Nutrition For Injury Recovery

Injuries happen - and there is no doubt that they are aggravating, annoying, irritating and disappointing. 

Whether it is an acute injury, chronic/recurring injury or if you’ve had to have surgery - we know that injuries and recovering from injuries are greatly impacted by our nutrition. We aren’t talking about pills or powders as replacements either, we are talking about real food that can provide your body with the right nutrients to support the healing process and enhance performance once you can return to your activities.

Optimal nutrition can play a key role in controlling inflammation, rebuilding injured tissue, minimizing muscle atrophy and supporting strength preservation and gain. 

First, let's review the body’s physical response to injuries and surgeries. The body responds to injuries with a 3 stage healing process and nutritional needs change in each stage:

1. Inflammation - pain, swelling, redness and typically heat as the body is drawing chemicals into the injured area.
2. Proliferation - Damaged tissues are removed, blood flow comes in and supports the body with building new, temporary, tissue.
3. Remodeling - Stronger, more permanent tissue is built to repair and restore the body.

5 Tips To Help You Manage Recovery and Support Your Body

1. Eat Enough Calories: Energy demands are higher as the body is repairing, recovering and rebuilding. Many individuals think they should eat less because they are moving less, but that is the opposite of what your body needs!  Energy needs are about 15-50% higher than normal so we need to fuel the healing process appropriately. After an injury or minor surgery athlete’s metabolic rate increases approximately 15% to 20%. Major surgery can increase these needs by almost 50%. (1) 
   
   Additionally, crutching requires two to three times more energy than walking. Insufficient energy intake (80 percent of total requirements) for 10 days can reduce muscle protein synthesis by 20%, thus impacting rate of complete recovery. The goal here is not to catabolize muscle, but rather to support the body with the right fuel to maintain mass and build new tissues which requires protein, and many other nutrients as we will discuss.
   
   
2. Eat Enough Protein and Leucine: Injury repair requires more protein. Atrophy from muscle disuse after injury is attributed primarily to a decline in muscle protein synthesis rate. Additionally, immobilization decreases the ability of myofibrillar proteins to respond to amino acid stimuli. This is called anabolic resistance, which makes the muscle building process more difficult. Nutritional strategies, such as supplementation of protein intake with leucine are feasible and effective in offsetting anabolic resistance.
   
   In order to combat this, research suggests that focusing on the amount, type, and timing of dietary protein ingestion throughout the day can decrease the loss of muscle mass and strength during healing from injury and stimulate muscle protein synthesis. Dietary proteins with a full complement of essential amino acids and high leucine contents that are rapidly digested are more beneficial in the healing process.
   
   Injured athletes should aim for 1.6 to 2.5 g/kg body weight, which is higher than the usual recommendation 1.2 to 1.7 g/kg for athletes and 0.8 to 1.0 g/kg for recreational exercisers. For example, a 150-lb (68-kg) athlete would require 109 to 170 g of protein daily during healing from an injury. To maximize muscle protein synthesis and optimize healing, athletes should consume protein consistently and distribute it evenly throughout the day at 20 to 40 g per meal or snack, rather than back-loading protein at dinner.
   
   The important piece to note here is the leucine content. Leucine is one of the three branched-chain amino acids and researchers suggest that it is the most important as it helps to regulate blood sugar, improves wound healing, and produces growth hormone. Leucine is best known for its role in the muscular system, aiding in muscle building, muscle repair and preventing muscle loss. (3) Foods high in leucine include chicken legs, skirt steak, pork chops, tuna, salmon, turkey, chickpeas, brown rice, eggs, soybeans, nuts, beef, and milk products. You could also consume a high quality BCAA such as HYDRATE (which also has other benefits we will talk about here shortly).
   
   
3. Manage Inflammation: Early nutrition is key to the recovery process, but postoperative nausea can present a barrier. If you are nauseous, you should aim to include more bland foods - we have all heard of the BRAT diet right? Banana, rice, applesauce, and toast. Consuming smaller and more frequent meals can be helpful as well as including easy to digest and palatable nutrient-dense liquids such as soups and smoothies. 
   
   During this time we would recommend removing inflammatory foods and sticking mainly with one ingredient whole foods.
   
   Consume anti-inflammatory oils such as Omega 3s, olive oil, avocado, flax seeds, nuts, coconut in all forms, wild caught fish, grass fed meat, fruits and vegetables. 
   
   Omit, or minimize, pro-inflammatory foods such as processed foods, greasy foods, processed meats [hot dogs, salami, pepperoni, etc], and vegetable oils [canola, safflower, soybean, corn, sunflower oil].
   
   You can also add in RELIEF - for a good dose of turmeric and curcumin which provide many benefits for inflammation!
   
   
4. Hydrate and support gut health and digestion! We have talked about the importance of hydration many times, but in this case we need to hammer it home again because all three stages of tissue healing require water as a vessel to supply the necessary nutrients to support healing. Additionally, we know that digestion is often slowed when the body is putting energy to the healing process and, therefore, some people can become constipated. Especially if you are taking certain pain meds.
   
   So, increasing your fluid and increasing fiber can support your digestive system and improve constipation. If this is not effective, you may try adding a small amount of prune juice each day.
   
   Additionally, if you have had surgery and need to be on antibiotics [important for preventing infection] you may want to also consider increasing your intake of prebiotic and probiotic foods. Antibiotics unfortunately kill more than the infection, they kill off beneficial gut bacteria we need for our digestive and immune health; so we want to focus on restoring the beneficial bacteria through the probiotics and prebiotics. We have discussed the difference between pre and probiotics in our recent blog HERE. But to summarize, probiotics are live, good bacteria that contribute to a healthy gut environment. Prebiotics are plant fiber that feed the good, probiotic bacteria. Probiotic rich foods include yogurt, kombucha, sauerkraut, miso soup and kimchi. Prebiotic rich foods include jicama, onion, garlic, asparagus, oats, wheat, barley and mushrooms.
   
   
5. Focus on Micronutrients! There are a variety of ways to support the body with micronutrients, but we don’t want you just to focus on powders, pills or supplements to accomplish this. As we always say, food first then supplementation. Focus on including a variety of fruits and vegetables throughout the day. Antioxidant-rich fruits and vegetables also help control inflammation, which can speed healing. Some of the highest sources of antioxidants include goji berries, blueberries, tart cherries, dark chocolate, pecans, artichoke, elderberries, kidney beans, cranberries, blackberries and green tea. Pineapple, turmeric, garlic and ginger have also been shown to have beneficial anti-inflammatory properties. 
   
   You can easily include these foods throughout the day. For example, start the day with an anti-inflammatory smoothie with greens, beerries, pineapple, ginger and CLEAN protein powder (see recipe below), have a big stir fry or soup for lunch with kidney beans and turmeric included with your protein source and a salad with goji berries, cherries, artichokes, pecans at dinner (along with a high quality dressing made from olive or avocado oil and your protein source of course!). Finish the day with a dark chocolate treat post dinner :)

Other ways to get Micronutrient support

Electrolytes - Electrolytes, such as sodium, potassium and chloride, are vital for maintenance of hydration, generating energy and contracting muscles, and are lost through sweat.

Vitamin C - Vitamin C plays a major role in tissue growth and repair, wound healing and bone maintenance and repair. Consuming adequate vitamin C will aid athletes in staying healthy and ready for game day.

Our HYDRATE includes BOTH Vitamin C and electrolytes including magnesium, sodium, potassium and calcium. 

Iron - Iron plays a role in transferring oxygen from the lungs to tissue and is critical for respiration and energy metabolism. Because iron influences endurance and performance, it is an important micronutrient.

Calcium and Vitamin D - Essential for bone health and growth, calcium also helps reduce the risk of stress fractures. Vitamin D is needed to maintain calcium levels in the body, develop healthy bones and the function of skeletal muscles. 

If you’ve recently experienced an injury, or know that you will be undergoing surgery, take these strategies to heart to optimize your healing so you can get back to doing what you love.  It can often be the difference between bouncing back quickly, or struggling to get back to normal!  

Sources

1. Bledsoe J. The sports injury doctor. Nutritional sports injury therapies — what you eat can play a significant part in preventing or healing a sports injury; [cited 2015 Mar 3]. Available from:http://www.sportsinjurybulletin.com/archive/nutritional-therapies.html#.
2. Wall BT, Morton JP, van Loon LJ. Strategies to maintain skeletal muscle mass in the injured athlete: nutritional considerations and exercise mimetics. Eur J Sport Sci. 2015; 15(1): 53–62.
3. Top Foods High In Leucine. https://www.webmd.com/diet/foods-high-in-leucine#1