Nutrition for injury recovery

As an athlete who has struggled with multiple injuries myself, I have realized that injuries – although they are unfortunate and extremely unpleasant – are an unavoidable part of your journey as an athlete. When you are injured, it’s tempting to focus on the negatives and dwell on what you have lost. However, it is way more effective to start focusing on what you CAN control. You CAN control your thoughts, mind-set and attitude. You CAN control your rehab process. And you most absolutely CAN control your nutrition and how well you fuel your recovery.

Nutrition should form an integral part of your recovery process from the get-go, and good nutrition is important in all stages of recovery, and should be individualised and customized as the recovery process evolves and changes in physical activity requirements. Deficiencies of protein, energy and other nutrients should be avoided. It is important to realise that poor nutrition, will impair recovery and healing from an injury.

STAGES OF INJURY

Injury recovery can be classified in 2 main stages and can then be further divided in into more detailed phases. Nutrition needs change as the recovery process develops and change.

Stage 1: Healing and recovery

This first phase involves inflammation, proliferation and remodelling.

Stage 2: Return to activity

As your nutritional intake during stage 1 can impact how fast you can return to activity, this article will mostly be aimed at the “healing and recovery” phase.

Injury activates the inflammatory response of the body in to start the reparation process, and while too much inflammation is not a good thing, inflammation does play a role in wound healing – therefore, drastically trying to minimize inflammation might not be beneficial to recovery.

In this recovery phase, several nutritional considerations are important:

1. Total energy:

When you have to reduce activity or stop training for a while due to injury, it might be tempting to cut a lot of calories in order to prevent weight gain. But did you know that injury recovery can increase energy expenditure by 15 % – 50 %, depending on the type and severity of the injury? Also, it’s important to know that using walking aids like crutches can increase energy expenditure significantly (I can certainly testify that this is true, after doing my fair share of hopping along through campus. Talk about an arm workout!)

If you restrict energy intake too much, recovery will be slower due to the negative impact this will have on your metabolism. Too little energy will impair healing and worsen muscle loss. This, however, does not give you permission to tuck into MacDonald’s every day – too much energy intake is also not desirable. Rather, focus on achieving energy balance, focusing on whole, nutrient-dense foods with optimum macro nutrients that will fuel your recovery.

1. Protein and Amino Acids:

As the synthesis and recovery of injury healing depends on having protein and amino acids – building blocks of the body – available, protein is a very important nutrient in the recovery process. The goal of protein intake during recovery should be to eat enough in order to minimize muscle breakdown and help the body repair damage as soon as possible. Higher protein intakes may be needed – up to 2 – 2.5g/kg per day, or at the very least, if energy intake is reduced, care should be given that protein intake is not also reduced in the process. Also, take note that muscle protein synthesis (the process of building muscle mass) is maximized if protein intake is spread over the course of the day. It has been shown that about 20 – 25g of protein (0.25 – 0.30g/kg) in single protein doses is an optimum dose for muscle protein synthesis.

1. Omega 3 fatty acids:

These nutrients have anti-inflammatory properties and may be preventative for muscle loss – however, appropriate doses for supplements injured athletes and specific injury and blanket recommendation for supplementation is cautioned. In come studies, excess omega 3-suplementation was even found more harmful than helpful. It is recommended that you speak to a Registered Dietitian or Sports Nutritionist before using (any) supplements. It is always good to try a food-first approach and get these nutrients from dietary sources.

1. Antioxidants

Immediately after injury, oxidative damage can occur, which can increase the breakdown of muscle injury. Research have shown that sufficient antioxidant intake, for example vitamin C and vitamin E – from whole, unprocessed foods, especially fruit and vegetables – is crucial for optimum recovery, but it is unnecessary to supplement on top of what is needed if your nutrient status is adequate.

1. Nutrients specific to injury

Some injuries will be due to, or cause, certain micronutrient deficiencies. For example, heavy bleeding can lead to iron losses. Bone injuries might require an increase in calcium and vitamin D intake. It might be a good idea to speak to your dietitian and doctor to get some biochemical tests done in order to find any micronutrient requirements specific YOU and address that.

1. Avoid alcohol

…Or at least consume only in small amounts. Alcohol ingestion has been found to reduce muscle protein synthesis in rats, and impairs the process of building muscle mass after exercise in humans. It has also been shown to impede wound healing by reducing the inflammatory response and increases muscle loss during immobilisation.

BOTTOM LINE

Make sure to get in optimum amounts of energy, protein and micro nutrients while you are injured. It may really be worth it to go and see a dietitian to help you determine YOUR individual needs and help you construct a plan that will help you make practical changes to optimize injury recovery. Remember, food is fuel. Food is also meant to be enjoyed. A balanced, whole foods diet that contains minimally processed foods should be the foundation of your nutritional strategy while you are injured – and although it may sound like boring advice, it still is the best thing you can do to help yourself recover.

References

Tipton KD. 2015. Nutritional Support for Exercise-Induced Injuries. Sports Med. 45: 93–104.

Tipton KD, Phillips SM. 2013. Dietary protein for muscle hypertrophy. Nestle Nutr Inst Workshop Ser. 76:73–84.