Injuries are a common but unfortunate part of sports and exercise participation. The nature and severity of an injury will dictate the recovery and rehabilitation time, and protocols followed. Muscle mass, strength and function are lost quickly when injuries result in reduced movement or immobilisation, and this can also lead to unwanted weight gain.
While physical therapies and rest clearly play a major role, good nutrition may also help accelerate injury recovery, while poor nutrition can delay and impede a return to training and competition. While overeating is not ideal, under-fuelling can also be problematic, as both injury trauma and surgery require additional fuel.
A well-balanced whole food anti-inflammatory diet, focussing on avoiding nutritional deficiencies, plus the inclusion of appropriate supplements where necessary is a good start. Diets are best tailored to an athlete’s specific needs.
Some goals in healing:
* Prevent or minimise loss of muscle tissue and function, and preserve lean body and bone mass
* Promote muscle protein synthesis
* Prevent excess weight gain and fat accrual during rehabilitation
* Mimimise time spent away from training
* Maintain energy production, protect immunity, and remain healthy physically and mentally
* Manage inflammation- following injury, an inflammatory response occurs which is key for healing. Some early inflammation is expected and beneficial, but prolonged excessive inflammation can be harmful.
Some nutritional musts for helping the healing;
Protein, especially those high in leucine. Protein is vital to help minimise loss of muscle mass and strength, and to help heal and repair muscle tissue and bones. The recommended dietary intake (RDI) for protein is 0.8-1 g/kg daily but this increases with exercise and rehab requirements. Recommendation for active training is generally 1.2- 2 g/kg body weight daily, while 2- 2.5g/kg may be required in rehab and recovery depending on stage of injury and when training recommences. Food sources include whey protein, lean meats, white fish or salmon, tuna or sardines, tofu or eggs, dairy foods, seeds and nuts, legumes and pulses including beans, chickpeas, soybeans and lentils. Distribute intake throughout the day.
Carbohydrates provide energy and fuel which helps protein usage, healing, and repair. Simultaneous carbohydrate and protein intake may inhibit muscle breakdown and atrophy. Daily amounts vary according to activity, with athletes generally requiring 3.0 to 4.5 g/ kg of bodyweight daily, bodybuilders needing 5-6 gm/kg, and 6-10g/kg for moderate to high intensity training (e.g., >1-3 hours daily). Intake is based on activity level and recovery needs, but 3-5g/kg daily is often recommended during rehabilitation. Ensure you are eating good carbs such as wholegrains, vegetables and fruit.
Good fats help reduce inflammation which can slow down recovery, and can assist in cell membrane production, immune support and avoiding fatigue. You need good fats to absorb some key antioxidants and nutrients. Studies have indicated that during recovery 0.8- 2g/k daily of good fats may be helpful. Sources include salmon and tuna, seeds and nuts such as chia, sesame, linseeds (flax), and their oils, and avocado, olive and coconut oil.
Fibre assists with regular bowel function and gut health, helps with clearance of toxins and limiting weight gain. Inactivity can also lead to constipation. Examples include whole grains, vegetables, fruit, and legumes
Anti-inflammatory foods provide antioxidants, immune support, fibre, vitamins and minerals. Combine fruit, vegetables and spices into juices and smoothies, Examples carrot, apple, celery, spinach, pineapple, papaya, lemon, horseradish, ginger, cinnamon, turmeric. Use the whole juice, do not strain.
Naturally occurring nitrates (NOT synthetic nitrates & nitrites found in preserved meat products), convert to nitric oxide in the body which acts as a vasodilator opening blood vessels and allowing more blood and oxygen to the muscles. Sources include green leafy vegetables (spinach, lettuce, chard), beetroot, bok choy, celery, garlic, onion, Chinese cabbage, and fruit such as apples, bananas, pears, kiwi fruit and oranges.
What to reduce or avoid;
Saturated and trans fats, especially from fatty, processed meats, deli meats, fried foods, snack and junk food.
Sugary and processed foods such as cakes, sweets, pastries, biscuits, and low-fibre sugary breakfast cereals, as they elevate glucose levels and trigger inflammation.
Alcohol which can impede healing and exacerbates muscle loss during immobilisation is best avoided.
Some useful nutrients for repair and recovery – as food or supplements;
Vitamin A for cell growth and development, and immune function
Vitamin C is an antioxidant, increases collagen synthesis which helps rebuild the body after injury, for wound healing, tissue repair, immune function, reducing inflammation
Vitamin D for immune health and reducing fatigue, for skeletal muscle function, bone health and calcium absorption. Low levels are associated with impaired muscle repair and regeneration and prolonged recovery time.
Magnesium is a co-factor in over 300 enzyme systems in the body, calms the nervous system, aids musculoskeletal health, protein synthesis, improves absorption and metabolism of calcium and Vitamin D, and promotes bone strength.
Calcium is good for skeletal structure and healing bone breaks and fractures, and Boron promotes bone health by increasing calcium and magnesium retention and enhancing the effect of vitamin D.
Zinc is a powerful antioxidant, and acts as an anti-inflammatory agent for wound healing, helps in tissue repair and growth, protein synthesis, and boosting immune function.
Silica is important in early stages of bone formation
Copper for immune function, bone health, and helps regenerate elastin
Iron to increase energy, and reduce fatigue, and a decline in athletic performance
Creatine monohydrate can be obtained from high protein foods such as beef and fish, improves exercise performance and lean body mass (when combined with exercise).
HMB is a natural metabolite of the essential amino acid leucine and assists in stimulating protein synthesis and muscle and tissue repair.
Protein powders can sometimes result in stronger anabolic effect that dietary protein. Whey protein isolate is considered by some researchers as more effective that plant protein for muscle synthesis.
BCAAs are all important for building and repairing muscles, especially leucine – an anabolic helper that stimulates protein synthesis in muscle.
Collagen is a primary structural protein of connective tissue and accounts for about 30% of total body protein. It is crucial for mobile joints, stable bones, healthy muscles, strong ligaments, and tendons.
Omega 3 fatty Acids – anti-inflammatory actions, inflammation increases fatigue. Nutrient absorption.
Always approach supplementation as a risk benefit decision and seek professional advice if uncertain.
Good nutritional choices can greatly assist injury recovery, but best results are achieved when diet plans are tailored and personal to suit specific needs, individual physiology, nature of the injuries and dietary preferences. Speak to your nutritionist for guidance.
Pamela Nelson is a Clinical Nutritionist, Naturopath and Herbalist at Health Space Clinic in Lane Cove