Nutrition and the foods you eat play an important role in preventing and recovering from injuries. Minimizing muscle loss during injury recovery can be impacted largely by the composition of your diet. Inflammation and weight management can also be attributed to the nutrient density of foods you eat.

The first step of the injury recovery process is an inflammatory response that helps with healing. This is a normal and necessary process of healing for bone and tissue injuries, so temporary inflammation in this case isn’t a bad thing! This process begins immediately after the injury occurs, and swelling may be a common result. Depending on the severity of the injury, a nutrition intervention to reduce inflammation may not be needed (ex. hurting a finger vs. tearing an Achilles’ tendon).

The second step of injury recovery occurs when the athlete starts to resume movement on the injury and it can become weight bearing again. In this situation, calorie needs for the athlete are increased because the body is working harder to recover. Caloric needs in this stage may be closer to someone who is trying to gain lean mass as the athlete is both training and working through an injury.

Increased Calorie Needs

It is often overlooked that athletes have increased calorie needs that can range from 15-50% more calorie needs depending on the severity of the injury. This means increased calories, more protein, and an emphasis on micronutrients and antioxidants. As your body is working harder to heal, it needs more energy through foods. That being said, your RMR (resting metabolic rate) is different during recovery than it was before. If calories are restricted during recovery, healing will be slowed because of the negative metabolic consequences that interfere with wound healing. It is better to slightly overfeed an athlete during recovery than it is to underfeed or undernourish them.

A common thought that occurs to athletes who have decreased their training load during injuries is that they need to drastically decrease calorie intake so they do not gain weight or change body composition. However, there are energy expenditures during recovery that need to be evaluated. Athletes using crutches burn 2-3 times more calories than just walking, and doing rehab through physical therapy uses a lot of energy. Our main goal with nutrition during this time is to prevent deficiencies while providing optimal nutrient needs to prevent muscle loss.

Increased Protein Needs

Muscle degradation is another common result after injuries due to less training, being in a cast, etc., which is another area where purposeful nutrition can help in recovery. Studies have shown that limb immobilization can result in muscle atrophy and loss in lean mass, which is where nutrition intervention comes in. Protein needs from high quality sources increase from being 1.2-2.0g/kg for athletes (or 0.8g/kg for the general adult) to 1.6-2.6g/kg per day (higher for larger athletes who do more weight training vs. an endurance runner. As a general recommendation, aim for about 2.2g/kg, which would be the equivalent of 1g of protein per pound of body weight. Make sure to incorporate leucine into intake by consuming foods like meat, fish, eggs, dairy, and beans. Spreading protein intake throughout the day in 20-40g increments every 3-4 hours is optimal for absorption and building.

Additional nutrients that can be beneficial are creatine, omega-3s, vitamin C, vitamin D, and calcium. Creatine has promising research that it may help with strength improvement and has been shown to prevent a decrease in GLUT4 concentration during immobilization of the injury.

Omega-3s are commonly supplemented during concussion recovery and research supports supplementation to help overcome anabolic resistance and inflammation. However, be aware of supplementing around the time of surgeries if the athlete has already been taking fish oil.

Calcium and vitamin D go hand in hand with bone health. Evidence shows athletes are more likely to get injured when they are getting an inadequate amount of vitamin D. Vitamin D and calcium are both vital to building strong bones and preventing osteoporosis. There is good data showing Vitamin D’s importance in preventing injuries and stress fractures. Supplementing with calcium may not be necessary if you are getting a well-balanced diet with dairy and fortified foods. If you are also supplementing with iron, do not take them at the same time because calcium interferes with the iron absorption.