Nutrition Considerations for Injury Recovery
Raise your hand if you’ve ever been injured. (If your hand isn’t raised at your computer-phone-thing right now, congratulations! You’ve won the workout lottery, you beautiful resilient unicorn.)
Now raise your hand if you’ve ever been injured, had to take some time off from the gym (or even go into surgery), and thought: “Since I’m no longer engaging in vigorous physical activity, I need to reduce my caloric intake.” I hear this all the time - those exact, clinical, words, as a matter of fact. Just kidding, it’s usually some fear-infused shame cocktail of self-judgment for harboring the audacity to continue eating a bunch of delicious foods while our bodies attempt to repair themselves.
What?
We need to eat especially when we’re injured. And we need to eat a lot of the right kinds of foods. Despite the fact that we’ve come a long way from diet culture (still, so much work to be done), some dregs of misinformation remain. One of those dregs is a strong association between 'earning food' and 'exercise'. I’d like to propose a paradigm shift with the help of some cold, hard formulas.
The reality is that we need plenty of water, micro and macronutrients to get our bodies through the recovery phase. Adequately addressing nutrition can be a highly impactful aspect of rehabilitation, while ignoring it may set you back. Enough of the right foods can do wonders for maintaining lean muscle mass and keeping inflammation in check (Note: Localized inflammation is part of your bodys’ healing response! It is not inherently bad. Oftentimes, in the immediate stages of recovery, we need to help our bodies chill [pun intended] a bit with the inflammatory response).
In accordance with my above silliness, the first consideration for eating during recovery is:
Total Calories
You may be tempted to slash calories while recovering, but we need to be careful here. This approach generally works against our bodies’ ability to repair themselves. As it turns out, rebuilding and repairing tissue takes A LOT of energy. When we workout, our muscles sustain microtears that need to be repaired. We make an effort to recover from this damage by eating well balanced meals (protein, carbs, and fats) post-workout to replenish energy stores, repair the damage and rebuild the microtorn tissue. A lot of the same is going on after injury and/or surgery, but on an even greater scale - which is why your metabolic rate (or, how much energy your body uses on a daily basis to exist) rises in proportion to the severity of your injury.
Oh, you did say something about formulas earlier. I feel like that’s relevant now.
You surmised correctly! Here we have it, from Volume 55, Issue 9 in NATA's Journal of Athletic Training, Sept 2020:
Total Daily Energy Requirements = Basal Metabolic Rate x Stress Factor x Activity Coefficient
When we are not injured, and feeling what we would consider 'normal', our Stress Factor is a 1.0. Conversely:
https://meridian.allenpress.com/jat/article/55/9/918/444137/Nutritional-Considerations-and-Strategies-to?fbclid=IwAR0vCP1rlGpkYOTxkPOqd_u-Vil6EqFlnYk2O_fDOyakr6bEzxE-2VSLmDI
Say what now?
Basically, the above equation states that the number of calories you need in a day are equivalent to the amount you need to function foundationally as a human (Basal Metabolic Rate [BMR]), multiplied by the stress factor that accounts for the severity of your injury (more below), multiplied by a factor for your activity level (more below).
In an ideal world we would all have access to indirect calorimetry for calculating the amount of heat we produce via measurement of oxygen consumed and C02 released (for exact BMR). Seeing as most of us can’t hop over to our local nutrition and metabolism lab for an assessment of individual energy requirements, the Harris-Benedict equation serves as a rough estimate of your BMR which can then be multiplied by a factor for physical activity level to find TDEE, or Total Daily Energy Expenditure. TDEE has many individualized components (if you’ve participated in Fuel Your Fitness [FYF], this should sound familiar), which we can discuss in more detail another day.
Finally, if injured, you include a stress factor to estimate the extent of your raised caloric needs. This may range anywhere from 20% (hence the 1.2) for a minor injury to 100% for a severe burn (again, see here). Any injury that activates a stress response will result in some degree of increased energy expenditure and protein catabolism (breakdown).
So, now that we've established how much to eat, what exactly should I be eating?
The most important thing you can do is prioritize whole foods (you know what these look like) over inflammatory foods (processed meats, excessively refined carbs, a plethora of added sugars, fried foods).
Protein, Carbs, Omega-3s Fatty Acids, Vitamin-D + Calcium, Antioxidants (Vit A, C, E)
Your total caloric intake should prioritize these components to help with maintaining lean muscle mass, reducing inflammation, promoting collagen synthesis, supporting skeletal bone and muscle health, and decreasing oxidative stress. These dietary components should not differ significantly from your usual intake! All of the above can be found in the same foods we’ve talked about time and again - a rainbow of produce, whole grains as tolerated, lean meats, fatty fish, nuts, seeds, spices like turmeric and ginger. If you would like to review each component in further detail as it relates to injury, refer to this excellent article by Dana Norris, RD.
And that's a wrap on this week's focus on nutrition as it relates to recovery. Until next time!
Laura
