We are so excited to have this Guest Blog from Morgan Bettini. Morgan is a Registered Dietitian and Registered Yoga Teacher who specializes in intuitive eating and yoga for athletes and plant-based eaters.
If you’ve been running or cycling for any length of time, injuries are bound to happen. Injuries can be minor or severe. Running injuries can also be acute or chronic. Acute minor injuries like scratches from tripping and falling require less intervention than a chronic overuse injury like plantar fascitis.
Nutrition has a place in reaching peak performance just as much as it has a place in recovery and repair. While you may not be running or cycling as much as you want to while rehabbing an injury, it’s an important time to eat foods that nourish and help heal your body. Sometimes it can be easy to throw in the towel on nutrition when you aren’t competing, but nutrition as an adjunct therapy is critical in helping you get better and achieve the results you want.
Let’s dive into some of the commonly asked questions around nutrition during rehab following an athletic injury.
How much should I be eating when I have a sports injury?
Depending on the severity of your injury, your resting energy needs may actually be slightly higher than normal as your body tries to repair itself. However, for the majority of athletes, slightly less energy is needed as your activity level as likely decreased. It’s more important to focus on your hunger and satiety cues than rely on specific calorie numbers as individual needs vary. If you aren’t used to paying attention to hunger cues, use this scale system as a guide below. Using the hunger scale takes practice and is more of an art than an exact science.
What nutrients should I focus on during injury rehabilitation?
There are some key nutrients to focus on during your rehabilitation process. A diet rich in plant-based foods can minimize inflammation in the body. You can also reduce inflammation by avoiding fried foods and foods high in refined sugars.
Omega – 3 Fatty Acids
Omega-3 fatty acids are an essential part of the diet but they are especially important for endurance athletes during training and recovery. Omega-3 fatty acids are precursors to prostaglandins. These prostaglandins are powerful hormone-like substances that help reduce inflammation, decrease swelling, and reduce sensitivity to pain. All of these are important when you are in recovery mode.
There are 3 types of omega-3 fatty acids (EPA, DHA, ALA). EPA and DHA omega-3 fatty acids are found in fatty fish including salmon, herring, and mackerel. ALA is found in plant-based sources including chia seeds, walnuts, and flaxseed/flax oil. ALA omega-3 fatty acids need to be converted to EPA and DHA to be utilized in the body.
Aim to consume fatty fish twice per week for adequate omega-3 fatty acid consumption. If you do not consume fish that frequently or at all, it may be good idea to consider an omega-3 supplement to help with inflammation and swelling. There are two types of omega-3 fatty acid supplement options. There are fish based supplements and vegetarian microalgae based supplements. The vegetarian capsules are helpful in preventing unpleasant fish burps or potentially complying with your vegetarian lifestyle.
For most healthy adults, the omega-3 fatty acid supplement recommendation is between 200-500mg of omega-3 fatty acids per day with at least 200mg coming from DHA/EPA. It’s important to choose a supplement that provides both DHA and EPA to improve utilization.
Supplementation needs vary depending on your lifestyle and intake and although omega-3 fatty acid supplements may be helpful for some athletes, they might not be advisable for everyone. As with any supplementation, please discuss with your primary care team or dietitian before starting a regimen.
Vitamin C is an important vitamin for healing wounds, supporting the immune function, and repairing tissues. Some of the best sources of vitamin C include citrus fruits, strawberries, bell peppers, and broccoli. If you’re eating a diet rich in whole fruits and vegetables (9 – 11 servings of fruits and vegetables per day), you are likely consuming adequate amounts of vitamin C. If this is not you, you may want to look into a multivitamin that provides vitamin C or a separate Vitamin C supplement but either way, it is an important vitamin to consume adequate amounts of while rehabbing an injury.
Vitamin A is a fat soluble vitamin (meaning it is best utilized when consumed with a source of fat) that plays a large role in cell repair and development. Vitamin A is a powerful antioxidant that helps mediate inflammation and the immune system. The active form of vitamin A, retinol, is only found in animal-based foods including liver, cod liver oil, salmon, butter, and some cheeses. Beta-carotene is the plant-based form of vitamin A found in sweet potatoes, carrots, and greens like kale, spinach, and collard greens. If you’re eating a well-balanced diet, consuming adequate vitamin A during injury recovery can be done easily. For example, one whole medium sweet potato contains 561% of the daily value of beta-carotene. However, if your diet is less varied or contains less vitamin A rich foods, consuming adequate amounts to help repair damaged cells in an injury may be more challenging.
In the last decade we’ve seen incredible interest and research looking into vitamin D. There is a strong relationship between vitamin D, athletic performance, and sports injury rehabilitation. Vitamin D helps muscle regeneration and adequate vitamin D levels have been shown to enhance the muscle repair process. Vitamin D also helps influence the immune response (this is in part why it’s important for adequate vitamin D during the winter months where you may not be getting sun exposure). Although adequate serum vitamin D helps support bone strength in healthy individuals, it’s important to note that the latest research has not shown a difference between serum vitamin D levels and bone health in athletic populations. This is likely related to weight-bearing activities like running that provide a stimulus for the bone formation and structure. Non-weight-bearing athletes (swimmers or cyclists) are still at risk for vitamin D deficiency and delayed injury healing if vitamin D intake is low.
We often hear about the sun being a great source of vitamin D but how well our body converts that into the active form of vitamin D can vary. As you age and if you have darker pigmentation, your body will convert less vitamin D.
Very few foods naturally contain vitamin D. Fortified foods provide the best source of vitamin D for most Americans. The most common fortified foods are dairy milk, yogurts, and ready to eat breakfast cereals. Non-dairy alternatives provide varying amounts of vitamin D fortification and it’s a good idea to check before relying on fortified foods. If your overall vitamin D intake is low and you experience minimal sun exposure (or always use sunscreen), consider a Vitamin D3 supplement to help meet needs.
Zinc is partially responsible for healing and protein synthesis to repair soft tissue damage. If you find yourself with frequent colds or injuries, it may be helpful to look at your zinc intake. I find many athletes avoid high zinc containing foods inadvertently – especially if limiting calorie intake. The best sources of zinc are more calorically dense (nuts, seeds, beef, poultry, seafood) but can help you recover faster.
Fluids often get overlooked in the nutrition recovery process but without adequate fluids, carrying nutrients to cells can be compromised. Fluids not only carry nutrients to cells but are particularly helpful in maintaining joint mobility and health. So if you are working with any joint, ligament, or fascia injury, ensuring adequate fluid is essential. A general recommendation is to consume half of your body weight in ounces of water everyday (150 pounds / 2 = 75oz or slightly more than 9 cups of water per day) but individual needs may vary.
Nutrition is an important component of athletic injury rehab. With a sound nutrition foundation, you will give your body the nutrients it needs to help repair damage and reduce inflammation. Nutrition is not a one-size fits all, so inherently, the same thing won’t work for everyone. However, ensuring adequate intake of the above mentioned nutrients is a great start.
If you have additional questions or would like to work with a dietitian, Please feel free to contact Morgan Bettini. She dishes up a hefty dose of wellness in her blog and newsletter at: morganbettini.com