What is key in diet when injured?
Have you suffered an injury during exercise? It’s an unwanted but unfortunately inherent part of doing sports. It is estimated that in professional athletes, for every 1,000 hours of activity, an average of about 4 (more serious or less serious) injuries occur.
It’s worth doing everything to counteract them (e.g. taking care of post-exercise recovery), but if injuries have already occurred, you need to bring out the big guns: incorporate the right nutritional strategy and rehabilitation. Nutrition during the period of injury is not radically different from the usual nutrition of athletes, but it is worth making some improvements that can be key for better shape and faster recovery.
The biggest challenge for immobilised athletes is to maintain the muscle mass they have developed, without accumulating unwanted body fat. The right diet will allow you to achieve this, while keeping you in shape and avoiding destructive oxidative stress in your cells. At the same time, it will also support your health and immunity.
Key in the diet when injured are first and foremost:
- optimal energy supply;
- sufficient dose of protein to support recovery;
- unsaturated fatty acids to regulate inflammatory processes;
- micronutrients that help repair tissues.
You can also support yourself with well-chosen supplementation.
Changes in the body when injured
To understand the role of nutrition after an injury, it is good to realise the metabolic changes that occur in the body at this time. They can be counteracted with a properly composed menu. Athletes are primarily concerned about the potential loss of muscle mass and strength through immobilisation, but this is not the only phenomenon occurring in the body during this time.
Injury-induced immobilisation carries a real and almost inevitable risk of losing muscle mass and muscle strength. Muscle atrophy in the initial phase after injury means the loss of about 0.5% of muscle tissue per day. This means that an active person can lose as much as 300-800 g of muscle mass from the legs alone in the first two weeks of total immobilisation.
Muscle atrophy, otherwise known as sarcopenia, is caused by: inflammation due to injury or surgery, the body’s hormonal response to injury and lack of exercise, and simply demobilisation of the muscle.
In addition to changes in muscle tissue, injuries also contribute to:
- decrease in bone mass;
- lowering the metabolic rate;
- decrease in insulin sensitivity;
- increase in accumulation of fat reserves.
How can you counteract these post-traumatic changes?
With the help of smart rehabilitation and proper nutrition. Here are important aspects of a diet to support active people when they are forcibly immobilised due to injury.
1. Count and adjust your calorie requirements again
An injury usually forces a big decline in physical activity. From day to day, when you don’t work out, you start to need much less energy, so likewise, in order to maintain your body weight, you need fewer calories. On the other hand, don’t go overboard with reducing the calorie content of your diet. Energy deficiency promotes the use of proteins as energy raw materials, and that, in simple terms, means muscle burning. Calories are also essential for tissue regeneration. How to properly estimate the calorie content of the diet in an injury?
When determining the calorie content of your diet in an injury, do not underestimate your calorie needs and rather do not go into an energy deficit. A period of injury is not a good time to lose weight. Recovery will be slower with a calorie deficit. A much better idea is to go for the “calorie balance” option, i.e. switch to a diet with calories in line with total metabolism for the duration of the injury treatment. It’s good to provide exactly as many calories as your body needs to work.
If an injury causes you to have to stop training for a while, simply subtract the energy burned in training from the previous calorie content of your diet, if it was a diet involving so-called calorie balance (not aimed at weight loss or gain). Estimate your daily or weekly workout energy expenditure and subtract it from the previously used calorie content of your menu.
Example: The injury does not cause total immobilisation, it just excludes you from training. If up to now you have been following a daily diet consistent with a total metabolism of 2500 kcal and training 3 times a week, burning approx. 400 kcal per workout, your weekly calorie consumption drops by 1200 kcal. Instead of following a 2500 kcal diet, subtract about 170 kcal from your daily menu and follow a 2300-2330 kcal diet.
If you don’t know how many calories you’ve been consuming so far, and you intend to control this better during an injury, you need to count your calorie requirements. Count the BMR (Basal Metabolic Rate), estimate the PAL (Physical Activity Level), and then you will get the total metabolic rate. Doing calorie recalculations from scratch will also be necessary if your injury is causing you significant immobilisation and limiting your overall activity, not just your training. Your spontaneous physical activity (non-exercise activity thermogenesis, NEAT) decreases, and this means a greater drop in energy requirements than just having to give up training.
Professional athletes, in order to avoid muscle atrophy, are recommended to follow a diet with calories even higher than their requirements during the rehabilitation period after injuries. 25-30 kcal/kilogram of body weight is the right value to maximise the side effects of immobilisation and speed up recovery, according to researchers.
It is also worth adjusting the calorie content of the menu according to the sport practiced. Those who specialise in activities in which a slight increase in body fat will not interfere with performance can choose higher calorie content to ensure that muscles get the best protection from disintegration. Those for whom maintaining low lean body mass is most important can go for a lower calorie diet.
2. Provide enough protein
The most important aspect of proper nutrition after injury and trauma is sufficient protein intake. No supplements or specific food products will work if you don’t take care of this aspect. It is worthwhile to establish an individual strategy for protein supply: its quality, the overall amount in the diet, the optimal portion in a meal, and the frequency of consumption.
The supply of protein in the diet when injured is not very different from the classic approach to this issue in athletes. However, it’s worth taking an even more orthodox approach and making sure that the portions of protein consumed are sufficient.
How much protein to eat when recovering from an injury? According to various sources, from 1.6 g up to 2.5 g of protein/kg of body weight. 2 g of protein/kg of body weight seems to be a sufficient intake for most active people with exercise injuries. Higher doses may be considered in special cases, such as when the protein comes exclusively from plant products, the injury is extensive or the injured person is >55 years old.
It is very important to evenly distribute protein into portions throughout the day so that you eat it every 3-4 hours. If your calculations tell you to consume, for example, 140 g of protein per day, and you know that you eat 4 meals every day, put about 35 g of protein in each meal. This will have a better effect than one protein-rich meal per day. For this reason, when recovering from an injury, it is better to shun intermittent fasting, and other strategies that involve abstaining from food for an extended period of time over the course of a single day.
Sometimes a strategy is also used to maintain an optimal concentration of amino acids in the blood at night: about 30 minutes before bedtime, it is recommended to drink a protein shake containing about 30 grams of casein. This protein releases more slowly than whey, so it provides extra protection for muscles during overnight fasting.
If your injury already allows you to do some rehabilitation exercises, make sure to eat a meal rich in protein (at least 20-30 g per serving) or drink a protein shake after such a series. This will improve the chances of faster success and support tissue regeneration.
It is also worth taking care of the quality of protein consumed. As a rule, animal proteins have a better protein efficiency ratio than plant proteins, but it is also possible to compose a valuable meal rich in good quality protein from vegan products. With a dose of >25 g of protein per meal you don’t have to worry about the leucine threshold, or the overall amino acid composition of the protein.
What exactly to eat? Use protein meal ideas for athletes. Meals rich in protein are worth combining with a dose of complex carbohydrates (optimally about 2 grams of carbohydrates for every 1 gram of protein), which enable efficient use of proteins, without excessively boosting blood glucose.
3. Include anti-inflammatory omega-3 fatty acids in the menu
Sources of omega-3 fatty acids should be present in any healthy diet, and they are also recommended to athletes as a means of preventing injury. So they can’t be overlooked when discussing nutrition during injury. Omega-3 fatty acids are all about reducing inflammation, supporting cell membrane fluidity, immunomodulatory properties, better regeneration, reducing free radicals and more. Their adequate supply also increases anabolic sensitivity to amino acids.
Regular supplementation with omega-3 fatty acids even contributes to the enlargement of muscle cells, according to some studies. This is a particularly important property for active people after an injury. We recommend supplementation with omega-3 at a dose of 2-4 g/day or sufficient intake of dietary sources of these acids, which are found in: oily sea fish, seafood, flaxseed oil, flaxseed, chia seeds and rapeseed oil.
Omega-3 fatty acids are also involved in the production and regeneration of collagen – a protein crucial to recovery from injuries and planned surgeries. It has been proven, for example, that people recovered faster after knee joint surgery if they took care of an optimal supply of omega-3 fatty acids (EPA and DHA).
4. Take special care of the quality of the menu
After an injury, it is worth taking care not only of the right amount of protein, supplementation and proper calorie content of the diet. It is advisable to simply follow a healthy, balanced and anti-inflammatory menu that will support the body’s natural recovery. Follow a healthy diet, eat a variety of meals and don’t shy away from fruit and vegetables. In doing so, you will supply other important elements that are crucial with injuries. Such as, among others:
- vitamin C – supports collagen synthesis and accelerates tissue regeneration;
- vitamin E – is a powerful antioxidant that counteracts the action of free radicals formed at the place of injury;
- antioxidants (e.g. from Polish seasonal fruit) – have anti-inflammatory, free radical-reducing and injury-preventing effects;
- gelatine – supports collagen production and connective tissue regeneration;
- fibre – helps maintain satiety with reduced energy requirements;
- zinc – is necessary for the proper work of enzymes that are involved in tissue regeneration and repair;
- calcium and vitamin D – necessary for rebuilding bones and joints, but vitamin D is also important in recovery from any surgery.
5. Give these up in your diet when injured
Perhaps just as important as what food products to include in your diet when injured is which ones to give up:
Alcohol – impedes recovery, reduces protein synthesis, has a pro-inflammatory effect and increases the risk of losing lean body mass.
Energy snacks for athletes (energy gels, carbohydrate shakes and energy bars, isotonic drinks) – they are very valuable if you move a lot, but with a static lifestyle after an injury, it is better to give them up due to their high glycaemic load.
Supplementation when injured
It’s hard to give universal advice on supplementation after an injury, because whether a supplement will be useful depends on, among others, physical fitness level, type of injury, form of rehabilitation, expected duration of immobilisation, and possible complications.
Here are some supplements that may work well during the rehabilitation period, but keep in mind that you need to consider them individually:
- creatine (monohydrate) – can reduce muscle atrophy when combined with rehabilitation exercises;
- omega-3 acids – have anti-inflammatory effects, support the pace of recovery in skeletal injuries;
- collagen – can support soft tissue regeneration in joint and tendon injuries and reduce joint pain, works best when combined with vitamin C;
- vitamin D and calcium – can be useful especially in bone tissue injuries (such as fractures);
- glucosamine – can support joint health and reduce joint soreness.
Read also: “12 stretching exercises to prevent injury”.
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References:
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2. Papadopoulou SK., Rehabilitation Nutrition for Injury Recovery of Athletes: The Role of Macronutrient Intake. Nutrients, 2020 Aug 14;12(8):2449. doi: 10.3390/nu12082449. PMID: 32824034; PMCID: PMC7468744.
3. Turnagöl HH, Koşar ŞN, Güzel Y, Aktitiz S, Atakan MM, Nutritional Considerations for Injury Prevention and Recovery in Combat Sports, Nutrients. 2021 Dec 23;14(1):53. doi: 10.3390/nu14010053. PMID: 35010929; PMCID: PMC8746600.
4. Rawson ES, Miles MP, Larson-Meyer DE, Dietary Supplements for Health, Adaptation, and Recovery in Athletes, Int J Sport Nutr Exerc Metab. 2018 Mar 1;28(2):188-199. doi: 10.1123/ijsnem.2017-0340. Epub 2018 Feb 19. PMID: 29345167.