From INJURY toward RECOVERY-

Nutrition to Hasten Healing

By Dr Mimi Zumwalt, MD

After sustaining a traumatic episode to any musculoskeletal structure, the body sets off a chain of reactions that occurs over time to help heal the injured area. The initial inflammatory stage lasts from a few days to a few weeks, depending on the degree of injury to soft tissues and/or bones. During this phase of inflammation, new blood vessels are formed, bringing in oxygen and nutrients to feed the damaged structures, along with white blood cells to clean up the dead portions. The most important step of this stage is not to cause more injury to the already traumatized area i.e. protect it from further harm. The next stage is proliferation for growth and repair, which happens anywhere from a few weeks to several months, when scar tissue forms then fills in gaps between the stretched/torn body parts. Rehabilitative exercises are instituted during this reparative stage, and continue into the third stage. This last phase of the healing process is remodeling, which occurs from a few months up to a year or more, where the body keeps on forming and reshaping the repaired structure, back similar to its original condition prior to injury. During this final stage of recovery, sports specific training is incorporated into the physical rehab program, so the athlete can return to competitive play again.

As for nutrition/dietary needs after sustaining a musculoskeletal injury, it is important for the athlete to consume the correct quantity AND type of foods, to provide the required raw materials that the body will use, to build replacement tissue for appropriate/timely healing. Even though one’s activity level may decrease after being injured, the basal metabolic rate (BMR) actually increases anywhere from 15% to 50% depending on the severity of trauma, thus consumption of an adequate quantity of calories is needed to keep up with the higher energy demands. Specifically, protein/amino acid intake (especially arginine, glutamine, and HMB) should increase from 0.8g/kg body weight per day (maintenance) to 2g/kg/d, to help with new tissue formation. As for carbohydrates, the daily percentage should be at least 50% of total calories to keep up with energy/metabolic requirements, so the body won’t become catabolic by burning lean muscle mass. In addition, maintaining glucose intake thus insulin level up in the bloodstream also helps with the anabolic (growth) state.

The third main macronutrient, fat, is also important to consume, especially monounsaturated and omega-3 fatty acids (FA) to fight off inflammation. In contrast, a diet rich in saturated/trans-fat and omega-6 FA’s will promote the inflammatory response, so avoid this type of foodstuff. The recommended portion of fat intake consists of 1/3 saturated (meats), monounsaturated and polyunsaturated types (mixed nuts, avocados, olive/flax seed oils, ground flax plus other seeds). Higher consumption of omega-3 FA’s also has been shown to promote deposition of collagen to help build healing tissue. One should ingest about 3 to 9g of fish oil per day to meet the recommended omega-3 needs. These essential FA’s are found in salmon, sardine, menhaden, krill, perilla, flax seed oils, walnuts, hemp seeds, salba, and green leafy vegetables. On the other hand, stay away from corn, cottonseed, soybean, and sun/safflower oils, all of which contain omega-6 that could cause even more inflammation. These FA’s are used to make crackers, potato chips and other snacks i.e. “junk food”, which are also present in corn-fed animal meats, so choose snacking wisely.

On a smaller scale but still significant; micronutrients also play a central role in their contribution to regenerate damaged musculoskeletal tissues. On a negative note, vitamin E appears to slow down healing so take this substance in sparingly. However, other vitamins that exert positive effects include: vitamin A 10,000-25,000IU per day reverses immune suppression and strengthens collagen strands - too much intake, however, can be toxic since it’s stored in fat; vitamin C 1-2g/d boosts immune system, adds antioxidant power, and helps in collagen bonds formation; the mineral copper 2-4mg/d - red blood cell formation, makes elastin with vitamin C to strengthen connective tissues; zinc 15-30mg/d - used for >300 enzymes, DNA and protein synthesis. And lastly, the following dietary herbs may be beneficial in terms of inherent natural anti-inflammatory effects to aid in the healing process: curcumin, the active form in turmeric (a flowering plant of the ginger family), an ingredient found in curry powder, is more powerful when taken as an extract supplement; garlic is also important since it inhibits two enzymes promoting the inflammatory cycle, along with turning on cells that clear dead tissues; one clove = 1g so eat 2-4 cloves or take 600-1200mg of aged garlic extract daily; consuming 500-1000mg per day of bromelain - a plant extract from pineapple, also helps with digestion along with analgesia (pain control); and finally, intake of flavonoids, which are chemicals found in cocoa, tea, fruits, vegetables/ legumes (also in blueberry, grape, green tea extracts and bioflavonoid supplements) act as antioxidative compounds, along with stimulating small blood vessel development and cell growth, which contribute to ultimate tissue healing as well.

In summary, after injuring a body part, an athlete should consume enough of appropriate nutrients to help heal damaged tissues. A good rule of thumb is to eat often, every 2-4 hours throughout the day; meals/snacks should consist of complete proteins (preferably whole foods such as lean meats, dairy or soy products, and eggs rather than protein supplements); carbs consisting of whole grain, minimally processed foods i.e. oats, yams, beans, brown rice, quinoa, plus add 1-2 servings of fruits and/or vegetables daily as well; remember to ingest the “good” fats in avocados, olive oil, mixed nuts, flax seeds/oil along with 3-9g of fish oil; if needed, also take in supplements such as multivitamin tablets or “natural herbs/extracts” (garlic, turmeric, or bromelain), but please do be careful with these and other nonfood substances, since they’re not regulated by the FDA, thus may contain hidden additives which could result in negative/harmful side effects.

#injury #recovery #nutrition