Injury Nutrition

Get mixed up in a bike crash? Return to run volume too quickly after the off-season? Unfortunately, injuries happen. Almost all athletes will experience some injury-related pause at some point in their careers. Injuries aren’t fun, but when injuries do occur, whether it’s a sprained ankle, muscle tear, stress reaction or bone fracture, the recovery process becomes critical to an athlete's return to function. Recovery isn’t straightforward, but nutrition is pivotal in how quickly an athlete heals. It affects the efficiency of tissue repair and the body’s ability to regain strength. The right nutrition aids in healing helps maintain immune function and ultimately allows the athlete to return to training and competition at full capacity. This article will explore the nutritional strategies to help endurance athletes dealing with an injury.

Energy Intake

Tissue repair requires energy. Some of this energy is drawn from fat reserves and protein stores. This siphoning of energy can lead to muscle breakdown if not adequately replenished. This is why ensuring sufficient caloric intake and proper macronutrient consumption is crucial during injury recovery. A lack of nutrition can lead to catabolism, where the body breaks down muscle tissue to meet energy demands, slowing recovery and making athletes more susceptible to further injuries. Adequate energy intake is fundamental to recovery, but determining what adequate calories actually means can be tricky.

Following an injury, the body’s energy requirements increase due to the energy expended for tissue repair. However, when injured, athletes simultaneously cease or lessen their training volume. While athletes may be training less, their calorie needs will still be higher than sedentary individuals because of the increased requirements of healing. If an athlete’s caloric intake is insufficient, the body will begin to break down its lean tissue (i.e., muscle) for energy. This delays healing and can result in significant muscle losses, further compromising recovery and athletic performance. 

Low Energy Availability (LEA), which occurs when athletes consume fewer calories than required to maintain normal physiological functioning, should be avoided. Experts debate the exact threshold at which LEA occurs, as this is difficult to measure outside of a controlled lab, but injured athletes should avoid consuming less than 30 kcal per kilogram of lean body mass per day. LEA has been linked to slower wound healing, muscle loss, immune dysfunction, and an increased risk of re-injury. 

Protein

Protein is perhaps one of the most critical pieces during injury recovery. The body uses amino acids from dietary protein to repair and regenerate tissues, including muscle, tendons, and ligaments. Unlike fats and carbohydrates, the body does not keep stores of protein for later use unless you consider muscle mass an energy source. Therefore, regular consumption of protein is required for muscle protein synthesis and tissue repair. After an injury, athletes should increase their protein intake to help counteract the catabolic effects of the injury. The body requires more protein to rebuild tissues and facilitate muscle protein synthesis. Endurance athletes should aim for 2.0 to 2.5 grams of protein per kilogram of body weight per day. This ensures that the body has a constant supply of amino acids available to meet its needs. Real foods should always be the first strategy to increase protein intake. High-quality protein sources, such as lean meats, fish, eggs, dairy, and plant-based proteins like beans and lentils, are all great choices. Supplemental protein powders can help fill in the gaps. 

Carbs

Low carbohydrate diets have been associated with immune dysfunction. Therefore, carbohydrate intake should be adjusted to meet energy demands, with an emphasis on complex carbohydrates from whole grains, fruits, vegetables, and legumes. A variety of fresh fruits and vegetables, together with grains and starchy veg, are recommended to be consumed during the day to provide antioxidants. Simple sugars, like white breads, or refined, sugary products like candy, should be limited outside of exercise. These items, which provide benefit in sporting situations, provide little micronutrient value compared to other carb sources like their fruits, vegetables, and whole grains counterparts.

Omega-3s

When an athlete sustains an injury, there are several phases to repair the damage: inflammation, tissue proliferation, and remodeling. In the early stages, inflammation acts as the body's first line of defense, triggering an immune response. Inflammation is a normal process of recovery. However, prolonged inflammation can hinder recovery, leading to muscle atrophy, loss of strength, and delayed healing time. Omega-3 fatty acids, found in fatty fish like salmon, walnuts, and flaxseeds, are known for their anti-inflammatory properties. They help regulate the body’s inflammatory response, preventing chronic inflammation that can prolong the healing process.

Athletes should aim for a moderate intake of healthy fats, focusing on omega-3 fatty acids. A balanced omega-3 to omega-6 ratio is essential for optimal recovery, as inadequate omega-3 intake can potentially interfere with healing. Fat plays a role in overall energy provision, containing nine calories per gram compared to four calories per gram for both carbohydrates and protein. Athletes should aim for a moderate fat intake, adjusting this based on overall caloric needs.

Micronutrients

 Looking smaller, several micronutrients play key roles in injury recovery. In almost all cases, athletes can focus on a diet rich in fruits, vegetables, lean proteins, and whole grains to meet their micronutrient needs. Some of the key micronutrients for injury are discussed below:

Vitamin D: Vitamin D is crucial for calcium absorption and bone health, making it essential for athletes recovering from bone-related injuries. It also supports immune function. Deficiencies in vitamin D have been linked to delayed healing and increased infection risk.

Iron: Required for oxygen transport in the blood, iron is crucial for tissue repair. Athletes, particularly female endurance athletes, are at risk for iron deficiency. While overall iron intake is important, heme iron, found in animal products like red meat, poultry, and fish, is better absorbed than non-heme iron, found in plant sources like beans and dark leafy greens.

Zinc: Zinc plays a critical role in cell proliferation and tissue regeneration. It is also involved in immune function. Zinc deficiency has been shown to impair wound healing and immune response. Seafood, meat, and fish are great sources.

Vitamin C: Vitamin C is essential for collagen synthesis, a key component of tissue repair. It also acts as an antioxidant, helping to reduce oxidative stress that can impair recovery. Vitamin C can be found in citrus fruits, peppers, and many other fruits and vegetables.

The hope is that athletes have adequate micronutrient status before the injury occurs, but this is not always true. In cases where deficiencies are identified, supplementation may be beneficial and necessary. Correcting nutritional deficiencies will aid in recovery, but over-supplementation of micronutrients will not provide additional recovery benefits.

 Food should be the foundation of an athlete’s diet. However, supplements can play a role when an athlete cannot meet their nutritional needs through food alone. For example, if an athlete has a reduced appetite due to injury or is dealing with digestive issues, supplements may help fill nutritional gaps. Protein powders can be useful for athletes who struggle to consume enough protein through whole foods alone. This works great mixed into pancake batter, oatmeal, or mixed into an afternoon smoothie. In regions with limited sunlight, athletes may benefit from vitamin D supplementation, particularly during the winter months. Those athletes diagnosed with iron deficiency may not be able to restore iron levels using food alone. Athletes should always conduct blood tests before supplementing.

Conclusion: Nutrition will facilitate faster recovery

Unfortunately, injuries happen. Adequate energy intake from protein, carbohydrates, fats, and micronutrients will support tissue repair, reduce inflammation, and make the return to sport easier. Athletes who don’t focus on these nutritional aspects risk delayed recovery, muscle loss, and an increased chance of re-injury. Athletes can support healing, return to training faster, and reduce the risk of future injuries with diets that prioritize real food and meet the body’s nutritional demands. Whether the injury is minor or severe, good nutrition is needed. So, fuel well to get back into those run trainers sooner.

 Megan