Injuries: Nutrition and Recovery
by John Berardi, PhD, CSCS and
Ryan Andrews, MS, MA, RD,CSCS
Rest, ice, and Celebrex. If you've got a sprain, a strain, a
tendonitis, a tendonosis, a fracture, or any other sports injury,
you're likely going to leave the doc's office with the same
prescription. Rest, ice, and Celebrex. Unfortunately you're
unlikely to hear about the healing benefits of curry powder, garlic,
pineapple, cocoa, tea, and blueberries. Nor will you be advised to
increase vitamin A, vitamin C, copper, or zinc intake. You
probably won't walk away with a prescription for fish oils. And you
certainly won't be given a stack of glutamine, HMB, and arginine. Maybe
it's because your doc thinks this is too much to remember. Or maybe
your doc isn't up on the latest nutritional research. Regardless of the
reason, it's a shame as nutrition plays an important role in injury
repair. From boosting immune function, to improved collagen deposition,
to a more rapid return to function, the right nutritional intake can
make a big difference.
There's more to treating injury that ice!
Nutrition and Injury Repair Although
we may perceive injury as chaotic — with the pain, swelling, and
dysfunction — when we look at things biologically we see that injury
does lead to an organized, consistent pattern of repair. Researchers
and clinicians typically break this pattern down into 3 defined stages.
Stage 1 — Inflammation This stage
lasts up to 4-5 days post soft tissue injury (2-3 weeks in bone injury)
and is in place to clear out injured tissue debris.
Stage 2 — Proliferation This
stage comes after inflammation and lasts about 2-3 weeks (10-12 weeks
in bone injury) and is in place to form temporary replacement tissues.
These tissues are usually weaker than the originally injured tissues
yet still provide some structure and function to the site of injury.
Stage 3 - Remodeling This
stage comes after proliferation and can last up to 1-2 years (even
longer in bone injury) and is in place to form new tissues nearly as
strong as the original tissues. By understanding this process
of injury and injury repair, scientists can look at each step in the
repair process, targeting different nutritional angles in the support
of injury recovery. These targets typically fall into the following
three categories:
1. Nutritional strategies that promote, yet manage, acute inflammation.
2. Nutritional strategies for supporting immune function.
3. Nutritional strategies that support long term tissue healing and regeneration. As
inflammation is the most acute and problematic phase, one major goal of
any injury repair protocol should be to support (but manage) the
inflammatory process. While most folks think inflammation is a bad
thing, it's important to know that the inflammatory process is critical
and that any strategy designed to eliminate inflammation or blood flow
to the injured area should be avoided. However, pro-inflammatory agents
should also be avoided as excessive inflammation could increase total
tissue damage, slowing down the repair process.
Further,
a secondary goal of managing inflammation is to reduce pain, as pain
can cause biomechanical compensations/changes that can lead to
secondary injury as well as restrict movement necessary for the
development of strong, functionally adapted replacement tissues.
However, again, strategies that eliminate pain often target
inflammation. And in this case, the elimination of inflammation (and
pain) may also reduce healing. With these goals in mind, it's
time to think about how specific macronutrient and micronutrient
interventions can help manage inflammation, boost immune function, and
help lay down stronger replacement tissues more quickly. We'll talk
about each of these in this article.
Dietary Fats and Inflammation Management A
diet high in trans-fats, omega 6 rich vegetable oils, and saturated fat
will be pro-inflammatory while a diet high in monounsaturated fats and
omega 3 fats will be anti-inflammatory. Of course, most of us already
know that it's the ratio of omega 6 to omega 3 in the diet that helps
us maintain a balanced inflammatory profile, but this refresher lesson
is often necessary during periods of injury recovery. Another
required refresher is the fact that beyond 3s and 6s, the overall fat
balance is important here. With a good balance of saturated,
monounsaturated, and polyunsaturated fats (about 1/3 of total caloric
intake each), the body's inflammatory profile will most likely fall
right into line — especially during periods of injury repair. To this end, the following simple strategies should go a long way during injury repair and even during injury prevention: To balance your fats:
Increase intake of olive oil, mixed nuts, avocados, flax oil, ground
flax, and other seeds, etc., making sure to get some of each fat source
every day. By eating these foods, you'll likely balance out the
saturated fats naturally present in your protein sources, leading to a
healthy profile without breaking out the calculator. To balance your 6:3 ratio:
Add 3-9g of fish oil each day while reducing omega 6 fats like
vegetable oils such as corn oil, sunflower oil, safflower oil,
cottonseed oil, and soybean oil, etc. This strategy should take care of
your omega 6:3 ratio.
The cycle of inflammation.
Using Herbs and Phytochemicals to Manage Inflammation Beyond
healthy fat balance, certain foods and herbs can be very beneficial in
the management of inflammation. These herbs include:
Turmeric Current
research shows that the active ingredient, curcumin, is responsible for
the anti-inflammatory benefits of turmeric. As turmeric is present in
curry powder, you could start by adding curry to your diet, although a
better strategy would be to add 400-600mg of turmeric extract 3x per
day to manage inflammation.
Garlic Garlic
has been shown to inhibit the activity of certain inflammatory enzymes
and impact macrophage function. Again, although eating more garlic is a
good start, supplementing with 600-1200mg of aged extract likely works
best.
Bromelain This is another
anti-inflammatory plant extract that comes from pineapple. While best
known for its digestive properties, it's both an anti-inflammatory and
analgesic. Doses of 500-1000mg/day should do the trick.
Boswellia This tree extract also has anti-inflammatory properties and is usually used in 300mg doses 3x per day.
Flavanoids Cocoa,
tea, red wine, and certain fruits and veggies are high in the
anti-inflammatory flavanoids. Again, while an increase in consumption
of flavanoid foods would likely be of benefit during times of acute
injury, blueberry or grape extracts, green tea extracts, citrus
extracts (hesperedin, naringin, etc), and bioflavonoid supplements
containing quercetin/dihydroquercetin and rutin may lead to more marked
anti-inflammatory effects. With all of these nutrients, caution
is warranted as wholesale suppression of the inflammatory response in
the body isn't warranted during the acute phases of injury. The idea
here is to control inflammation from getting out of control, not stop
it from happening. So, in the end, the key is not to load up on
all of these anti-inflammatory supplements at once. Rather, focus on
foods rich in natural inflammation modulating agents such as these
below,
only supplementing if inflammation becomes a major/chronic problem(this would likely be discussed with your physician first).
Curry powder/turmeric
Garlic
Pineapple
Cocoa
Tea
Blueberries
Accueil 
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