If you're athletic, or at least you try to be, there is nothing worse than taking time out to recover from an injury or surgery. Injuries are, most often than not, a side effect of being physical, and most of us will experience at least one injury throughout our active lifetime. Whether it's a sprained ankle, a pulled muscle, a ligament tear, or, heaven forbid, a broken bone, the older we get, the more likely they seem to be. One thing I've realized about getting older is that I've mysteriously become less invincible. As a result, injuries take me out of the game longer, and it looks much more challenging to regain my hard-won fitness levels.
When you're active and love exercise as a stress reliever and a way to build a sense of personal accomplishment (as I do), taking time out for injury is the biggest insult to the ego you can get. As a result, I am very interested in ways to prevent injury and get back in the game faster when the time comes.
I'm not talking about finding the magic pill or elixir to circumvent our body's natural healing processes or any quick fix to mask pain. I'm talking about using good old fashion food as fuel and its powers to encourage healing.
Understandably, relying on nutrition to help heal us from the inside out is like practicing blind faith on a daily basis. Although the benefits of eating a wholesome, natural diet are plentiful, many of those benefits are intensely internal. Unless we scientifically plot our body's health, many benefits will happen beneath the surface. If we want to help improve our body's resources to help heal us, I'm sorry to say that eating one tomato won't cut it; it has to be a long-term, consistent approach to eating. The more you invest in eating wholesome, natural foods, the more your body has the right tools to heal you from injury.
Let's dip our toes into the healing process to understand food's role in this journey better. Healing happens similarly, whether it's a mishap on the sports field or a planned surgical venture. According to Dr. John Berardi at Precision Nutrition in his 5-part series on Injury Nutrition, there are three stages of recovery. The first is inflammation, which is an excellent thing to happen during the initial stages of an injury. Our body rushes its defenses to the site of the wound to protect it and sweep away garbage and debris, which comes in the form of protective inflammation. Some obvious signs of inflammation are pain, swelling, redness, and heat. This stage of our healing process aims to support, not eliminate, this beneficial inflammation.
But over the next few days, proliferation steps up, and inflammation should step down. Oxygen and nutrients start flowing back to the site, and collagen fibers start laying down to form "scar" tissue. Next comes the remodeling phase, where our wound begins to heal.
Throughout this process, there are a few ways we can support our healing with nutrition: adequate calorie intake and protein, anti-inflammatory foods, micronutrients, and probiotics.
If you're recovering from an injury, your appetite may have tanked because you're suddenly sedentary and not moving as much. You also become afraid of gaining weight because you're not as active. In this case, you purposefully want to eat less. However, the main emphasis of post-injury nutrition is consuming enough calories. Your body is internally putting in serious work to repair the damage, and that labor requires energy. By under-consuming calories for whatever reason, you're depriving your body of the necessary energy to do it's job.
However, the number of calories you need to consume will be at a different level than when you're training or at the peak of your fitness. Whatever your sedentary baseline requirement of calories is per day (for example, 1600 kcal), you should consume 20% more. This amount will be lower than what you'd eat if you hit the basketball courts hard every week but slightly more than sitting at a desk job all week.
To get the most out of your calories, quality matters. Not all food is fuel; food items that are heavily processed or deep-fried aren't the nutritious choices you need to fuel your healing. Wholesome, natural foods over sugary, salty, and fatty snacks are always the fuel of choice.
According to the article Rehabilitation Nutrition for Injury Recovery of Athletes: The Role of Macronutrient Intake, published in the peer-reviewed journal Nutrients in 2020, protein intake during injury recovery is paramount to recovering adequately. According to its author, Papadopoulou, for longer-term injuries that require rest of that particular muscle (around six weeks), that muscle can atrophy at 0.5% daily. Also, according to her research, if a quadriceps loses 8% of its muscle mass, you can lose 23% strength!
Therefore, consuming enough protein to maintain lean muscle mass is essential for rehabilitation. According to Dr. John Berardi, an injured person should consume protein every few hours and aim for 1.5-2.0 g/kg, up from the usual 0.8 g/kg. Papadopoulou agrees and suggests the addition of leucine, an amino acid that helps switch on protein synthesis, should also be a priority. The National Athletics Training Association (NATA) tells us that leucine-rich foods include cheese, meat, fish, nuts, and seeds, which you should eat regularly throughout your day. NATA even suggests consuming casein-rich (dairy-based foods) before bed, as they will slowly release through your bloodstream throughout the night. Talk about working overtime to heal you faster!
Short-term stints of inflammation are beneficial to wound healing. However, chronic or excessive inflammation is not. Two types of nutrients promote or inhibit inflammation: Omega 6 and Omega 3. Omega 6s are required in our bodies to help with inflammation, but not to the degree to which modern humans consume them. Examples of Omega 6 food that promote inflammation are processed junk food, deep-fried foods, and vegetable oils. The goal is to rebalance the ratio of Omega 3, which are anti-inflammatory, to mitigate the effects of Omega 6s, which we can easily do by changing our cooking oils and including Omega 3-rich foods like seafood, nuts, and seeds. Simultaneously, reduce the amount of junk and processed food you consume, and you'll be on your way to reducing chronic inflammation.
MICRONUTRIENTS & ANTIOXIDANTS
Dr. John Berardi tells us that the scientific jury is still out on whether to supplement for specific micronutrients when injured or ensure we don't have a deficiency. However, most of us lack the required amount of fresh fruits and vegetables in our diets, so placing careful emphasis on including 1-2 fists of colorful vegetables per meal is a good way of ensuring we get the micronutrients we need. Some valuable players in our healing will be Vitamin A, which supports early inflammation; Vitamin C, which helps with collagen production; Copper, which promotes red blood cells; and Zinc, which aids tissue regeneration and repair. Other foods with powerful antioxidant properties that can help heal are turmeric, bromelain (pineapple), Boswellia, garlic, and flavonoids (ex., Blueberry and cocoa). Another positive effect of eating so many vegetables is that some medications prescribed by your doctor may make you constipated, and adding in extra vegetables is a gentle way to make this issue pass.
PRO & PREBIOTICS
Medications can alter your gastrointestinal system. Eating plenty of probiotics (fermented foods such as kimchi, kombucha, yogurt, miso, etc.) and prebiotics such as barley, oats, wheat, and mushrooms will help rebuild your gut bacteria.