Nutrition for injury recovery. An athlete’s guide.
Whether you are a serious athlete or a recreational one, chances are you’ve found yourself struggling with an injury at some point or another and wondered whether your diet could play a part in how quickly you recover.
Regardless of whether your injury is a minor sprain or a serious tear, understanding how our bodies go through the process of recovery and learning how to strategise your nutrition can play a critical role in how quickly you are able to return back to fighting form again.
This blog will cover the stages of damage repair, what you can do in each stage, and what kinds of supplements you can take to aid in recovery.
What actually happens when we get injured?
Regardless of the nature of the injury, chances are there will be some damage to bone, muscle and tissue.
In a normal functioning body, oxygen and blood flows around the body bringing nutrients to the muscle, bone and vascular tissue. During injury this flow may be restricted. When this happens, cells may become damaged and die.
Unless you are Gregor Clegane The Mountain from Game of Thrones you will likely experience the following symptoms; pain, redness and swelling. While these symptoms might not sound like much fun, they are actually a really important part of healing.
It is during this process that inflammation begins as a way to clear out the dead cells. Certain chemicals and blood proteins are brought to the site of injury so that debris can be cleared out and a healing process can begin.
Recovery can be characterised in 3 stages:
Inflammation
As mentioned above, inflammation is usually defined by 3 elements:
Pain: Caused by chemicals interacting with pain receptors to help initiate inflammation, which then may cause swelling
Swelling: During the initial injury, blood vessels may have been damaged which causes fluid to seep into blood tissue from the blood vessels.
Redness and/or heat: This can be caused by restriction of blood flow to the affected area
2. Proliferation
Once the initial inflammation has abated and oxygen begins to flow freely though out the injured area again, collagen and fibronectin - which are basically fancy words for scar tissue - will begin to form in the area. This scar tissue will actually shorten and become more rigid as it heals as a way to minimise the size of the injury.
For this reason it is extremely important that athletes continue with rehabilitation programmes and physical thereapy through out all the stages of injury management.
3. Remodeling
In this stage of rehabilitation, the first layers of scar tissue degrade and are replaced by stronger scar tissue (type I collagen). During this stage it is essential that athletes continue to lengthen that scar tissue through functional movements and physical therapy.
How much should I eat during injury?
Now that we understand the stages to recovery let’s look at how and what we can eat to help speed up the process of rehabilitation.
Calorie needs
While you’re probably not going to be training for a marathon, you’re also likely not completely inactive either, so it’s important to find a balance in your energy needs, so that you are eating enough to maintain muscle mass, and not too much that you are gaining fat which will make it harder to return to training.
During injury, our bodies increase in it’s resting metabolic rate to help compensate for energy expenditure. This means that you’ll have to increase your calories slightly higher than a healthy non training day, but not as high as a typical training day.
What might that look like?
A non serious injury like a sprain might allow for a slight increase in calories by up to 15% while a more severe injury like a torn ACL or anything that requires surgery might need a calorie increase by up to 50%.
Each athlete is different and tracking key progress indicators through out the entire healing process may be required depending on serious you wish to take your rehabilitation progress.
So let’s say a female athlete that weighs 60kg (132lb) trains around 12 hours a week pre-season aims to consume around 2,600 calories on a training day and around 2,100 on a rest day, during injury recovery, she’ll aim to sit somewhere in between those two numbers.
It should also be noted that a consistent supply of nutrients to the body will be needed during tissue and bone repair so athletes should aim to eat every 3-4 hours.
Macronutrient needs during injury
It goes without saying that macronutrient needs are as important as an athlete’s overall calorie intake. Although it might be temping to binge watch the next Netflix show whilst snacking on Cheetos and popcorn, your body will need the right nutrients to help with recovery.
Protein needs during injury recovery
The basics still apply. During injury recovery, the need for protein increases even more. Athletes should aim to eat 1g of protein per pound of body weight and can increase that to up to 1.2g per pound of body weight.
Fat needs during injury recovery
The kinds of fats your consume during this time really matter. Again, if you’re approach to managing injury is to eat fried chicken while your muscles and tissues repair, think again.
Remember earlier in the blog we discussed how important the process of inflammation was to injury? Well although extremely important in the initial stages of healing, you don’t want to prolong inflammation.
Different types of fats can either increase inflammation or promote recovery. Let’s look at the different types.
Anti-inflammatory fats
These types of fats can be found in most fatty whole foods like oily fish, avocado, nuts, seeds and olive oil.
Pro-inflammatory fats
These fats are often found in highly processed foods that contain vegetables oils like corn, sunflower, and soy beans or ultra processed foods made with trans fats.
Fun fact: Our cell layers are made of fats and the foods you eat can determine the quality of the cell membranes. This means that the tougher the cell membranes get the harder it becomes for nutrients to permeate.
Finding balance between Omega-3 and Omega-6
Although most natural fats found in whole foods will contain a combination of both Omega-3 and Omega-6, like avocados for example, overall increasing your fat intake through whole food sources (though making sure to remain within the constraints of your overall energy needs as to not cause too much fat mass) and minimising processed foods,
is a great place to start.
Micronutrients matter too
The term “eat the rainbow” couldn’t be more pertinent right now and sadly I don’t mean your kids rainbow sprinkles - although those might just make your soul do a happy dance for a while - I mean the colours found in fruit and vegetables.
If you want to learn more about the different natural pigments found in food and need some recipe inspo for each of the colours, check out this blog here where I outline the vitamins and minerals found in different vegetables.
Vegetables contain a variety of anti-inflammatory compounds, like spinach or kale that contain vitamin K which is essential in the process of blood clotting.
Supplementing for sports injury
Omega-3
As discussed previously in the blog, Omega-3’s are going to be the superfood you can turn to to speed up recovery.
So exactly how much do you need to take?
Anywhere within the ranges of 2-4 g of total EPA+DHA daily, is helpful during the inflammation stages however once past the initial stages of recovery, athletes can return to 1-2g of total EPA+DHA.
Multi-vitamins
In the early stages of injury or post surgery, an athlete can take vitamin D in addition to multivitamins to help maintain serum calcium levels, however please note that vitamin D can react with certain prescription drugs, so always check with your doctor.
After the initial stages of recovery, multi vitamins can be taken as a part of sports recovery and maintenance.
Supplementing with the following 2-4 weeks post injury may also be helpful:
Vitamin A
Vitamin C
Copper
Zinc
Other supplements that have been shown to aid in recovery:
Curcumin
Bromelain
Garlic
Boswellia
Arginine
HMB
Glutamine
Proteolytic enzymes
Creatine monohydrate
What about anti-inflammatory painkillers?
When it comes to non steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and similar over-the-counter drugs for acute injury, the studies have produced mixed reviews.
Some studies suggest that using such drugs could slow down recovery especially in the early stages where inflammation is actually needed.
One study found that it reduced ligament strength in injured rats by 32%. There has also been evidence that NSAIDs may interfere with weight training adaptations and bone healing, but not all of the research is consistent.
If you decide to use NSAIDs to help you with recovery, use it sparingly and under the guidance of a specialist.
Conclusion
Nutrition is a huge part of injury recovery and while it might be tempting to engage in self pity chocolate binges, I can assure you that the more mindful you are in those early stages of recovery, the faster your recovery process will be.
When it comes to frequency of meals, athletes to should aim to eat every 3-4 hours to make sure that nutrients are entering the body at regular intervals. This will be especially important during the early stages of injury.
Make sure to enjoy a balanced diet full of whole foods, plenty of healthy fats and consider supplementing with vitamins and minerals.
Each athletes’ specific requirements will be personal to them, so if you’re looking for a bespoke plan then I’m just a click away.
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Resources
Elder CL, Dahners LE, Weinhold PS. A Cyclooxygenase-2 Inhibitor Impairs Ligament Healing in the Rat. The American Journal of Sports Medicine. 2001;29(6):801-805. doi:10.1177/03635465010290062101
Şimşek T, Şimşek HU, Cantürk NZ. Response to trauma and metabolic changes: posttraumatic metabolism. Ulus Cerrahi Derg. 2014;30(3):153-159. Published 2014 Sep 1. doi:10.5152/UCD.2014.2653
So J, Wu D, Lichtenstein AH, Tai AK, Matthan NR, Maddipati KR, Lamon-Fava S. EPA and DHA differentially modulate monocyte inflammatory response in subjects with chronic inflammation in part via plasma specialized pro-resolving lipid mediators: A randomized, double-blind, crossover study. Atherosclerosis. 2021 Jan;316:90-98. doi: 10.1016/j.atherosclerosis.2020.11.018. Epub 2020 Dec 7. PMID: 33303222.
Pence, J. , Martin, K. and Bloomer, R. (2021) Beyond Nutrition Recommendations: What Healthcare Professionals Should Know about Dietary Supplements to Best Serve Their Patients. Health, 13, 334-346. doi: 10.4236/health.2021.134027.
