Injury recovery is an uphill battle. Youre burdened by pain, isolated from training partners, inundated with appointments and rehab, worried about your diagnosis (or lack thereof), and sidelined from a sport that you love. On top of all that, you might feel the need to rethink the way you eat, since your level of activity is lower than normal.
There are conflicting schools of thought when it comes to how to best fuel up while youre in recovery mode. Ifyoure training less, it might seem logical that you should be eating less.On the other hand, maybe youveheard that you should err on the side of more calories, since even a small nutrient deficitcanimpede your healing. Research suggests that the sweet spot lies somewhere in the middle. Below, three registered dietitian-athletes share the latest findingsin injury nutrition, plus actionable advice, so that food can be an asset and a source of pleasurerather than a source of stressduring an already trying time.
Respect the energy demands of healing. You may be moving less than normal, but the body immediately gets to work after trauma, explains Claire Fudge, an Ironman triathlete, a registered dietitian, and the founder of 4th Discipline Triathlon Nutrition in Birmingham, England. If youre dealing with an acute injury,your heart rate speeds upin response to tissue damage, pain, and anxiety (whichis an immediate psychological response to injury). The site of your injury swells as your blood flow increases and your body ramps up theproduction of cytokines, a type of protein that helps mediate inflammation. To keep up with all this extra work, your metabolism increases, too.
Metabolism can increase 15 to 20 percent with trauma, minor surgery, and the use of crutches, saysCatherine Kruppa, a masters marathoner and registered dietitian who owns Advice for Eating, in Houston. Major surgery spikes it even more.Exact caloric demands depend on the type of trauma and your position in the chain of healing events, but the bottom line is that your body is under stress, and your energy needs likely increased at the onset of injury. Your priority should be getting enough calories to support healingnot limiting your intake because youre moving less.
Gaining weight is a common fear among sidelined athletes, but do your best to put that aside. Its true that eating exactly as you did pre-injury may lead to a change in body composition. In some sports, that could result in a competitive disadvantage upon your return. The natural conclusion for most athletes, then, is to decrease food intake to prevent increased body fat and total mass. But a fixation on weight or leanness can muddy the ultimate goal of healing quickly and completely. As Kelsey Beckmann, an Olympic Trials marathoner and a registered dietitian in Jacksonville, Florida, puts it: Were faster when were a few pounds heavier than we are when were injured.
Beckmann encourages injured athletes to keep in mind that marginal differences in body weight are typical across a season for most people, andsimilar to a postseason break, your body will normalize once youve returnedto full training.The single most important nutritional consideration during reduced muscle activity and/or immobility is to avoid nutrient deficiencies, a 2015 study published in Sports Medicine concluded.
Just aseliterunners eat differently during 100-mile weeks than during taper weeks, your nutritional needs will change throughout a season of injury. There arethree widely accepted phases of healing: inflammation, in whichyour immune system is activated and damage-control cells rush to the injured site; proliferation, which is when your body builds new tissue, restores blood vessels, and covers the surface of any exposed wounds; and remodeling, the period inwhichthe traumatized area matures and regains strength, often leaving a scar in its wake.
As your bodys natural inflammatory response goes to work during the first few days post-injury, Kruppa suggests eating balanced meals with plenty of whole foods, especially asmany fresh fruits and veggies as you can get your hands on. Purported anti-inflammatory foodslike turmericget a lot of buzz, but the bottom line is that a healthy, well-rounded diet is the best culinary defense against inflammation, rather than one specific ingredient. However, there are certain ingredientsthat promote inflammation. If it doesnt create too much stress, try to moderate your intake of refined carbs, simple sugars, trans fats, and alcohol.
During proliferation and remodeling, which start around day four and last as long as your injury does, your body is busy replacing damaged tissues with new, healthy ones. Kruppa explains that your goal during this time should still be balanced nutrition, and she emphasizes how crucial it is that you get adequate calories in the form of ample protein, complex carbohydrates, and healthy fats.
Of the three macronutrientscarbs, fat, and proteinresearch best supports the role of protein during injury recovery. Whenever a body experiences a health disturbance, such as sickness or inflammation, extra protein is required to maximize muscle protein synthesis. Consume too little of itand your healing will lag, inflammation will increase, and muscle loss may follow.
Beckmannrecommends aimingfor one gram of protein per pound of body weight per day while recovering from an injury, so 140 grams for a 140-pound person. Spreading that intake throughout the day is helpful, tootry and sneak a littleprotein into each meal and snack, and geta final hit at bedtime. A 2016 studypublished in the journal Nutrients found that eating protein immediately before sleep can stimulatemuscle protein synthesis as well as adaptation from that days training. Seek outavarietyof proteinsources, such as ethically sourcedmeats, dairy products, eggs, beans, tofu, and tempeh. All of these high-protein options are alsorich in leucine, an essential amino acid involved in the growth and repair of muscle, skin, and bone.
The bodys primary fuel source is glucose, one of the simplest types of carbohydrates. Anytime you eat a carbwhether thats from fruit, bread, or potatoesyour body breaks it down into glucoseand either uses it immediately for energy or stores it as glycogen. Its a critical part of cellular health: glucose gives our cells the chemical energy and heat they need to function, which means its also a major player when it comes to recovery. Not eating enough carbohydrates could prompt us to mobilize our lean body massmuscleas fuel, Beckmann warns. Were extra vulnerable to losing muscle when were injured, so its even more important not to skimp.
Her recommendation is to eat a minimum of 1.4 grams of carbohydrates per pound of body weight per day, and aim to get about 40 percent of your total daily calories from carbohydrates. Because you dont need quick-digesting carbs like bagels and sports drinks to fuel your training, its a good time to load up on complex ones like sweet potatoes and whole grains. These offer more nutrients, ample fiber, and longer-lasting energy. And dont stress too much about a sugar craving. At the end of the day, our bodies are going to break either type of carbohydrate down to energy, as molecules of glucose, Beckmann says.
Beckmann endorses a deliberate approach to fat intake while youre out of commission. Trans fats, omega-6 fats, and saturated fats are considered pro-inflammatory, she says. Adding to your bodys natural inflammatory response may be counterproductiveespecially in the early stages of healing. But research shows that a diet high in monounsaturated fats and omega-3s aids with collagen deposition, a key part of the rebuilding process in which tissues gain the strength and structure necessary to absorb impact and force again. Avocados, nuts, seeds, olive oil, and fatty fish are some of Beckmanns favorite choices for athletes on the mend.
A supplement, by definition, is supposed to be an add-on, not the main ingredient. If you are eating a balanced diet full of lean protein, healthy fats, dairy, whole grains, and fruits and vegetables, you will be ahead of the game and likely wont need supplements, Kruppa says. She recommends leaning on real foods containing the following micronutrients: vitamin A, vitamin C, vitamin D, calcium, magnesium, zinc, and copper. These are largely found in colorful fruits and vegetables as well as in dairy products, nuts, and seeds. Mushrooms, for example, are great sources of copper, which assists with red-blood-cell formation, immune function, and bone health. Legumes contain high levels of magnesium, which plays a role in protein synthesis, circulation, and the absorption and metabolism of calcium and vitamin D.
That said, its not always possible to meet your nutritional needs through food alone. With a bone fracture, for instance, Kruppa says that your calcium needs increase to 1,500 milligrams per day, which may necessitate supplementation. For context, a singleserving of cows milk has 305 milligrams of calcium.In addition, many healthy and injured athletes alike supplement their iron, an essential mineral that helps transport oxygen from your lungs to your musclesand an easy one to run low onespecially if youre a female endurance athlete. If you think you might be deficientcommon symptoms include dizziness, fatigue, and weaknessconsult with a doctor and get a blood test before supplementing iron.
Fudge and Kruppa agree that its also worth considering supplemental protein, amino acids, and collagen.Leucine, a branched-chain amino acid, stimulates muscle protein synthesis faster than other amino acids. Casein, a milk protein that comes in powdered form and many dairy products, contains all the amino acids your body needs to build and repair muscle. Creatine, an amino acid, may help prevent muscle loss, especially while a limb is immobilized. Whey protein may boost ligament, tendon, and muscle healing when consumed within an hour after exercise or rehabilitation. And collagen, when ingested before exercise with vitamin C, may help with the recovery of ligament and tendon injuries.Consult with your doctor or a nutritionist first to ensure a supplement makes sense for you.
As with most nutritional questions, there is no one-size-fits-all answer. The keys to a good recovery diet are simple: pay attention to what your body needs and wants, make sure youre getting enough nutrients and calories, and dont sweat the small stuff. Youll be back in the saddle before you know it.
How to Eat When You're Injured - Outside Magazine