Have you recently sustained a physical injury? Are you feeling frustrated? Do you just want to overindulge in tasty comfort food to make you feel better? Well, DON’T! Try and beat the temptation as these foods are not ideal for rapid recovery. Not many people know that eating a healthy, well- balanced diet during rehabilitation actually facilitates the healing process, allowing you to resume your training as quickly as possible.
I guess you’ve gone to your doctor and walked out with the obvious advice of rest, ice and a couple of anti-inflammatory drugs… am I right? Doctors never seem to mention the importance of nutrition and the healing benefits of such foods, including curry powder, garlic, pineapple, cocoa, tea and blueberries.
If you get injured you should think about refocusing your nutrition on aiding your recovery, rather than fuelling your workouts. Your big focus in the recovery period, is to fight inflammation and fuel injury repair. The more serious the injury, the more critical the diet- for example, your nutritional needs will be drastically higher when recovering from surgery, compared to recovering from soft tissue damage, such as tendonitis. Overall, your diet should be focus on anti-inflammatory foods, cutting out pro-inflammatory foods, maintaining high intake of vitamins and minerals, and boosting your protein intake for complete repair.
Depending on the type of your injury, whether it is soft tissue or bone the healing process will be slightly different. The healing process of any injury is split into three steps:
- Inflammation is the first stage of healing and is the body’s response to trauma, to eliminate all damaged or dead cells replacing them with new ones. Inflammation is initiated by the increased movement of specific chemicals, such as leukocytes, neutrophils, macrophages and phagocytes into the injured area. These chemicals remove any unwanted cellular debris and increasing blood flow to the injury site. The 3 symptoms linked with inflammation are pain, swelling and redness. Although this is the most painful and irritating stage, it is essential for repair without it injuries wouldn’t heal. This phase usually lasts between 3-5 days.
- Proliferation is the second stage, where the structure of the damaged muscle or bone is rebuilt and regeneration occurs. The restoration of oxygen and nutrient flow to the damaged area, allows special cells, known as Fibroblasts to begin to replace Platelets. This creates a framework of Collagen for new cells to develop, and form scar tissue. Scar tissue is laid down in alignment with the forces being placed on the injured area, as the healing continues it will contract and shorten, reducing the size of the injury. This phase usually lasts between 48 hours and 6 weeks, depending on the injury.
- Remodelling begins at 6 weeks. At this stage your healing injury is reasonably mature, but as you move more your new scar tissue if often put under stress and finds that it isn’t strong enough to deal with increased physical demand. Your body often realises that a repaired structure isn’t as strong as it needs to be and will automatically make new tissue to help strengthen and support the healing tissue until it meets your demands of physical movement. The period between six weeks and three months post-injury is known as the remodelling phase.
The importance of nutrition during recovery
Our first instinct after getting injured would probably be, to reduce our overall daily calorie intake since we won’t need as much energy to fuel our trainings. Although, our energy requirements may lower when we are out of training- many of us aren’t aware that our Basal metabolic rate (BMR) increases from around 15-50% over a recovery period. An inadequate energy intake during recovery may prevent an athlete from getting healthy. There are no specific carbohydrate recommendations for injured athletes, however you should have an adequate consumption for good micronutrient intake. Carbohydrates should be got from whole grain, high-fibre sources such as oats, sweet potatoes, beans and legumes, whole grain rice, quinoa, etc.
A diet with an overall fat balance is very important, having a total fat intake, consisting of 1/3 of each fat (saturated, mono- & poly- unsaturated) will maintain a good inflammatory profile within the body. In addition to this, the ratio of omega-6 to omega-3 should be between 3:1 to 1:1 to again have a balanced inflammatory profile. Therefore, in line with these recommendations you should:
- Increase your intake of anti-inflammatory fats, such as olive oil, avocados, fish oil, flax seeds, mixed seeds and nuts and fish, including mackerel, salmon or sardines. This is because omega 3, aids in the process of healing and collagen deposition.
- Reduce your intake of high processed fatty foods (pro-inflammatory), vegetable oils (corn, sunflower, safflower and soybean) and refined carbs, high in Trans fats, such as biscuits, chocolate. As excessive inflammation could increase total tissue damage, slowing down the repair process.
Other than dietary fats, specific herbs and phytochemicals also help manage inflammation, including curry powder, garlic, pineapple, cocoa, tea and blueberries. The benefits of each of these foods will be described in more detail below:
Garlic inhibits the activity of certain inflammatory enzymes and impact macrophage function. Increasing the intake of garlic in your diet would be beneficial, however for the best results you should try, supplementing with 600-1200mg of aged extract.
Turmeric is thought to have anti-inflammatory benefits, due to its active ingredient curcumin. As turmeric is one of the main ingredients in curry powder, you should add more curry to your diet or a better strategy to manage inflammation would be to add 400-600mh of turmeric extract into your diet 3 times a day.
Bromelain is an anti-inflammatory plant extract present in pineapple. Other than being an anti-inflammatory, it is also an analgesic and has digestive benefits. You should add 500-1000mg of bromelain per day.
Cocoa, tea, red wine, and a range of fruit and vegetables are high in the anti-inflammatory flavonoids. An increase in consumption of flavonoid foods would be beneficial during times of injury, however an intake of specific plant extracts including blueberry or grape extracts, green tea extracts, citrus extracts and bioflavonoid supplements containing quercetin/dihydroquercetin and rutin may lead to more marked anti-inflammatory effects. Each meal or snack should contain 1-2 servings of fruit or vegetables.
An increase intake of protein is required during injury for a quick recovery, injured athletes should aim for 1.5-2.0g/kg of bodyweight and this should be taking consistently throughout the day. A good source of protein should be available at every meal, including lean meats and beans/legumes.
Vitamins and minerals are an essential part of the diet for metabolic reactions in the body. They can act as:
- catalysts that bind to enzymes to facilitate enzyme action in the body;
- coenzymes that work with other enzymes
- substrates that are directly metabolized themselves.
Vitamins A, B, C, and D alongside calcium, copper, iron, magnesium, manganese, and zinc are all important for injury recovery. However, vitamin E may slow healing so avoid vitamin E supplements during injury.
A number of these vitamin and minerals require additional supplementation in the few weeks after an injury, below we will summarise what each of these micronutrients is needed for and how much it should be supplemented.
Vitamin A enhances and supports early inflammation during injury, reverses post-injury immune suppression, and helps in the formation of collagen. You are recommended to supplement 10,000IU per day for the first 1-2 weeks post-injury.
Vitamin C boosts neutrophil and lymphocyte activity during inflammation stage of an injury, and it too also assists in the formation of collagen. A supplement of 1-2g of vitamin C per day is recommended to help you have a speedy and healthy recovery.
Copper aids in the formation of red blood cells and assists vitamin C to form elastin and to help strengthen connective tissue. During the first couple of weeks of recovery, a supplement of 2-4 mg of copper is recommended every day.
Zinc is essential for tissue regeneration and repair, as it plays a main role in DNA synthesis, cell division and protein synthesis and is required for around 300 enzymes within the body. During the first stages of the healing process, it is recommended to supplement 15-30mg per day.
Other beneficial supplements include arginine, HMB, glutamine, proteolytic enzymes- these have powerful effect on healing and speed up the process.
Take home messages
- The doctors’ orders aren’t always the best with Nutritional advice, but why, shouldn’t they know best? The majority of doctors send us home with anti-inflammatory drugs, however research suggests these drugs may interfere with muscle strain healing, weight training adaption and bone healing. Therefore, moderate the use of anti-inflammatory drugs during injury recovery.
- Eat healthy balanced diet! Carbohydrates, fats and protein are essential in adequate amounts during repair and recovery alongside micronutrients, especially the ones mentioned in the above article. A balanced diet will ensure a healthy and speedy recovery and help you back to the gym, pitch or track in no time.
- Just because you’re not training, doesn’t mean you stop fuelling your body! Your body needs energy to carrying out the healing process, so if you’re not eating enough this will delay healing! Food is just as important as rehabilitation for injury recovery!