Rehabilitation Nutrition for Tendon and Ligament Injuries: From Collagen Remodeling to Return-to-Activity and Sport

Background/Objectives: Tendon and ligament injuries are challenging conditions because of limited vascularization, slow collagen turnover, and prolonged rehabilitation timelines. This narrative review aimed to synthesize current evidence on nutritional strategies that may support connective tissue rehabilitation and return-to-activity or return-to-sport progression. Methods: This narrative review synthesized the relevant clinical, mechanistic, and applied sports nutrition literature identified through targeted database searches and manual reference screening. Results: Adequate energy availability and protein intake emerged as foundational priorities for tissue repair, endocrine and immune function, and tolerance to progressive loading. Collagen or gelatin supplementation with vitamin C before tendon- or ligament-loading exercise may provide targeted substrate and cofactor support for collagen remodeling. Creatine may assist muscle preservation during reduced loading, while micronutrient adequacy and omega-3 fatty acids may support musculoskeletal health and inflammation resolution. Conclusions: Nutrition should be viewed as an adjunct to, rather than a replacement for, structured rehabilitation loading. Phase-specific and individualized nutritional strategies may support rehabilitation when integrated with structured loading; however, additional well-designed clinical trials are needed to determine their effects on clinically meaningful outcomes, including return-to-sport time, reinjury risk, and long-term tissue outcomes.