Diet the missing piece of the puzzle in injury recovery
There is no denying that injuries are an inescapable aspect of exercise. Foolishly trying to show off in front of my children at the snow, quickly turned into a severe shoulder injury that impacted greatly on my capacity to train and maintain a healthy level of fitness. Post an MRI and the prognosis wasn’t good, most likely a shoulder reconstruction. Arghhh!
As a holistic practitioner, I knew that to reduce my time on the bench and avoid surgery, I needed to initiate a total recovery plan. One that included working with our osteo, masseuse, using hot & cold therapy and writing my-self a nutrition plan.
Nutrition was going to play a huge role in managing my inflammation, providing key nutrients to rebuild injured tissue, minimise muscle wasting and help strengthen the shoulder. Injuries typically have two stages. Immediately after an injury, wound healing begins. It is a complex process involving three, overlapping phases: inflammation, proliferation and remodeling. This stage is coupled with inactivity or very lite activity and almost always results in a level of reduced muscle mass, strength and function. This is the time to allow our natural inflammatory process to go to work, blood vessels enlarge to allow more blood to flow to the tissue, different substances are released that aid in protecting injured tissue and advancing the healing process. This process is relatively short lived, normally hours but if the injury is severe enough it will last a few days. In my case, it was a matter of waiting a few days until I activated a full anti-inflammatory nutrition and supplementation plan.
The second stage of inflammation is different. Rehabilitation and increased activity serve this stage well, so too does the nutrition. Here it becomes critical to influence the response of muscle and tendon to injury-induced immobilization. The single most important nutritional consideration during reduced muscle activity and/or immobility is to avoid nutrient deficiencies. Deficiencies of energy, vitamins, minerals and macronutrients—particularly protein—will impair wound healing and exacerbate loss of muscle and tendon mass and function. As a nutritionist, I always looks at the ratio of muscle protein balance, after injury the goal is to improve protein synthesis rather than tip heavily towards protein breakdown. Fighting against inactivity can be tough to keep the balance, as it’s the primary reason for protein breakdown and muscle mass wastage. Simply increasing protein consumption isn’t enough, inflammation will impact the metabolism of protein.
So what did I do?
I ate the correct amount of protein for my weight and energy output, plus a little extra to counter for impaired metabolism. Getting this right is important, because too little will impair wound healing and too much will lead to decreased insulin sensitivity, plus alteration in muscle and adipose metabolism.
2. Reduced inflammatory food and drinks – ALCOHOL & FATTY FOODS
Yes, alcohol had to go! I really noticed the impact alcohol had on my recovery and how even after 2 months if I had a glass of wine it would make my inflammation skyrocket. Fatty foods did the same thing, albeit a slower response.
3. Increased my Hydrochloric Acid (HCL)
Because I am a little older, my HCL is in decline which means I have less digestive secretions. Therefore it is more difficult to absorb nutrients from the food I eat. By using digestive enzymes during this time or various methods to stimulate their flow I was able to get the most out of my diet.
4. Anti-inflammatory Diet
The Mediterranean diet is probably the most well recognised anti-inflammatory diet. It involves the reduction of inflammatory foods like red meat and an increase in fresh fruit, vegetables, legumes and fish. This was ideal to implement a couple of weeks into my recovery. I added an additional serve per week of oily fish to my diet and upped my red and orange foods to get the full anti-inflammatory effect.
There are huge range of anti-inflammatory nutraceuticals to choose from. I used a downstream metabolite of fish oil and a high dose curcumin. Both have been proven to inhibit the inflammatory pathways, however, as stated earlier, it is important that these are not commenced too early in the post injury stage as they will impact the beneficial stage of inflammation.
Within 3 months, combining rehabilitation exercises, diet and supplementation my shoulder had recovered. Not completely, I am still giving it some love but enough that surgery wasn’t necessary. Next task,… work on that ego of mine and ensure that this year’s trip to the snow is a safer one.
· Space your protein intake: Absorption is best at 20-25g per sitting.
· Supplement with essential amino acids for optimal protein synthesis: research demonstrated that 20g of essential amino acids ingested twice daily between meals for 1 week prior and 2 weeks following total knee arthroplasty enhanced recovery in older patients.
· Leucine in the diet helps improve protein synthesis, sources include: Chicken, Tuna, Tofu, legumes, eggs.
· Zinc is required for zinc finger motifs within DNA transcription factors, and is thus important for building new tissue, such as articular cartilage.
· Vitamin C: Needed for collagen synthesis.