Last year the Nutrition Works team attended the Sports Dietitians Australia Nutrition Masterclass in Melbourne. Today’s blog, prepared by team member, Claire Ricciardo, is a summary of the latest nutrition strategies that can be used in conjunction with an appropriate rehab program from your physio.
Nutrition for rehabilitation from injury
Most athletes will be plagued by an injury at some time during their career. Muscle and tendon injury is responsible for the majority of visits to a sports physician and results in an average of 3 weeks away from sport. Just as an athlete will periodise their nutrition for hard vs easy training days, an injured athlete has another unique set of nutrition requirements.
Being injured and rehabilitating back to peak fitness is tough!
Nutritional support can assist with recovery both by minimising muscle mass loss while you are resting and avoiding any unwanted changes to body composition.
Immediately following an injury, the affected limb is often required to be rested or immobilized completely. Studies on prolonged disuse of a muscle have shown that the average muscle loss is about 0.5% of total muscle mass per day, which is an average of 1kg of muscle mass in the first week with large losses seen in the first 5 days. Athletes muscle mass can generally be expected to be higher so muscle loss could be greater.
To minimise muscle loss during this time protein intake is important. Most athletes we see are already eating enough protein. But most of it is eaten at the end of the day in the form of a steak or piece of chicken.
To prevent muscle protein breakdown, the protein in your diet needs to be of high quality (eg: lean meat, fish and eggs) and eaten in even doses (20-40g or 0.3g/kg) spread evenly throughout the day (every 3-4 hours).
It may look like this:
Breakfast: Bowl of cereal with 250ml of milk, a tub of Greek yoghurt and fruit
Morning Tea: Tin of tuna with crackers and a slice of cheese
Lunch: Wholemeal roll with 60g of ham and salad
Afternoon tea: 2 slices toast with 2 tbl peanut butter and a latte
Dinner: 100g of meat chicken with 2-3 cups of steamed vegetables
Supper: High protein yoghurt (eg: Chobani, Rokeby Farmes or YoPro) +1 cup of fruit salad
After surgery, when the rehab process commences with your physio, it’s important to ensure that each of these rehab sessions are supported by consuming foods that provide the right building blocks for muscle recovery within the recovery window (30 minutes!).
Milk protein is high in quality protein while providing some carbohydrate for muscle glycogen replenishment
For example foods such as Greek yoghurt with fruit, flavoured milk and smoothies make great recovery foods. Protein powders are not always beneficial or required.
Another issue you may face while injured is weight gain (or loss). Some athletes find they do more ‘boredom’ eating, while others lose their appetite completely when activity levels are reduced. Diet quality is particularly important during injury to maximise the nutrient value of your diet and limit over consumption of nutrient poor foods. Your sports dietitian can provide appropriate advice around portion sizes, suitable foods and strategies and can monitor your body composition during this time with skinfold and girth measurements.
Once you have all of the above right, there is some evidence for the use of creatine monohydrate in the maintenance of muscle mass during recovery from injury, and for fish oils. Care needs to be taken with fish oils as they are anti-inflammatory and inflammation during the initial phase of injury is necessary for healing to occur. But after this including fish oils in the form of fish may reduce muscle loss. For more information, speak to your Sports Dietitian who can provide a detailed protocol specific to you.
If you are in rehab at the moment, we wish all the best and hope you’re back on track soon!
References
Tipton, K.D. (2015) Nutrition Support for Exercise-Induced Injuries. Sports Medicine. Vol 45: 93-104.
Wall B. T, Dirks M. L, Snijders T, et al. (2014) Substantial skeletal muscle loss occurs during only 5 days of disuse. Acta Physiol. Vol 210: 600–11.
Wall B. T, van Loon L. (2013) Nutritional strategies to attenuate muscle disuse atrophy. Nutrition Reviews. Volume 71 (4): 195–208,