resources

Tendon and Ligament Health | SinewUS
RE: Tim Seeks Tennis Elbow Relief | Twitter
How this Climber Went from V0 to V15 in 5 Years | Josh Rundle
My Life Extension Pilgrimage to Easter Island | The Tim Ferriss Show #193
Work Medium, Play Medium | Pretty Alright Goods
Free Weights vs. Machine Weights? Here’s How to Choose. | GoodRx
Orthopaedics in the Dawn of Civilisation, Practices in Ancient Egypt | International Orthopaedics
The Characteristics of Valter Longo’s “Longevity Diet” | USC Leonard Davis

SHOW NOTES

[00:07:12] How I discovered Keith’s work through a tweet about tennis elbow and rock climbing.
[00:07:54] Emil Abrahamsson’s hangboard training protocol.
[00:09:20] The fundamental principles of strength training and connective tissue adaptation.
[00:10:36] mTOR complex 1 and its role in muscle growth.
[00:12:06] Engineered ligaments and the discovery of minimal effective doses for tendon adaptation.
[00:13:50] The refractory period between optimal tendon loading sessions.
[00:16:42] Rapamycin’s effects on muscle hypertrophy.
[00:18:49] Protocols for tennis elbow rehabilitation.
[00:20:28] Why isometrics work better than eccentrics for tendon healing.
[00:22:14] Stress shielding and how load distribution affects tendon healing.
[00:29:07] The misconception about eccentric loading for tendon injuries and why velocity matters.
[00:29:58] Ideal duration for isometric holds (10-30 seconds) based on injury status.
[00:33:50] My elbow issues and current rehab approach.
[00:36:02] Overcoming vs. yielding isometrics and optimal loading strategies.
[00:47:11] Dr. Barr’s movement prescription for my tennis elbow.
[00:52:18] Loading timing post-surgery and RICE protocol criticism.
[00:56:58] Achilles tendon rehabilitation after surgery.
[01:00:18] Critique of orthopedic suturing techniques and recommendation for resorbable sutures.
[01:04:02] Multiple position isometrics for tennis elbow rehabilitation.
[01:07:26] Collagen synthesis, supplementation, and vitamin C timing.
[01:12:59] Critique of BPC-157 and other injectable peptides for tendon healing.
[01:18:19] Evaluation of orthobiologics’ (PRP, prolotherapy, stem cells) effectiveness.
[01:21:37] JAK-STAT inhibitor drugs and their effects on tendon growth.
[01:25:35] Drugs that increase risk of tendon ruptures (fluoroquinolones, AT-1 receptor drugs).
[01:29:33] How estrogen affects tendon stiffness and injury risk in women.
[01:32:48] Testosterone’s opposite effects on tendon compared to estrogen.
[01:35:31] Protein intake recommendations and timing.
[01:40:11] Ketogenic diet effects on mitochondrial biogenesis and longevity.
[01:41:57] Comparison of ketogenic diet, low protein diet, and rapamycin for longevity.
[01:47:19] Inflammation’s role in adaptation and when to reduce it.
[01:51:17] Timing of ice baths relative to training for optimal recovery.
[01:52:33] Parting thoughts.

MORE DR. KEITH BAAR QUOTES FROM THE INTERVIEW

“The number one cost to the US medical system is actually musculoskeletal sprains, strains, and tears—the back and the neck as well as the rest of the body. It’s more than diabetes and heart disease combined.”
— Dr. Keith Baar

“If passive flexibility was really important for decreasing tendon injury, then the women’s gymnasts who have the most passive flexibility wouldn’t be the NCAA sport with the highest rate of Achilles tendon rupture.”
— Dr. Keith Baar

“Injury related to flexibility is a U-shaped curve. So our injuries are really high when we’re very inflexible. When we get into that sweet spot where we have good mobility, we can do the full range of motion, actually the injury rate is very low. If we become hyper-mobile, we actually have that injury rate go up as well.”
— Dr. Keith Baar

“We don’t use a ketogenic diet if we want to go fast, but if we’re training for life, we see that it increases longevity, that the ketones themselves are really good for brain function.”
— Dr. Keith Baar

“The first recorded immobilizer for an ankle or a leg is from Egyptian hieroglyphs where they showed pictures 4,500 years ago. If I took you and you said you had cancer, you would not want a treatment that was developed 4,500 years ago. You would hope that something new has been developed in the last 4,500 years. That is where we are for our orthopedic situations.”
— Dr. Keith Baar

“The reality is that there are especially certain athletes like climbers where they’re doing all kinds of heavy lifts, they’re doing all kinds of heavy work, they’re doing all kinds of really dynamic moves. And what happens, what breaks down, is they break down in their finger tendons and they break down in the little pulleys within the tendons.”
— Dr. Keith Baar