Injury Nutrition and Supplementation: How to Get Back in the Game Sooner
Written on August 9, 2012 at 9:01 pm, by Eric Cressey
Today’s guest blog comes from nutrition expert, Brian St. Pierre.
About three weeks ago, I broke part of my tibia while playing in a rugby tournament. Fortunately, my break isn’t too bad (though it is rather rare), as I only broke the bottom portion of the tibia, not the entire bone.
I got tackled on the final play of the game, and while we went on to score, giving us a chance to tie. Unfortunately, we missed the kick, and even more unfortunately, my ankle everted excessively. This eversion caused huge strain on my tibiocalcaneal ligament (the white one in the photo below), which is so damn strong that instead of spraining, it simply broke the bone where it attached to my tibia.
The worst part is that 1 in 6 of these breaks require surgery. I am young, fit and healthy, so I am hopefully not the “1,” but I still felt it was in my best interest to do everything I could to decrease the surgery odds.
Injuries are a part of the game; whether that game is rugby, baseball or just being a recreational exerciser – they can happen to all of us. While prevention is always the goal, once injury occurs, what can we do about it? A lot, actually.
You see, the body has a very organized recovery process. First is the coagulation phase which lasts 1-2 days. An inflammation phase follows, lasting up to 5 days post –injury. Third is the migration phase, which lasts from day 4 to 21 days post injury. Finally, the remodeling phase lasts from day 5 up to 2 years post injury.
With this in mind, we can use appropriate nutrition and supplement choices to improve the recovery process. The goal with an injury is to manage inflammation by controlling swelling and pain, and to assist with the remodeling phase to stimulate tissue growth (in my case, bone).
The trick is to not completely eliminate inflammation, as some is necessary for proper recovery, but too much can increase tissue damage and lengthen the recovery time. Here are some strategies for modulating inflammation:
1. Eating appropriate fat-dense foods.
Focusing consumption on plenty of extra virgin olive oil, various nuts, avocados, ground flax, chia seeds and wild fatty fish or fish oil. Fish oil is a must here, with a good goal being 3-9g of total fish oil per day.
In this same vein, it is even more important to minimize inflammatory promoters such as industrial vegetable oils – corn, cottonseed, safflower, soybean, sunflower, etc and especially trans fats.
2. Including specific foods and supplements.
Curcumin at 1-2g/day.
Bromelain 500-1000mg/day or 1 cup pineapple/day
3. Using NSAIDs appropriately.
NSAIDs do help with managing inflammation, but they also can hinder appropriate healing, in addition to many other possible side effects such as GI distress, bleeding, etc. They are best reserved for the inflammation phase of recovery only.
In addition to managing inflammation, it is also important to note that injuries increase our resting metabolic rates by 15-50%. In my case it is probably closer to 15, in the case of severe burns covering large amounts of the body, then it approaches 50%. As such, we need to consider the extent of the injury when we decide how to plan out nutrition to optimize tissue repair.
While overall calories needs will be higher than your needs if you were not injured, they are not as high as your needs are if you are healthy and training hard. In my case I was still able to lift 4x/wk with some modifications, but I was no longer able to walk the dog everyday for two miles, and my overall movement decreased, so my intake reflected that.
In addition, having some vitamin or mineral deficiencies can also inhibit healing and recovery. These deficiencies include vitamins A, Bs, C, and D, as well as copper, iron, magnesium, manganese, zinc and calcium.
Additionally, some micronutrients may actually speed healing (though some are more specific to wounds than bone): vitamins A and C, copper and zinc are examples.
With all of that in mind, what did I actually do with my nutrition and supplementation to ensure a good recovery?
I actually increased my already substantial fruit and vegetable intake to help ensure adequate vitamin and mineral status, as well as providing anti-inflammatory phytonutrients and compounds.
I will also note that I have been experimenting with a BSP version of intermittent fasting (meaning I am not a slave to it, I do it on days when it fits my schedule, and don’t do it on days when it doesn’t, and I don’t worry if I only fast for 14 hours instead of 16 either).
Wake @ 5:30am – 12oz black coffee
7:00am – 12oz black coffee
7:30-8:30am – train
10:00am – Breakfast
• 5 whole pasture-raised eggs in 1 tsp grass-fed ghee
• ½ cup mixed peppers and onions
• large handful organic spinach
• salt and pepper to taste
• ½ cup old fashioned oats cooked with a little unsweetened vanilla almond milk
• 1 banana, sliced
• 1 tbsp organic milled flax
• cinnamon to taste
• 1 smoothie made of 2oz POM, 1 cup organic whole yogurt, ½ scoop vanilla protein, 5g creatine, bunch of blueberries and strawberries
2:00pm – Lunch
• 1 Ezekiel wrap
• 2 tbsp extra virgin olive oil pesto
• large handful or two of organic spinach
• 1 chicken breast
• ½ 100cal pack wholly guacamole
• 12 baby carrots with other half of guac
• 1 organic apple
• (when uninjured I have another cup of yogurt, another half scoop of protein, a few slivered almonds, and some chopped strawberries here, but I intentionally dropped this knowing my needs were less)
6:00pm – Dinner
• 3 cups organic mixed greens
• 4 baby carrots
• ½ cucumber
• ¼ cup black beans
• ½ cup brown and wild rice
• a few croutons
• 2 tbsp expeller pressed canola oil ranch dressing
• 10oz grass-fed lean sirloin
• 1 glass wine or 1 Coors Light
• 3 squares Green & Black’s Organic 85% Cacao chocolate (1/4 serving)
• 1 serving mixed dried fruit
• Innate Response One Daily 2x/d
• 1g Curcumin 2x/d
• 500mg Vitamin C 2x/d
• 2000IU Vitamin D on weekdays
• 3g fish oil 2x/d (total of 3.6g EPA and DHA)
• 1 probiotic daily
• 3 ZMA 4x/wk
In advance, I’ll answer some of the questions I know will come up.:
1. I am only taking vitamin D on weekdays because I get plenty of sun on the weekends, and in fact I was only taking it a few days a week prior to the injury since I was walking the dog each afternoon and it has been a gorgeous summer.
2. I am taking the vitamin C merely because we had some kicking around the house; they were about to expire and I figured it wouldn’t hurt.
3. I don’t normally take ZMA, but I figured I would get a bottle for the extra zinc and magnesium, just for the next 5-6 weeks or until it runs out. I only take it on the nights before I train, as I tend to feel groggy if I take it every night.
4. I will only take the supplements in these amounts for four weeks. After that it returns to multi just once, 500mg curcumin, and 2g fish oil (1.2g EPA/DHA).
5. I will also not that I did take 800mg of ibuprofen 2x/d starting on day 3 of recovery, after the coagulation phase, and then only took for three more days, or until the inflammation phase was complete.
Don’t let an injury come between you and your health and fitness goals. As Eric has written, you can always train around an injury, and there are steps you can take to provide your body with the materials it needs to heal as rapidly and completely as possible.
Have you employed any nutritional or supplementation strategies to assist your recovery from an injury in the past? I’d love to hear your experiences in the comments section below.
About the Author
Brian St. Pierre is a Certified Sports Nutritionist (CISSN) and a Certified Strength and Conditioning Specialist (CSCS). He received his degree in Food Science and Human Nutrition with a focus in Human Nutrition and Dietetics from the University of Maine, and he is currently pursuing his Master’s degree in Human Nutrition and Dietetics from the same institution. He was the Nutritionist and a Strength and Conditioning Coach at Cressey Performance in Hudson, MA for three years, and is now a coach with Precision Nutrition. Brian authored the Show and Go Nutrition Guide, the accompanying nutrition manual to Eric Cressey’s Show and Go Training System.
With his passion for seeing his clients succeed, Brian is able to use his knowledge, experience, and energy to create highly effective training and nutrition programs for clients of any age and background. For more information, check out his website.
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