Nutritional strategies for optimizing injury recovery

Sports injuries directly affect the athlete's health and performance.

In this sense, it is well known that repeated injuries throughout the season interrupt the training period, affecting the subsequent adaptations to it, and also result in the inability to attend competitive events.

The main thing will be to try to prevent the appearance of these injuries through proper programming of the training, and, and a correct one nutrition y rest.

However, injuries can inevitably happen, and when they do occur, nutritional goals they'll be:

i) optimize the response to treatment for injury and/or surgery;

ii) maintain adequate body weight and composition;

iii) ensure a return to training as quickly as possible [1].

Furthermore, we cannot ignore that during the period of injury, immobilization occurs, which will increase the risk de atrophy muscular, a lower ability to gain muscle mass and a loss of force [2].

Energy intake: the great overlooked during injuries

We must bear in mind that energy intake plays a fundamental role in maintaining muscle mass. In addition, spending energetic en repose during an injury increase by 15-50% compared to the pre-injury situation [3].

This is due to the energy requirements to repair damaged tissue, the related inflammatory processes and the hormonal response to the injury. However, if the athlete must remain completely immobilized or bedridden, the energy expenditure derived from physical activity and exercise will decrease.

Therefore, during an injury No. it will be due reducir drastically la intake energetic, paying attention to the necessary requirements according to the physical activity and physical exercise performed by the individual and the stress factor of the injury.

Protein intake: the second link in nutrition during injuries

As we have mentioned, during injuries there is a loss of muscle mass and muscle strength due to different mechanisms (muscle disuse, increased inflammation, hormonal factors, etc. [4].

In this sense, protein requirements can increase by up to 80% [2]. Therefore, protein intake it will be due increase compared to the time before the injury.

In addition to increasing total protein intake, other aspects must be taken into account, such as:

i) in the event that any action is taken strength training for rehabilitation, include a protein intake enough post-workout

ii) include a protein intake of sufficient quantity and quality before going to sleep

iii) try to include sources of proteins high quality with sufficient essential amino acids, especially leucine (e.g. whey protein, meat, fish, eggs, etc.) [2].

Considerations regarding carbohydrate and fat intake

It is important to keep in mind that even if you reduce the amount of physical exercise you do, No. we must delete completely the intake of carbohydrates.

Carbohydrates have functions in regulating inflammation, maintaining muscle mass and other hormonal aspects.

In this sense, although we must adapt carbohydrate intake to our training, we should prioritize fruits, vegetables, legumes and whole grains, mainly reducing all sugary foods or products that we usually eat.

Regarding the fat, we should prioritize fat monounsaturated y polyunsaturated since they can have a beneficial effect in regulating inflammation in the event of an injury. In this regard, the intake of nuts and seeds, oily fish, extra virgin olive oil and avocado should be prioritized as the main sources of fat.

Potential supplements in injury

There are studies that show that supplementation with creatine It can mitigate muscle atrophy due to disuse and improve muscle recovery from injury [5,6].

On the other hand, supplementation with omega-3 It could have a positive effect on muscle mass in the face of disuse, and could reduce inflammation resulting from injury [7].

Finally the HMB It is a metabolite of the amino acid leucine that has anti-catabolic functions. Therefore, the use of this supplement during periods of inactivity in which one or more muscle groups are not used could improve or maintain muscle mass during injuries [8–10].

Conclusion

In conclusion, during an injury, energy intake, protein intake, and the quality of carbohydrates and fats must be monitored to enhance recovery.

In addition, different supplements (e.g. creatine, omega-3, HMB, protein) can be used that could improve the progression of the injury, especially affecting muscle mass.

Author

Lucas Jurado Fasoli – Contributor to Crown Sport Nutrition. 

PhD in Biomedicine (UGR). Dietician-Nutritionist. Postdoctoral researcher at the Joint Institute of Sport and Health and Department of Physiology, University of Granada.

Highlighted

[1] Papadopoulou SK. Rehabilitation nutrition for injury recovery of athletes: the role of macronutrient intake. Nutrients 2020;12:2449.

[2] Smith-Ryan AE, Hirsch KR, Saylor HE, Gould LM, Blue MNM. Nutritional considerations and strategies to facilitate injury recovery and rehabilitation. J Athl Train 2020;55:918–30.

[3] Frankenfield D. Energy expenditure and protein requirements after traumatic injury. Nutrition in Clinical Practice 2006;21:430–7.

[4] Bodine SC. Disuse-induced muscle wasting. Int J Biochem Cell Biol 2013;45:2200–8.

[5] Hespel P, Op't Eijnde B, Leemputte M Van, Ursø B, Greenhaff PL, Labarque V, et al. Oral creatine supplementation facilitates the rehabilitation of dysuse atrophy and alters the expression of muscle myogenic factors in humans. J Physiol 2001;536:625–33.

[6] Johnston APW, Burke DG, MacNeil LG, Candow DG. Effect of creatine supplementation during cast-induced immobilization on the preservation of muscle mass, strength, and endurance. The Journal of Strength & Conditioning Research 2009;23:116–20.

[7] McGlory C, Calder PC, Nunes EA. The influence of omega-3 fatty acids on skeletal muscle protein turnover in health, disuse, and disease. Front Nutr 2019;6:144.

[8] Deutz NEP, Pereira SL, Hays NP, Oliver JS, Edens NK, Evans CM, et al. Effect of β-hydroxy-β-methylbutyrate (HMB) on lean body mass during 10 days of bed rest in older adults. Clinical Nutrition 2013;32:704–12.

[9] Maughan RJ, Burke LM, Dvorak J, Larson-Meyer DE, Peeling P, Phillips SM, et al. IOC consensus statement: Dietary supplements and the high-performance athlete. Br J Sports Med 2018;52:439–55. https://doi.org/10.1136/bjsports-2018-099027.

[10] Wilson JM, Fitschen PJ, Campbell B, Wilson GJ, Zanchi N, Taylor L, et al. International Society of Sports Nutrition Position Stand: beta-hydroxy-beta-methylbutyrate (HMB). J Int Soc Sports Nutr 2013;10:6. https://doi.org/10.1186/1550-2783-10-6.