Choosing what is good to eat can be confusing enough when you’re able-bodied, let alone when you’re injured, perhaps in pain, and wondering about the best nutrition for injury recovery.
With all the complicated food messages in the media and online about diets it can be hard to sort the fab from the fad. Should we go paleo, vegan, low-carb, cabbage soup, high-fat, ketogenic…? Do we need to do something completely different when recovering from injury?
Digging in to the internet for diet expertise can be a great starting point but it can be hard to find credible information quickly. And like many fields of health and wellbeing, the science around food and nutrition for injury recovery continues to evolve. (That said, I’ve included some interesting research at the end of this article.)
Add to these complex messages the pain, upset and pure exhaustion that can come with injury — plus the pure physical inability to make food easily — and it’s a recipe for nutrition, and wellbeing… disaster.
Food and nutrition for injury recovery and wellbeing
Food is crucial to our health and wellbeing and to injury recovery. Both the body and the mind can be enhanced (or hindered) by our approach to what we choose to let pass our lips.
Fumi Somehara, an accredited dietitian and conditioning coach specialising in helping dancers perform at their best and recover when they’re injured, summed up where this focus should be beautifully when I interviewed her recently.
“Meal times are a great occasion to connect with food, people, and yourself — both physically and emotionally,” she said.
“Food can be healing from it’s pure nutritional, scientific characteristics and it can also be really healing from that psychological, emotional part of it. Maybe it’s your mum’s chicken soup or your grandma’s biscuit… there’s that part to healing as well: feeling comfortable.”
“When you’re injured your body does need more energy and macronutrients and micronutrients. But while we can get into all those details, self-compassion, awareness and body respect and kindness are paramount.”
“You really need to dose up on those and also try to look at the positive side of things, which isn’t always easy,” said Fumi.
Watch the full video interview with Fumi Somehara below or on the Recover from Injury YouTube channel.
Healing processes
Healing is a busy time for your body. Many physiological processes kick in to heal the injured body part/s. This takes more energy and nutrients and you’ll no doubt be more tired than usual.
The injured area goes through acute inflammation (an essential part of recovery) then regrowing the damaged parts with scar tissues and remodelling. (Read a great summary here from Dr John Berardi; Warning: don’t get overwhelmed by the article, which goes into a lot of detail about which nutrients/foods help with which process; just use it to keep some ideas in the back of your mind.)
So how do you implement the healing tool of food to enhance nutrition for injury recovery and have a better time?
The answer: by focusing on listening to your body, nourishing yourself with foods that make you feel good and eating with minimal stress.
It’s best to not get too concerned about the ‘extra’ nutrients or supplements list or stress about doing more and making big changes (which was how I originally thought about it: ‘what will help my bone and ligaments heal faster?’)…
Because food and nutrition for injury recovery can be an overwhelming topic, here are six simple approaches to move you forward and help give you the best recovery possible.
Six simple food and nutrition approaches for your injury recovery
1. Be kind to yourself
This is number one for a reason! Self-compassion is critical at this time.
If your mum’s lasagne is your favourite meal and her cooking it for you helps her show you love then enjoy it whole-heartedly. Enjoy a meal with family or friends as often as possible to get the social benefits from food: love, laughter, connection and whatever else you treasure.
This is not the time for putting militant dietary rules on yourself.
According to Tim Crowe, a Dietitian, Researcher and Educator from Thinking Nutrition by over-focusing on the food you ‘should’ be eating, you can increase your stress levels.
“Be kind to yourself and eat as well as you can in your situation and realise that there is no one perfect diet or way of eating. Get it right most of the time and don’t sweat on it the rest of it.”
Enjoying food with family and friends can provide nutrition for injury recovery and other social and mental benefits.
2. Be practical, make things easy
What is your practical capacity right now? Can you make your own food? Or are you on crutches with multiple injuries, barely able to make it to the kitchen let alone able to carry a plate of food with you?
Get clear on this so you know what you can do OR what help you need. Then ask for it.
Whether you need a family member or friend to bring you some food for a week or so or you need to get a longer-term carer to help, it’s important to get the help you need rather than toil away struggling alone. (And family members and friends often truly want to help so don’t deny them their chance to express their love and concern.)
Perhaps you can change the way you buy food by having it delivered and you make it yourself or have full meals delivered.
I couldn’t have survived without Lite ‘n Easy being delivered up my three flights of steps (read more about possible food delivery services in this helpful guide). When I was injured, in pain, barely sleeping and anxious about what was going to happen to my leg, I lost my appetite completely. Making food was tricky and the idea of cooking a yummy meal was beyond me, even though I craved nutritious foods like roasts and soups.
3. Heed credible medical advice
What medical or health advice have you received prior to your injury and after? Do you know that you need to watch your cholesterol or your sugar intake to manage some health conditions?
Consider your general level of health and follow any new advice from your doctor, surgeon or dietitian about nutrition for injury recovery.
Check out our fabulous food tips from 7 dietitians and nutritionists here.
Depending on your injury (for example if you have burns or have been through major surgery), your doctor may recommend medical-type, nutrition products that need to be purchased from a pharmacy.
If you think you should talk to someone about food and nutrition for injury recovery, then talk to your doctor or find a credible professional in your country:
- Australia: Dietitians Association of Australia where you can find an accredited, practicing dietitian.
- United Kingdom: The Association of UK Dietitians
- Canada: Dietitians of Canada
- USA: Academy of Nutrition and Dietetics
- Asian countries, look for an organisation listed with the Asian Federation of Dietetic Associations (AFDA).
- Other countries: start with the International Confederation of Dietetic Associations.
4. Check in often with how you’re feeling
“How am I feeling today?” is a crucial question to ask yourself frequently. And you should consider your answer because food is an important contributor to general mental wellbeing.
If you’re feeling stressed or depressed, then you can use food and beverages as a way to relax, nourish yourself and share time with friends and family.
Does having your favourite flavour of tea or coffee at your local cafe usually bring you immense joy? Then do that often to help you feel better. Recovering from injury means taking each day at a time and looking for ways to work through emotions and find happiness again; so use meals or coffees out as a small thing to help.
If you have an upset stomach due to medications or because you are stressed/anxious/depressed, it’s important to change your diet accordingly and work through some of these issues as soon as possible.
As Fumi said in our interview together, stress is proven to reduce absorption of nutrients. Not want you want!
5. Eat a little more
When injured you’ll generally need a little more food than before injury (if you were eating the right number of kilojoules/calories) as your body is working hard to heal itself.
According to Michael Newell, in a recent article Here’s what to eat to recover from an injury: “when injured, your daily energy expenditure can increase by as much as 15–50% over normal, particularly if the injury is very bad”.
He goes on to say in his article that “If your injury is so bad you need crutches, your expenditure during walking can be even higher.”
No-one ever told me that and I wish I’d known because I lost so much muscle mass while non-weight bearing, on crutches. My left leg is still smaller than my right… Anyway, I digress.
So eating more? Check ✅
6. Focus on variety (not nutrients)
While what you eat delivers your nutrition for injury recovery, it’s better to focus on eating a variety of foods and enjoying the experience, rather than trying to add in nutrients specifically. However, if you’re like me and you’d like to know what the science says about changing nutrient needs during injury then this part is for you. Note there isn’t a one-size-fits-all approach but having these ‘rules of thumb’ in the back of your mind can help.
Here’s the low-down from the dietitians:
According to Fumi Somehara, “Injury recovery is about key nutrients, but we don’t just eat nutrients, we eat food and food is much more to us than the nutrients it contains from the taste, social aspect, mindfulness during preparation and so on.”
“So, it is important to look at the bigger picture of the dietary patterns you’re following as it will be feeding much more than the injury,” she said.
“Typically when you’re injured you’ll need more energy and you need more protein and vitamins like A and C just to name a few,” she said.
“But most of the time the evidence isn’t clear-cut that if you eat X, Y, Z foods you will heal quicker. So you have to be willing to experiment. Just because the evidence shows one thing, if it’s not practical for your situation then it may not give you the most advantage,” said Fumi.
Tim Crowe added, “The most important nutrients in recovery from an injury are firstly adequate energy and then protein, essential fatty acids, vitamin C, vitamin A, vitamin E, zinc and iron.”
“Magnesium is an important nutrient for fracture healing, but it is not of much benefit on it its own as the other three key nutrients of calcium, vitamin D and vitamin K are just as important and that’s why there are now targeted supplements containing all these nutrients together.”
“Someone with severe burns would have incredibly high protein needs (more than double what is normal) because of the trauma from the wound so there is no fixed recommendation for all injuries. For someone in a recovery phase from an injury, the principle focus will be around eating as well as possible with a focus on key nutrients important in the healing process such as protein,” said Tim.
According to recent research, a deficiency of protein can impair all sorts of healing processes and affect the immune system, making it harder to fight off infection.
Remember that stress and worry about the food you’re eating can have a negative effect on your health (this too is proven by science).
Taking on board the approach from Kaitlyn Anderson, Dietitian and Nutritionist at Bite In2 Life of ‘less thinking, less stress’ is a great summary of this final point 6.
“I’m always very conscious of encouraging people to listen to what their body is telling them, and choose foods that help them to feel good within themselves rather than following a strict set of ‘rules’,” she said.
“The body does not use any one nutrient in isolation, and it is really about eating a wide variety of nutritious foods, not trying to be perfect,” said Kaitlyn.
In summary, it’s good to increase the variety, increase the nutritious foods, eat more protein, get a good balance of carbohydrates, fats (including monounsaturated fats and limiting animal fats and processed fats) and calories and see how you feel.
Through taking a positive and mindful approach to the food you eat you’ll be enhancing nutrition for injury recovery.
Eat a little more, focus on variety-filled meals and the experience, rather than a specific nutrient checklist. #Food tips for injury recovery @Recover_Injury
Back to basics before thinking about nutrition for injury recovery
You may at this stage be wondering: “What should I have been aiming for as healthy enough before I got injured?”. You can consider the general guidelines for a healthy diet:
- plenty of fruits and vegetables
- high-quality proteins (such as lean meats, fish, eggs, nuts and seeds, and legumes)
- adequate fibre, whole grains, and essential fats
- plenty of water.
And here are some handy links:
- Take the Healthy Eating Quiz on Dietitians Australia website. Remember, I recommend this for some general guidance and ideas, not as something to obsess over.
- Australian Guide to Healthy Eating, Australian Government (National Health and Medical Research Council and Department of Health).
- MyPlate (healthy eating style recommendations based on the Dietary Guidelines for Americans, 2015-2020), see below.
- Eating for Strength and Recovery, US Academy of Nutrition and Dietetics.
- Some quick ideas on ‘nutrient dense’ foods from Runners Connect.
Then I recommend going back and reading points 1 to 6 above and if you are still wondering about your food and nutrition for injury recovery and whether you could be helping your healing along, ask for help or look for credible resources.
Hopefully if you’re in hospital you are connected to a dietitian right there and if not, ask. You should be given information about the people in your local area that you can talk to. Of course, your doctor will be able to refer you to an accredited dietitian.
MyPlate from US government recommends a mix of fruits, vegetables, grains, protein and dairy for healthy eating.
Research to watch
Because I am a fan of scientific research to give us new knowledge and tools for life generally and specifically when recovering from injury, I wanted to include a section on some of the latest news I’ve found.
The research that is going on into which foods and nutrients can be better for our health is truly exciting!
An example is the exploration of whether or not consuming gelatin with vitamin C can speed up tendon and ligament repair as it helps increase the production of collagen, the main protein found in tendons and ligaments (very early-stage research).
Gut bacteria
Another area is all about our gut bacteria, which is called the microbiome. This is the community of different strains of bacteria, some good, some bad.
There’s a growing body of evidence that shows that this bacterial community has a huge impact on how we digest our food, absorb nutrients and how healthy we are generally.
The key food the good bacteria need is resistant starch (as found in lentils, peas and beans, cooked and cooled potato, cold pasta salad, firm bananas, and certain wholegrain products). Note that fibre is good to have more of (think fruit, vegetables, bran) but not all fibres are the same; resistant starch is a fermentable fibre.
According to CSIRO, Australia’s national science agency: When resistant starch becomes exposed to the healthy bacteria in the large intestine, the bacteria break down the fibre into chemicals (a process called bacterial fermentation) that nourish our cells and reduce inflammation, keeping the large intestine tissue healthy. Watch the video to learn more:
Over the long term, not getting enough resistant starch means that the ‘good bacteria’ starve. This starvation process leads to the bacteria stopping its nourishment of the intestinal wall. Then toxins, bacteria and undigested food particles have a greater chance of crossing over into the blood stream. When this happens, it can cause an increased risk of a variety of health conditions, such as: irritable bowel syndrome, Alzheimer’s, autism and colon cancer.
Our gut and nutrition for injury recovery
Why am I telling you about the emerging knowledge about gut bacteria and our general health? It’s important for injured people to know because with the added stress and challenges from injury, eating properly can be more difficult. And there’s a risk that recovery will be slowed by changes in gut bacteria preventing you from getting effective nutrition for injury recovery.
A recent study found that traumatic injury had a sudden and significant impact on gut bacteria. The researchers involved think that health professionals should be aware of this, particularly where injuries are severe.
“The gut bacterial community is known to modulate inflammation, and is related to a range of clinical outcomes in the patient who is critically ill,” they write.
The gut bacteria of people who had suffered a traumatic injury started to change within 24 hours. By 72 hours, three types of bacteria were depleted in the traumatic injury group, relative to the non-injury group, and the levels of two other types of bacteria had risen.
The implications of these changing microbiota are not yet known but the researchers believe that the findings so far point to the possibility that intestinal bacterial composition could in some way be critical to patient outcomes after a traumatic injury.
Supporting stem cells and other natural healing processes
Recent research in the US has uncovered that stem cells in our body respond to injury and activate various processes to assist healing. Stem cells exist in different parts of our body, for example in bone marrow, and can repair tissue damage. When one part of the body suffers an injury, adult stem cells in uninjured areas throughout the body enter a primed or “Alert” state.
There are a number of triggers in our blood chemicals to activate these stem cells and researchers found that enzyme called Hepatocyte Growth Factor Activator is particularly important. They are now exploring whether certain treatments could be given to improve healing after surgery or prior to injury (for example, if injury likely in a combat situation).
While the science of producing human-ready treatments isn’t finalised yet, it stands to reason that we can help our natural healing responses by nourishing our bodies effectively and ensuring we drink enough water. Thus, we can help unlock better nutrition for injury recovery.
A few words of warning about nutrition claims
I want to emphasise here that you’ll no doubt see all sorts of claims about specific nutrients and foods helping to reduce inflammation and pain, promote healing, regrowth of tissues etc.
They may or may not be true. But you can find out more about the facts behind nutrition for injury recovery.
In Australia, New Zealand, the United States of America, Canada and many other developed countries, health claims about food (either on the products themselves or in advertising) must be based on evidence and a particular approach, called systematic reviews. These reviews are where all the credible research is analysed by a global independent network of researchers, professionals, patients, carers, and people interested in health and summarised into a report.
There are two types of health claims:
- General level health claims refer to a nutrient or substance in a food, or the food itself, and its effect on health (e.g. calcium for healthy bones and teeth).
- High level health claims refer to a nutrient or substance in a food or the food itself and its relationship to a serious disease or to a biomarker of a serious disease. For example, ‘diets high in calcium may reduce the risk of osteoporosis in people 65 years and over’.
There is a list of 200 pre-approved food-health relationships in the Schedule 4 of the Australia New Zealand Food Standards Code for general level health claims and 13 pre-approved for high level health claims, based on a series of commissioned reviews.
These are worth checking if you hear of someone telling you that X mineral will solve all your injury problems.
In the case of protein, which I and the dietitians have talked about a bit in this article, there are a number of health claims that are permitted by these government standards. These are that protein:
- is necessary for tissue building and repair
- is necessary for normal growth and development of bone (in children and adolescents)
- contributes to the growth of muscle mass
- contributes to the maintenance of muscle mass
- contributes to the maintenance of normal bones.
There is also a publicly-available ‘food nutrient database’ (plus one for supplements) produced by Food Standards Australia, New Zealand. It records a standard assessment of nutrients in 5,740 foods.
Looking at protein again, it’s no surprise to see the highest amounts of protein in amino acid/creatine powder, gelatine, protein powders, gluten, then cod (fish). There are some odd things analysed in the list but it’s very interesting.
Exploring these resources can help you uncover more tips to eating and improving your nutrition for injury recovery.
The fundamentals of food and nutrition for injury recovery
Which foods you eat is important. Not just to your nutrition for injury recovery and physical healing but also your mental coping.
Bouncing back from injury can be a tough job. There can be a lot going on physically, psychologically and practically. How you feed yourself is another thing to manage.
If you take away one piece of advice from this article let it be this: Take it easy. Eat a variety of foods without putting undue pressure on yourself and emphasise the fun in the food experience.
And there is always help available so if you feel that you need to talk to someone about your injury recovery, we have coaching available to help you get clear on what you’re struggling with and to get you on track with a plan to thrive.
Note that the images used in this article were sourced from Envato Elements under license and are not to be published elsewhere.