Nutrition & Injury

Injury and Nutritional Needs

We do our best to avoid injuries, but they are a reality of life and training. We often focus on the physical therapy/rest/exercise modification side of rehabbing. But when it comes to recovery from an injury, nutrition is an important factor that gets overlooked. If we prioritize our nutrition on healing it can aid in our ability to maintain lean muscle mass and reducing inflammation. So, what promotes healing? Having adequate energy and nutrient intake is important in the promotion of muscle preservation and healing.

Energy – Calorie Needs

Many people may believe because they are injured (and potentially have reduced movement/physical activity) that they need to eat less to avoid unwanted weight gain. BUT having a negative energy balance (calorie deficit) while injured could exacerbate the problems you are having and slow down the healing process and lead to loss of muscle. Not eating enough can lead to losses of function strength and prolong your ability to return to full activity.

Consistent and adequate consumption of nutrients throughout the day will preserve lean muscle mass and promote muscle protein synthesis. It is important to prioritize nutrition around training/exercise times, as carbohydrates and protein availability around these times can result in greater strength, functionality, and lean mass.

Macronutrients

Worried about weight gain? (one – I will say – you should NOT) Research has found that macronutrient composition of diets during the injury rehabilitation period can help manage body-composition changes. Diets higher in protein, a 2:1 Carbohydrate protein ratio, have been found to promote positive changes in body composition and meet the nutritional needs of recovery. This does not mean a LOW carb diet. Carbohydrates are essential in the recovery process as a source of energy, and they can negate muscle breakdown if the body is in a catabolic state. During recovery from an injury, approximately 3 to 5 g/kg or 55% of total calories during rehabilitation or recovery should be delivered as complex carbohydrates. The aim is to meet the carbohydrate need in the form of complex carbohydrates such as whole grains, fruits, and vegetables. Complex carbohydrates provide a variety of micronutrients and fiber, which assist in the rehabilitation process.

Protein needs are increased to support wound healing, tissue rebuilding, and glycemic control. If you do not get adequate protein, the body will begin to break down muscle to meet amino acid needs. For active individuals, a range of 1.4 to 2.0 g/kg/d of protein is recommended to maintain a neutral nitrogen protein balance. The amino acid leucine is especially important during recovery as it is primarily responsible for stimulating muscle protein synthesis. High leucine foods include: fish, poultry, tofu, edamame, eggs, may help aid the recovery process. During rehabilitation, protein intakes of at least 1.6 g/kg/d and closer to 2.0 to 3.0 g/kg/d are recommended, with an emphasis on consuming about 3 grams of leucine per serving

Inflammation is often demonized – the inflammatory process is a normal body process that happens upon injury and it’s important for healing. A prolonged inflammatory response can be detrimental to recovery/healing. Adequate consumption of fat can help reduce the degree of prolonged inflammatory response. Polyunsaturated and monounsaturated fatty acids are used for cell membrane production, saturated fatty acids are often used for fuel. During recovery, a diet containing high levels of monounsaturated fatty acids and ω-3 polyunsaturated fatty acids is ideal. A recommendation of ~20% to 25% of calories should be from fat: 0.8 to 2 g/kg/d and recommended daily intakes are 2 g per day of omega-3 fatty acids and 10 g per day of omega-6 fatty acids. Common food sources of omega-3 fatty acids are avocado, olive oil, fish, flax, nuts, and seeds.

TLDR; make sure you are an adequate and balanced diet to aid in your recovery and rehabilitation of an injury. If you are unsure, speak to a registered dietitian about what your specific nutritional needs are.

Abbie E. Smith-Ryan, Katie R. Hirsch, Hannah E. Saylor, Lacey M. Gould, Malia N. M. Blue; Nutritional Considerations and Strategies to Facilitate Injury Recovery and Rehabilitation. J Athl Train 1 September 2020; 55 (9): 918–930. doi: https://doi.org/10.4085/1062-6050-550-19

Papadopoulou SK. Rehabilitation Nutrition for Injury Recovery of Athletes: The Role of Macronutrient Intake. Nutrients. 2020 Aug 14;12(8):2449. doi: 10.3390/nu12082449. PMID: 32824034; PMCID: PMC7468744.