Using nutrition to recovery from injury
There are many components to a successful rehabilitation program, such as, physiotherapy, strength training, conditioning, possibly surgery, although nutrition is usually largely overlooked. We know that good nutrition is important to supply nutrients, vitamins, and minerals throughout the body to maintain energy levels, to maintain a strong immune system, and to regulate hormone levels. So why can’t we use nutrition to help us recover quicker from an injury?
Injury recovery seems messy and unorganized although the body has a very systemic approach to injury repair;
Stage 1: Inflammation
When we sustain an injury the vessels that supply that tissue (muscle, bone, connective) likely also get damaged, meaning that tissues supply of oxygen and nutrients is impaired. This lack of blood flow and actual physical damage leads to cell death. In order to clear out the dead cells and lay down new ones, the body kicks off it’s inflammatory process.
Stage 2: Proliferation
Once the inflammation phase is over, most of the damaged tissue is removed and new vasculature will have developed. This new blood supply will now nourish the damaged area and allow to new cell growth to occur.
Stage 3: Remodelling
With new cells being laid down they can be remodelled and somewhat normal function can be restored. With the injury repair process in mind we can now start to look at how nutrition can have an impact on each of the stages above.
Once an injury has been sustained, not consuming enough energy (calories) can prevent the damaged tissues from recovering. In fact energy needs maybe increased during acute injury due to the increase work the body has to do to repair itself. Our Basal Metabolic Rate (amount of energy we burn during the day without exercise, BMR) can increase by up to 50%. However we need to match our energy needs with our exercise output, therefore if pre-injury exercise volume was high and is now reduced so to much the energy intake. As you can see energy intake should be reduced (relative to the training and competition) although, we must be careful not to reduce it too much as undereating can impair injury repair process.
Along with energy, it’s also important to consider the macronutrients (protein, fat and carbohydrates) requirements during the injury repair period. Protein can help speed up the healing process, it’s recommended that an athlete consumes 1.5-2.0 grams/kilogram of body weight. Fats, in particular omega 3’s, have anti-inflammatory properties, while omega 6’s are pro-inflammatory. Therefore, it’s recommended that injured athletes should reduce their omega 6 intake and increase their omega 3 intake, for example, eating more salmon, tuna, walnuts and less refined oils. Carbohydrates will be important to keep the anabolic hormone insulin stable, which assists in tissue growth or healing. Carbohydrate sources such as fruits and vegetables are the best options as they also provide important micronutrients (vitamins and minerals), while processed carbohydrates (including sugars) should be avoided as these may trigger inflammatory processes in the body.
Micronutrients (vitamins and minerals)
Vitamins and minerals don’t necessarily have a direct impact on tissue healing, although they are still very important to the athlete during the injury recovery process. The most important micro-nutrients appear to be vitamins A, B, C, D and minerals calcium, copper, iron, magnesium, manganese and zinc. Fruits, vegetables, nuts, seeds and high quality meat are great sources of these micro-nutrients.
Turmeric, garlic, bromelain, Boswellia and flavonoids have all shown to have anti-inflammatory effects. Although it should be noted that too much anti-inflammation can have a negative effect on healing during the acute injury phase. The idea is to use anti-inflammatories to control the inflammation during these phases.
Nutrition is an important part to any athletes quest for improved performance, yet it is so often over looked when we get injured. Being injured is not a time for self pity and binge eating, it’s an opportunity to get better.