TRT, Tendon Injuries, and Training Smart for Men Over 40
By Gert Louw | GertFITNESS
In today’s fitness world, one hot topic keeps coming up for older men: the possible link between testosterone replacement therapy (TRT) and tendon injuries.
As a coach specializing in fitness for older men, I’ve long supported TRT when prescribed by a doctor for men with clinically low testosterone. The benefits are clear—more muscle, better mood, fat loss, and renewed vitality. But a recent study suggests TRT may raise the risk of biceps tendon injuries. Let’s unpack the science, the risks, and the smarter way forward.
🎥 Watch my video breakdown here: TRT and Tendon Risks Explained
TRT Benefits Are Real
Low testosterone isn’t just about energy dips—it can lead to muscle loss, fat gain, depression, and long-term health issues. For men over 40 and 50, TRT can be life-changing when done correctly under medical supervision.
Still, strength without wisdom is dangerous. As I’ve learned on my journey, the goal of training is not ego or vanity—it’s longevity, health, and living with purpose.
A Friend’s Injury Warning
A close friend of mine, older and on TRT, suffered a serious injury recently: both biceps tendons ruptured at once. Not only is that devastating physically, but the muscle breakdown can strain the kidneys and cause lasting complications.
This kind of experience is a wake-up call. It shows how fragile tendons can be as we age—especially if we push too hard in training.
The Science on TRT and Tendon Risk
A 2023 study analyzed data from over 776,000 men aged 35–75. Findings: men on prescription testosterone were about 400% more likely to suffer a distal biceps tendon injury compared to those not on TRT.
📊 Numbers in plain terms:
- Without TRT → 1.5 injuries in 7,769 men
- With TRT → 6.5 injuries in 7,769 men
Yes, it’s a 400% increase, but the absolute risk remains tiny—just 0.084%. Most men will never face this.
The real danger comes less from TRT itself and more from how men train when their hormones (and drive) are restored.
Why Training Pride Is the Bigger Risk
Many men in their 50s and 60s still try to train like they did in their 20s. Heavy weights, pushing through pain, ignoring recovery—that’s where tendons snap.
At 60, I no longer chase numbers. I use lighter weights (10 kg dumbbells for biceps) but focus on:
- Slow, controlled reps
- Squeezing the muscle at the top
- Supersets and time under tension
This way, the muscle gets maximum stimulation without putting dangerous stress on tendons and joints.
My Rule of Thumb for Training After 40
- 40s → You can still push heavier loads.
- 50s → Start shifting to technique, control, and smart volume.
- 60s+ → Prioritize tendon safety and longevity over brute strength.
Train for life—not for ego. Muscles built wisely will last. Muscles built recklessly will break.
Biblical Masculinity and Strength With Purpose
I believe true strength is about more than how much weight you can lift. It’s about discipline, responsibility, and living with purpose. Training should make you stronger for your family, for your mission, and for the life ahead—not just for a photo.
This is where Biblical masculinity guides us: build muscle, yes, but build it with wisdom and humility. Strength is not for show—it’s for service.
Conclusion: Should You Fear TRT?
The science says TRT slightly raises tendon injury risk, but the numbers remain very small. For most men, the benefits of restoring healthy testosterone levels far outweigh the risks—provided you train smart and respect your body’s limits.
TRT can help you reclaim vitality. But reckless training will ruin it all. Be disciplined, train with humility, and you’ll thrive well into your 60s and beyond.
If interested in my COACHING or PROGRAMS just click the words.
—Gert Louw
gertlouw 