Injury Recovery & Nutrition
Sprained ankles. Achey knees. Bum shoulder. You’ve been there. I’ve been there. We’ve all been there at some point-from playing sports as a child to slipping on wet concrete or just out and about having too much fun. You’ve most likely been told to R.I.C.E. especially after an acute injury. Rest, ice, compression, and elevation. “Dr. Google” will tell you R.I.C.E. if you type in the search box, “how to treat a sprained ankle”. In general, R.I.C.E. is an effective first-aid treatment, but it isn’t a cure for soft tissue injuries. It is to help manage any internal bleeding and discomfort and to help with inflammation and swelling.
Stage 1- Inflammation: Regardless of the injury, there’s damage to vascular tissue, bone, and muscle. When tissue is damaged, blood flow is limited and can lead to cell death. The reason why we experience inflammation with acute injuries is because our bodies initiate this process to help filter out the damaged cells and to regenerate new ones. The acronym Never Let Monkeys Eat Bananas describes what our bodies stimulate to the injured area: neutrophils, leukocytes, monocytes, eosinophils, and basophils in addition to the macrophages.
You may recall your last injury where you experienced pain, swelling, redness, and even some warmth. Local pain receptors interact with certain chemicals, which can lead to some swelling placed on these nerve endings. The blood vessels in the injured area were damaged by the trauma and as a result, fluid enters. The redness and warmth you may have experienced is due to vasodilation to help shunt blood flow to the injured area. Even though it’s painful, our bodies need the inflammatory process to help us recover. However, chronic inflammation can lead to other problems so be sure to keep an eye out.
In the inflammation stage, it is recommended to eat more anti-inflammatory fats like avocado, fish, nuts, or olive oil along with some inflammation-managing spices and herbs like turmeric, cocoa, tea, berries, garlic, and even red wine…in small amounts. It is also important to eat less of pro-inflammatory foods during this stage such as processed foods and vegetable oils.
Stage 2- Proliferation: By now, the damaged tissues should have been repaired with new healthy cells. Scar tissue, aka [type II] collagen and fibronectin, were stimulated and formed. Scar tissue, despite its negative reputation, are laid and will contract as it matures. This helps reduce the size of injury due to fibroblast differentiation. However, this is why rehabilitation and physical therapy is important.
Stage 3- Remodeling: In this phase, type I collagen should have replaced the type II collagen and can become relatively strong, but most likely not 100% normal. Because type I collagen fibers increase with tension, rehabilitation is crucial in the recovery process.
In both stages 2 and 3, energy intake is priority because our metabolisms can increase 15-50% due to energy needs during acute injury repair. It is recommended to eat adequate protein, eat enough carbs to help fuel the recovery process, balance dietary fat, and eat a variety of colors (aka eat the rainbow). It has been found that certain micronutrients can help increase the recovery process 2-4 weeks post-injury. These micronutrients are Vitamin A, vitamin C, copper, zinc, glutamine, arginine, and more.
Protein
1-2.0 g/kg to help ensure a quick recovery because injury repair requires more protein
Fats
more omega-3s and cut down omega-6s [3:1 ratio is recommended] like fish oil and reducing corn/sunflower oil
Carbs
enough to ensure stable insulin concentrations, which can affect wound healing
Below is a list of each micronutrient’s role in the recovery process.
Vitamin A
supports early inflammation and assists in collagen formation via collagenase; increased intake is suggested for more serious trauma or surgeries
carrots, sweet potato, squash
Vitamin C
enhances lymphocyte and neutrophil activity; crucial role in collagen synthesis by forming bonds between fibers; strong antioxidant
broccoli, celery, berries, oranges
Copper
A key antioxidant mineral; assists in formation of red blood cells and to help strengthen connective tissue with Vitamin C
sesame seeds, cashews, mushrooms, garbzano beans, lentils, walnuts
Zinc
A mineral required for hundreds of enzymes, critical role in cell division, DNA and protein synthesis, tissue regeneration and repair, wound healing
beef, lamb, sesame seeds, lentils, garbanzo beans, quinoa, turkey, cashews
Calcium/Iron
If deficient = higher risk for stress fractures
Tofu, yogurt, cheese, mustard greens, almond milk, soybeans, lentils, spinach, swiss chard, kidney beans
Arginine
An amino acid; stimulates insulin release and IGF action which help stimulate protein synthesis and collagen deposition; can help increase blood flow to injured area and activate macrophages that produce growth factors needed for healing
Fish, chicken, beef, chocolate, milk
Glutamine
An amino acid, especially needed during sepsis and trauma, essential for cell turnover [lymphocytes]
Meat, poultry, seafood, eggs, nuts, beans, legumes
THE TAKEAWAY MESSAGE: being able to manage inflammation while eating enough calories and supplementing with micronutrients may dramatically speed up the injury recovery process.