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Athletes, Injuries, and Nutrition

BY NANCY CLARK
PHOTO BY PETER SPURRIER

Athletes get injured. It’s part of the deal. Be it a torn ACL, Achilles tendinitis, or a pulled muscle, the questions arise: What can I eat to recover faster? Would more vitamins be helpful? What about collagen supplements?

At this year’s virtual Food and Nutrition Conference and Expo of the Academy of Nutrition and Dietetics, several presentations offered updates on nutrition for injuries. 

Pre-injury diet:   You never know when you’ll break a bone that requires a surgical fix, get hurt in a car accident, or end up with Covid. That’s why you want to prepare your body for the worst by eating wisely on a daily basis. While you need not eat a “perfect diet,” you certainly want your meals and snacks to include at least 90 percent quality calories.

If you know you’ll be having surgery for, let’s say, a rotator-cuff injury, you certainly want to undertake the surgery being well-nourished, with your liver stockpiled with the vitamins and minerals needed for healing. (A well-nourished person’s liver stores enough Vitamin C to last for about six weeks.)  Well-nourished patients have shorter hospital stays and faster recoveries. A lightweight rower who restricts food intake could easily be undernourished. Be proactive; eat well every day. Prehabilitation makes rehabilitation easier.

By allotting two-thirds of your plate to wholesome grains, fruits, and vegetables, you’ll optimize your intake of not only vitamins and minerals but also fiber. Fiber feeds the microbes in your gut. These microbes influence the strength of the immune system. Other foods that boost health of the microbiome include yogurt, kefir, blue and other “moldy” cheeses. In contrast, low-fiber ultra-processed foods do little to enhance gut health and immune health. Keto-athletes, take note: Some (but not all) studies suggest low-fiber keto diets may be detrimental to the microbiome. 

Post-injury diet: Injured rowers may be tempted to restrict calories, believing they “don’t deserve to eat” because they are not exercising. Wrong. Even rowers on bedrest require about 10 calories per pound of bodyweight to support their resting metabolism (energy used to fuel organs such as the heart, lungs, liver, brain, and just be alive). That means, if you weigh 150 pounds, you likely need about 1,500 calories for your resting metabolism, plus more fuel for such basic daily activities as brushing teeth, getting dressed, etc., plus 10 percent to 20 percent additional calories for wound healing. When healing injuries, you do not want to restrict your intake of valuable nutrients.

On the other hand, you don’t want to overindulge and smother your injury-related grief and/or boredom with ice cream. Rather, add structure to your day with scheduled meals and snacks. Sports dietitians can offer a nutrition-rehab plan that identifies the amount of protein needed to prevent loss of lean muscle and an appropriate calorie intake to optimize healing without undesired fat gain.  They can suggest also ways to boost your intake of iron and zinc (to optimize healing), as well as identify anti-inflammatory foods, such as berries, leafy greens (spinach, arugula, kale), cruciferous vegetables (Brussels sprout, broccoli), extra-virgin olive oil and oily fish (salmon, trout). 

Ruptured tendons, torn ligaments, and muscle pulls

So-called “soft-tissue injuries,” such as ruptured tendons, torn ligaments, and muscle pulls (muscle torn off tendons), can be season-ending. Preventing them from happening in the first place could save a lot of angst. Research suggests strength training (more so than stretching) reduces the incidence of these injuries.

Keith Barr, a researcher at the University of California, Davis, says tendons and ligaments have a collagen matrix. To heal tendon and ligament injuries, loading or stressing them helps increase collagen synthesis and make them stronger. For example, the anterior cruciate ligament (ACL) gets thicker and stronger during a training season.

Unlike muscles, your tendons and ligaments get nourished with little nutrient-providing blood flow. Rather, fluid in connective tissue gets squeezed out when the muscle stretches during exercise. Nourishing fluid then gets sucked in when the muscle relaxes. Consuming a collagen supplement 30 to 60 minutes before exercise assures having collagen-building amino acids circulating around the damaged tissue. This has been shown to enhance healing.

To create tissue that is more injury-resistant, athletes in sports that feature explosive movement (basketball, track and field, soccer), might want to take collagen supplements prophylactically. Doing so may also enhance their performance. One study suggested that hydrolyzed collagen taken during training improved explosive performance compared to a placebo.

While research is limited (and commercial collagen products are exploding), hydrolyzed collagen, collagen peptides, and yes, Knox gelatin, all offer the amino acid glycine, which is needed to heal these tissues. Dana Lis, Barr’s fellow researcher at UC-Davis, says that not all collagen supplements are created equal. Bone broth, for example, has low levels of glycine. Hydrolyzed collagen seems to be absorbed better than gelatin and tends to be more palatable.

Lis notes that Vitamin C is a co-factor needed to repair damaged tissue, so athletes should consume 50 milligrams of Vitamin C (for example, the amount in four ounces of orange juice or a half cup of cooked broccoli), along with the collagen supplement. To date, research has not been done to determine if glycine-rich foods (meat, fish, and poultry, or soy, nuts and plant proteins), are as effective as supplements. Would eating pre-exercise chicken and broccoli do the same job? Stay tuned.

The bottom line: Don’t underestimate the power of nutrition in preventing and healing injuries.

Sports nutritionist Nancy Clark, M.S., R.D., counsels both casual and competitive athletes in the Boston area (Newton; 617-795-1875). Nancy Clark’s Sports Nutrition Guidebook offers abundant information that can help you eat to win. Visit www.NancyClarkRD.com. 

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