Nutrition For Injury

Overdid it? Slipped on the ice? Didn’t keep the rubber side down? Injuries suck, but if you’re going to get injured, the offseason is a good time to focus on rest and recovery.

Two important notes here before we jump into this article. One: Food is amazing, but food alone cannot fix injuries. It’s important to have realistic expectations of what it can do. Proper nutrition isn’t going to replace the need for medical care, PT, a proper return-to-training protocol, etc. It is a tool to aid in recovery, not magic. Two: this article isn’t meant to be taken as individual medical advice. Talk to your healthcare team about what is best for you.

Generally, there’s two phases of injury recovery. The first phase is healing and recovery, which is often characterized by a reduction or complete cessation of training. Tissue repair begins, and is characterized, by three phases: inflammation, proliferation, and remodeling. Second is the return to activity. Nutrition may help reduce the duration of or lessen the negative aspects of reduced activity, as well as assist in the return to training.

Energy Balance

It’s important to try and maintain energy balance during injury. This means avoiding a large calorie deficit or large calorie surplus. Athletes who’ve undergone injury are likely moving less, training less, and therefore their energy demands decrease. However, during the initial stages of the healing process, calorie needs increase. It takes energy to repair damage, whether it be surgery, concussion, or otherwise. This is especially the case in severe injuries, where

Conversely, a large positive energy balance is undesirable for optimal healing and recovery. You’d think that positive energy balance would be beneficial to maintaining muscle mass. However, there’s evidence that a positive energy balance actually may accelerate muscle losses, increase fat storage, and may reduce insulin sensitivity. It’s about striking a fine balance of enough energy but not too much.

Protein

When athletes decrease their overall calorie intake, they also generally decrease their intakes of protein. Increased downtime results in a decrease in muscle protein synthesis rates (MPS). Have you seen someone’s arm after they’ve had a cast removed? The reduction in MPS causes muscle loss in times of injury. While these losses aren’t totally avoidable, they can be reduced with adequate protein intakes. Aim for frequent doses of protein, roughly 0.3g-0.4/kg body weight every 3-4 waking hours which equates to ~20-27g protein doses for a 150lb athlete. Additionally, the amino acid, leucine, is thought to stimulate muscle protein synthesis. Foods high in leucine are preferred over leucine-isolated supplements. So, athletes should choose foods like soy products, chicken, beef, pork, dairy, seeds, and tuna.

Nutrients of Concern

Depending on the type of injury, athletes may want to consider paying attention to their intakes of certain nutrients. Micronutrients like zinc, calcium, magnesium, and vitamin A play an important role in healing. The goal with these nutrients is to avoid deficiency, as these nutrient deficiencies can delay recovery times and slows healing. However, some is good. More isn’t better. Supplementation above sufficiency may not be beneficial. Adequate calcium and Vitamin D are necessary for bone reformation after a fracture.

Creatine may be beneficial for concussion injuries. Creatine is involved in maintaining cellular energy reserves in the brain and is important for normal brain function. Creatine may offer a neuroprotective effect if taken shortly after a concussion occurs. It is a naturally occurring substance in the body and is generally considered safe to supplement. To date, there have been no reported adverse side-effects with long term, appropriately dosed use. Creatine can also be found in animal products like wild game, beef, poultry, and fish.

Injury often causes inflammation. While this inflammation is a necessary part of the recovery process, excess inflammation can be detrimental. Antioxidants from foods like fruits and vegetables, nuts, and seeds can be beneficial, but high doses of antioxidant supplements aren’t recommended. Omega-3 fatty acids may also benefit athletes during periods of injury. The standard American diet includes drastically more omega-6 fatty acids than omega-3 fatty acids. Specifically, the omega-3 fatty acids EPA and DHA are the main nutrients of concern. Increased amounts of EPA and DHA may help against inflammation. Additionally, omega-3 may lessen the diminishing rates of muscle protein synthesis during injury. As with most things I discuss, a food first approach is preferred. It’s recommended to include two servings of fatty fish like salmon, sardines, or tuna. Algae oil may be beneficial for athletes following a plant-based diet.

Collagen is having a moment. Collagen is an abundant protein in the body found in bone, skin, ligaments, and tendons. It’s produced by the body, but collagen supplementation ensures adequate amino acids are available for collagen synthesis. Supplementation may reduce return-to-play times after a tendon or ligament injury. Vitamin C is an important cofactor in collagen synthesis so should be consumed alongside collagen. Food sources of collagen include bone broth (hello tonkatsu ramen!) and gelatin, and pair it with vitamin C rich foods like citrus, bell peppers, or tomatoes.

Now, if you’re seriously immobilized, then we need to discuss fiber. Limited activity can increase rates of constipation. Fiber is important for adding bulk and softens bowel movements so be sure to eat plenty of fiber rich foods like legumes, whole grains, fruits, and vegetables. Prune juice also works great for keeping things moving.

Now for the bummer (at least for some people). Alcohol is known to inhibit muscle protein synthesis and delays wound healing. Alcohol intakes, especially high alcohol intakes, should be limited, and drowning your sadness in booze probably isn’t the best idea for more reasons than just nutritional reasons.

Conclusion

Injuries can happen as a part of any sport. Nutrition may not be able to fully prevent injuries, but it can support recovery. Ultimately, maintaining a well-balanced diet prior to injury will put athletes in the best place should an injury occur. It’s better to start from a place of good health rather than needing correct nutritional deficiencies after an injury has occurred. So, the conclusion here is to eat well, take care of yourself, and put your body in the best circumstances to heal.

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