Managing injury recovery well, can allow us a speedier return to doing what we love most. No-one wishes to be sidelined longer than necessary, and as such that which is seen as most beneficial to recovery is given the highest priority. Therefore the focus is commonly on treatment of an injury and adherence to rehabilitation exercise.
To compliment this treatment, injury recovery can be taken a step further by focusing on nutrition as part of the treatment plan. Generally we try to apply the maxim ‘quality in, quality out’ when healthy, and quality applies not only to exercise but nutrition as well. Wether a professional pursuit or a casual pastime, good diet is essential for performance and improvement of physical activity.
Yet these principles can be easy to forget once injured. In terms of injury recovery food is more than just fuel, as the body requires quality nutrition to aid healing. Supplying what the body needs is great for general health, but during injury recovery can assist in the rebuilding of muscle and bone, along with the repair of damaged tissue.
Whether an acute or chronic injury, or a planned surgical procedure, there is much nutrition can offer towards injury recovery. Thankfully regardless of the injury and the chaos that ensues, the process by which we heal follows an organised pattern that we can use to carefully plan, what foods are best to use and when.
Food to deal with inflammation
When we hurt ourselves, the body’s natural reaction is inflammation, that initiates a biochemical process that removes injured tissue and starts the job of repairing bone, muscle and connective tissues. Even though this is painful, inflammation is a natural process of healing, so at the onset of an injury, it is best not to interfere and instead let the body do it’s job. On the other hand excessive or prolonged inflammation for more than a couple of weeks, can be counter productive, reducing mobility and slowing repair, but this is dependent on the injury.
Your doctor or physiotherapist will be able to determine whether or not the swelling is of concern, sometimes prescribing non-steroidal anti-inflammatory drugs (NSAIDs) to help assist in pain relief and the body’s range of motion, within the first week of injury.
Then at some point it will be appropriate to introduce foods that have anti-inflammatory qualities. These include foods such as garlic, and turmeric that can be taken as a whole food or supplement, as can bromelain from pineapple. Flavononoids can also help manage inflammation through their antioxidant qualities and can be found in foods such as cocoa, tea, blueberries, and leafy greens like silver beet, bok choy and broccoli. Although in a balanced diet it is best to eat more of these foods, for some it may be more achievable to take a supplement that contains these nutrients.
One of the most potent anti-inflammatory sources are foods containing omega-3, for example fish such as salmon, anchovy, tuna as well as soybeans and spinach. Nuts like pecans, pistachio and walnuts are also a great source, as are seeds such as chia and flax. However there is a debate as to which source of omega-3 fatty acids is better, as plant based sources may be harder to absorb, so it is best to use a variety of foods to cover all bases. In addition it is good to balance out the fats found in protein sources with monounsaturated fats, from ingredients like olive oil, avocado and almonds.
Nutrition for repairing and rebuilding of tissue
During a period of injury recovery, and hence time off from regular activity, it is common for there to be a loss of appetite. This under eating can then lead to a loss of lean mass and an increase in fat mass of the body. So once returning to normal function the body is at a disadvantage when attempting to return to previous exercise levels.
To maintain lean body mass, the calorie intake must sit somewhere between what the body will consume at rest, and the energy which it consumed daily in pre-injury exercise. Also ideally the balance of nutrition will see enough protein to help with repair of the body’s structure, whilst other foods provide calories to maintain body mass without replacing muscle with fat. Although unrealistic to measure this on a daily basis, this is where some simple rules that balance protein, fats and carbohydrates, can be put into place.
For each meal measuring the correct portion of each food type, is helped by using our hands as a guide. So ideally we use the following to provide a basic guideline to eat by; one palm size portion of protein for women, and two for men; one to two fist size serves of vegetables and fruit; one or two palmfuls of unprocessed carbohydrates; one or two thumbs worth of high omega-3 and monounsaturated fats. During injury recovery it is important to eat these portions around every four hours, to ensure the body has a steady supply of nutrients to draw upon. Although small portions, eating fibre rich foods such as vegetables, fruit, legumes and unrefined grains, will help create the feeling of fullness after a meal.
The first thing this transition to repairing injured tissue will need is a constant supply of protein. The building blocks of life, protein is broken down by the body into acids that assist in this cell growth and repair phase of injury recovery. This involves the laying down of new soft tissue, whilst the scar tissue that was previously developed after injury, strengthens.
The body can source protein from meat, fish or eggs, as well as green peas, kidney beans, quinoa, almonds, sunflower seeds and foods made from soybeans such as tofu.
Vitamins and minerals
For small metabolic reactions to take place in the body, sufficient levels of vitamins and minerals are essential. Without them injuries are more likely, and once injured healing will be slower. So being deficient in some vitamins and minerals will create problems, yet that does not mean that we then have to have great amounts of supplements to aid injury recovery.
A balanced diet or a multi vitamin will ensure that the body has sufficient levels of vitamins and minerals such as calcium, vitamin D, manganese, magnesium, iron and vitamin B. Some vitamins and minerals rely on each other to be more effective, for example Vitamin D and magnesium aid in the body’s absorption of calcium for muscle and nerve function as well as strengthening bones. For these nutrients it is important for the body not to be deficient, yet some vitamins and minerals can be taken as supplements to aid in the speed of healing, these include Vitamin A, Vitamin C, Copper and Zinc.
Vitamin A strengthens cross linkage of collagen, the main protein found in connective tissue, while vitamin C aids in the production of collagen, helping to build and strengthen ligaments, tendons, bone and cartilage. Copper works with vitamin C to create elastin, a highly elastic protein in connective tissue, whilst Zinc is necessary for tissue repair. So where do we find these vitamins?
Dark, leafy greens such as kale and spinach cover both Vitamin A and C, as do broccoli and peppers. Cooked sweet potato, carrot or pumpkin are sources of vitamin A, as are fish, dried apricots, and tropical fruits. Vitamin C can be found in citrus fruits, berries and strawberries. Note that Vitamin A is a fat soluble vitamin, so needs to be consumed with fat or oil in order to be better absorbed. The same fat soluble rule applies to vitamin D, found in fish oils, fatty fish, mushrooms, cheese, and egg yolks or by having it produced naturally by the body when skin is exposed to the sun.
As the body needs vitamin D to better absorb calcium, it is widely added to many foods that are naturally high in calcium such as milk. Once again dark, leafy vegetables and broccoli are a good source of calcium, as are green beans, whole grains and fish eaten bones and all. Copper can be found in seafood, such as oysters and squid, sesame seeds, cashew nuts and kale. Zinc can be sourced from red meat, chicken, oysters, lentils, rice and dark, leafy greens, pumpkin seed and nuts.
In fact raw nuts and seeds plus leafy greens cover most of these sources along with other nutrients such as magnesium and vitamin K that aids in cartilage repair.
Other nutrients to consider for injury recovery
These supplements can include a good quality mix of amino acids. These are commonly sold as post training recovery supplements, but can also be used for post injury recovery. Mixes that contain ingredients such as Arginine, Glutamine and HMB are popular, as they are used to protect muscle protein breakdown in both the medical and sports fields. There is some controversy as to how effective these supplements are so taking them will be a personal choice.
Glucosamine, although shown to be effective in managing osteoarthritis, has not been confirmed as effective in injury recovery treatment. So for these and other compounds it is best to research evidence of their effectiveness.
Regardless of the vitamin, mineral and amino acid components mix that is chosen, ideally they are firstly consumed as whole fresh, foods, yet when deficiencies in the body are identified or the food form is not practical, they should be taken more conveniently as supplements. Either way this will ensure the nutrients for injury repair are accessible, no matter where you are.
Organising food for success
Injury unfortunately interrupts our otherwise active routine, but it can also provide an opportunity to motivate us in making improvements to our diet. Knowing that adding certain foods to a diet is potentially going to make pain go away or improve recovery time, can in the same way make it easier to avoid foods that promote inflammation.
The main focus with any improvement to our heath should be consistency. As having half the recommended nutrients one day and half the next will not work, rather a consistent supply of nutrients each day will ensure the body has what it needs when it is needed. Everybody’s situation is different though, so for some, eating these foods will be achievable, whilst others will need to use supplements to achieve their nutritional goals.
To do this requires some form of planning, after all buying the ingredients and having them on hand is great, but only if you remember to eat them. So keeping a daily checklist in a diary or on the fridge, to tick off foods and supplements, will keep an injury recovery nutrition plan on track. The simpler the set up of this nutrition management, the greater chance of success.
Food to avoid post injury
Red wine in small amounts is an anti-inflammatory, but excessive alcohol consumption should be avoided as it leads to dehydration, which in turn can be counter productive, as a lack of fluids will slow the rate of nutrient absorption. Alcohol should definitely be avoided immediately after injury, as its blood thinning properties can increase the bleeding and swelling around soft tissue. Further to this, alcohol dulls the senses and masks pain, creating a greater likelihood the injured area will be over used. This can then increase damage to the injured area, being counter productive to the protection that inflammation naturally provides. A false indication of how severe the injury appears can also lead to a delay in seeking physiotherapy treatment.
Saturated and trans fats are now well associated with major health risks, and when consumed in excessive amounts are also counter productive, in that they create inflammation in the body. The same can be said for refined sugars and carbohydrates, so where possible the rawer the ingredient the better, as whole grains and natural sources of sugar provide better nutritional value.
Avoiding injury is the ideal, yet once injured the elements needed for injury recovery can be limited, yet nutrition is one factor that can always be improved upon. Therefore time spent during injury recovery, can be done so wisely with healthy food that compliments rehabiliation, strengthening the body inside and out.