A Primer on Sports Nutrition for Injury Recovery & Prevention
We received some great feedback on our article, Supplements for Injury Recovery: The Definitive Guide.
But one thing kept coming up when speaking with our clients: it's a lot to take in.
That's why we created this short(er) primer article.
It covers the main concepts of sports nutrition for injuries without getting into the weeds of research on each relevant nutrient.
If you're wondering if supplements are relevant for injury recovery and prevention.
Why NSAIDs like ibuprofen do more harm than good (even though they relieve pain).
Or want to understand the main goals of injury supplementation without digesting the full guide, this primer article is for you.
To read the full guide, including detailed breakdowns of the research on all relevant nutrients, go here.
Or if you're looking for a detailed plan of exactly what supplements to take for injury recovery — download our free 6 Week Post-Injury Supplement Plan here.
We put together a 6 week post-injury supplement plan using only the most research-backed (and cost-effective) supplements. Forget NSAIDs and OTC pain killers — use this free 6 Week Plan to boost recovery and prevent future injuries:
Nutrition for injury recovery is the most neglected aspect of injury rehabilitation.
There's no substitute for intelligent rest and physical therapy, but the right nutrition strategy can improve recovery outcomes and speed up the healing process.
At the very least — you should follow the golden rule of injury treatment.
Which is "DO NO FURTHER DAMAGE."
Physiotherapists who use this motto are referring to being smart in the gym and on the practice field.
i.e. Don't let a partial tear turn into a full-blown tear by refusing to acknowledge your injury.
But nutrition also plays a role in preventing excess (counterproductive) tissue damage after an injury.
A good post-injury nutrition plan provides your body with the right nutrients in proper amounts to facilitate the repair process.
It's less about eating magical superfoods, and more about getting out of your body's way.
Give it the raw nutrition it needs, and let your body repair itself.
(We'll get to the magical superfoods part in a minute.)
The Basics of Sports Nutrition for Injury Treatment
1. Stay hydrated
Even slight dehydration can reduce blood flow and nutrient delivery to injured tissues, impairing the healing process. Water intake is also crucial to the wound healing process.
The old adage of 'drink eight 8 ounces glasses of water per day' is a useful reference. The important thing is to not let yourself become dehydrated at any point. So keep water handy at all times during your recovery, and sip on it before you become overly thirsty.
2. Consume adequate calories
Lack of adequate calories or protein can slow down muscle protein synthesis, an important outcome for getting back to full function. While your total daily maintenance level of calories decreases with a reduction in overall physical activity after an injury, the injury repair process itself requires additional calories.
So your best bet is to eat roughly the same of amount of calories as you did before the injury.
This is not the time to drastically cut calories or try to quickly lose body fat. If you're worried about gaining body fat, you can increase your daily protein intake as a percentage of total calories while slightly reducing overall calorie intake. More on that below.
3. Increase daily protein intake
Assuming your exercise intensity and frequency is reduced after injury, your appetite will likely decrease as well. Resulting in a spontaneous reduction in calories consumed.
If you eat the same types of meals (with the same proportion of protein) then your total daily protein intake will be reduced.
Not good. Because studies show demand for protein in the body is increased substantially post-injury to aid the healing process. Reducing protein intake could hinder your recovery.
A good workaround here is to increase your protein intake as a percentage of total calories.
Aim for at least 1 gram of protein per per pound of body weight post-injury.
4. Balance your macronutrients
The post-injury period is not a good time to dramatically restrict calories. Likewise, it's no time to restrict any one macronutrient (carbohydrates, fat, or protein). Your body needs ample levels of carbohydrates and fat to support the healing process.
So skip the Keto Diet, and skip the extreme low-fat bodybuilding diet.
Instead, eat balanced meals that contain reasonable portions of lean protein, complex carbohydrates, and fats.
5. Avoid junk food
Consuming junk food causes excess mineral excretion, raises inflammation levels, and produces free radicals that cause more damage to your injured tissues. By "junk food" I mean overly processed foods, fried foods, high-sugar desserts, and alcoholic beverages.
While this seems obvious, it's the rule that is violated most among recently-injured athletes. When you get off your normal exercise routine, or are bummed about being hurt, it's easy to lose discipline or feel like your diet doesn't matter.
Not true. While indulging every now and then won't set your injury recovery back, you also don't want to subsist on potato chips and ice cream.
Keep your diet clean so you can get back to full function sooner rather than later.
6. Supplement smart
Once you've covered your nutritional bases, it's time to optimize recovery with intelligent sports nutrition supplementation.
While there's no supplement that will magically fix a broken bone, there are natural compounds proven to support your body's injury repair process.
But first, let's talk about the elephant in the room.
That is, the fact that NSAIDs like ibuprofen provide instant relief.
And most doctors recommend them for pain relief and getting over injuries.
Here's the low-down on NSAIDs for injury recovery:
Non-steroidal Anti-Inflammatory Drugs (NSAIDs) like ibuprofen do wonders for pain/inflammation relief in the short-term.
But in the long-term, you’re selling your joints out.
One reason for this contradiction is they interfere with the inflammatory process during those first few days of an injury, impairing the body’s ability to clear damaged tissue and bring fresh nutrients to the injury site.
This leads to reduced collagen mass in the injured joints, and weaker tissue formations that are more prone to re-injury.
It’s a clear trade off.
Here’s how we recommend handling this conundrum:
Best Practices for NSAID Usage
If you must, opt for pain relievers like acetaminophen (Tylenol®) instead of anti-inflammatories like ibuprofen (Advil®) and naproxen (Aleve®) during the first 7 days post-injury.
Use NSAIDs and prescription anti-inflammatories only as necessary to relieve (unbearable) pain and excessive inflammation. Remember that we need inflammation to heal injuries. Use them for 3-7 days if necessary, then get off (see #4).
If at all possible, get through the first 7 days of your injury without taking NSAIDs or prescription pain pills. This will allow the inflammation process to run naturally, clean up dead tissue, and bring fresh nutrients to repair the injury.
Best option: Use the supplements below to help manage inflammation and pain, while also supporting long-term recovery outcomes.
You can use these as your first line of defense or switch from NSAIDs to these natural supplements after the pain starts to subside.
Bottom line: use the minimum amount of pharmaceutical or OTC pain relievers possible.
Instead, use natural supplements to accomplish these three injury-healing goals:
Prevent further damage to injured tissues (via inflammation and oxidative stress management).
Optimize collagen production and formation (collagen synthesis).
Consume adequate amounts of specific vitamins and minerals that are fundamental to the injury repair process.
Let’s take a deeper look at each of these goals, and the natural ingredients proven to aid these recovery processes:
Primary Goals of Supplementing for Injuries
Prevent further damage to injured tissues.
The golden rule of injury treatment is DO NO FURTHER DAMAGE.
You should stop doing whatever exercise or movement caused the injury in the first place.
But there are also nutritional steps you can take to prevent further damage.
There are two main factors that can cause further damage to injured tissues: oxidative stress and inflammation.
After injury occurs, the demand for antioxidants goes up — so it’s important to consume sufficient amounts of antioxidant rich foods and extracts during those first few crucial weeks.
Increased tissue damage can occur when the number of free radicals in the body outnumber antioxidants. This causes oxidative stress and increased inflammation levels that can slow down recovery.
While some inflammation is necessary to clean up dead cells and deliver fresh nutrients, too much is a bad thing — potentially spilling over pro-inflammatory cytokines into the blood stream, causing systemic (total body) inflammation.
We assembled the top antioxidants and inflammation supplements that are also proven to support the injury recovery process:
- Fish Oil
- Cissus quadrangularis
- MSM (Methylsulfonylmethane)
- Grape Seed Extract
- Olive Extract (from fruit or leaf)
- CoQ10 (Coenzyme Q10)
Optimize collagen production and formation.
The second goal of injury supplementation is to optimize collagen synthesis.
Just like protein supplies the building blocks for muscle repair, collagen supplies the building blocks for joint tissue repair.
Due to its tensile strength and resistance to stretching, collagen makes the perfect construction compound for tendons, ligaments, bones and skin.
Your body is constantly cleaning up dead or damaged cells, and replacing joint structures with new collagen.
But rarely do you hear about how collagen metabolism relates to injury recovery.
Even though studies on injured athletes and people suffering from chronic tendinosis have demonstrated a direct connection between collagen metabolism and recovery outcomes.
For example, a 12 weeks study of runners suffering from chronic Achilles tendinosis showed that eccentric exercise (the lowering portion) under moderately heavy loads increased the collagen synthesis rate — improving recovery time and collagen formation strength.
Likewise, nutrients that stimulate collagen production and aid healthy collagen formation can be transformative during the recovery process.
Here are the best supplements for collagen synthesis:
- Collagen Protein
- Type II Collagen
- Vitamin C
- Hyaluronic Acid
- Green Tea
NSAIDs impair collagen synthesis
Here’s another reason to look for natural alternatives to NSAIDs, pain killers, and other OTC pills: they impair the collagen synthesis process. Animal studies have shown reduced collagen synthesis, reduced osteoclast (bone builder) cell activity, and deleterious effects on tendon healing.
- "The enthesis is the specialized junction between a tendon or ligament and bone..."
- "...animal studies have shown that overall, NSAIDs appear to inhibit proper enthesis repair..."
Our final injury supplement goal is the least sexy, but the most fundamental:
Provide the basic micronutrients your body needs to repair connective tissue.
Micronutrition — consumption of vitamins and minerals — is another overlooked aspect of injury repair protocols.
Just like how demand for antioxidants increases after an injury, demand for certain micronutrients increases as well.
Studies show that consuming these vitamins — sometimes in excess of the RDI (Reference Daily Intake) — is beneficial for injury recovery.
The RDI levels are only meant to prevent disease in the general population — they’re not designed to help repair injuries, or even optimize health for people with greater demands of these nutrients.
Though the RDI serves as a useful and safe guideline, we looked at studies of specific micronutrients in clinically-effective dosages for injury recovery.
This list doesn’t encompass all nutrients your body needs, but instead focuses on those that are either most important or work well with an increased dosage after an injury:
- Vitamin A
- Vitamin C
- Vitamin D
- Vitamin K
RDI (Reference Daily Intake)
- RDI (Reference Daily Intake): Daily intake level of a nutrient sufficient for the general population, dictates % Daily Value amounts listed on food labels.
Tissue Specific Injuries
While joint related injuries occupy the lion’s share of total incidents, it’s worth looking at muscle and bone injuries separately since recovery goals are slightly different.
Muscle injuries are less common than joint injuries.
In soccer, for example, only 31% of injuries are qualified as muscular.
And they rarely exist as separate from connective tissue injuries.
Typically, the main site of an injury is the musculotendinous junction — where a tendon inserts into the muscle body.
Though it can occur in the middle of the muscle body, as depicted in the hamstring injury diagram above.
Also, most injuries have an overuse component.
Which almost always starts with the breakdown of connective tissue.
Still, it’s worth noting that musculoskeletal injuries have slightly different goals and recovery mechanisms than connective tissue injuries.
Collagen formation optimization may not be as important.
And in addition to the other goals we’ve already discussed, the following are more relevant:
- muscle damage markers
- muscle protein synthesis
- skeletal muscle atrophy
- muscle soreness
- muscle oxygenation
Here are a few proven supplements that will aid your muscle injury recovery efforts:
Muscle Protein Synthesis
As you can imagine, one of the main components of repairing a muscular injury is muscle protein synthesis — the process of assimilating proteins into new muscle tissue. So it stands that exercises and supplements that support that goal are a good idea during injury recovery periods.
To learn more about how each supplement benefits the muscle injury repair process, click the nutrient's name:
Muscle Damage, Clean Up and Repair
In addition to the joint-building supplements we've already referenced, these micronutrients bolster the repair process after a bone injury:
All-Stars: The Most Research-Backed Supplements for Injury Recovery
Even though we narrowed down the list of antioxidants, joint supplements, and micronutrients to those most relevant for injuries — it’s still an extensive list.
It's simply not practical to take the recommended dosages for everything referenced in this guide.
This list below highlights the all-stars: ingredients with the most research backing, and those that cross over multiple injury recovery goals.
If you want to optimize the quality of your injury recovery, and help speed up the process, focus on these top performers:
In head-to-head studies, turmeric outperforms ibuprofen for joint pain and function scores (while presenting far fewer negative side effects).
Not only does turmeric reduce oxidative stress via its antioxidant effects, it reduces inflammation in osteo-cartilagenous tissue. And animal models demonstrate that curcumin can help regenerate damaged nerves after injury.
One placebo-controlled human study showed that joint stiffness improved by 86%, and subjective pain levels improved 40% in just 6 weeks.
Studies show that wounds treated with curcumin heal faster and produce stronger collagen formations (higher levels of collagen present in treated wounds). And animal models demonstrate that curcumin can help regenerate damaged nerves after injury.
As you can see, curcumin optimizes nearly every facet of the repair process.
Dosages of 200mg to 1500mg have been proven safe and effective for pain relief, joint function, and overall inflammation.
Pro Tip: Take black pepper extract (piperine) with your turmeric – studies on animals and humans have shown a 2,000% increase (20X) in absorption when turmeric is combined with black pepper extract.
Cissus is one of the few herbs proven to improve joint function in athletes. While cissus is most notably referenced for its ability to stimulate bone-building osteoblast cells, it also possesses antioxidant properties.
Cissus' unique bone-building, joint-supporting effects make it a top performing post-injury supplement.
While 300mg per day appears to have benefits related to inflammation and metabolism, the most relevant study for joint injuries used a dosage of 3,200mg per day for 8 weeks.
Grape Seed Extract
In addition to supporting healthy circulation, grape seed extract is an effective supplement for reducing inflammation from overtraining and reducing total body oxidation.
Subjects in one study had 38% lower C-Reactive Protein (CRP) levels, a measure of inflammation, after taking grape seed extract.
Another study showed that grape seed extract reduces swelling by up to 70% (in subjects who had swelling from prolonged periods of sitting).
Grape seed has also been combined with olive extract in animal studies for preventing post-traumatic tissue damage .
Clinically-supported dosages of grape seed extract range from 150-300mg per day (comprised of at least 95% total polyphenols).
A metabolite of the amino acid leucine, HMB is short for β-Hydroxy β-Methylbutyrate. In supplement form, HMB reduces muscle damage markers.
A 1-3g dosage is recommended during muscle injury recovery periods.
CoQ10 reduces exercise-induced oxidative stress and reduces exercise-induced tissue injuries in athletes, largely due to its antioxidant properties.
The clinically-supported dosage for CoQ10 ranges from 90-200mg per day (must be taken with food).
Because CoQ10 is a relatively expensive ingredient and 200mg provides only marginal increases in efficacy, 90mg per day is the recommended dosage.
Vitamin C supplementation after injury has the potential to accelerate joint and bone healing rates, increase type I collagen synthesis, and reduce post-injury oxidative stress levels.
Recommended dosages of Vitamin C for muscle recovery, immune support and injury repair are far above the RDI of 90mg per day. Though studies have yet to prove that mega-doses of Vitamin C (2-5 grams per day) are beneficial — it does appear that taking 500-1000mg per day during recovery periods offers additional protection without added risk.
Collagen Type II
Supplementing with Type II collagen produces a novel effect in the body: it regulates the immune response responsible for intercartilaginous inflammation, which supports the overall healing process and helps manage pain levels.
Researchers believe that supplementing with Type II collagen stimulates the body to produce more of its own, along with other proteins that support the structure of joints and skin (elastin and fibrillin)
Also, animal studies have shown that collagen may speed up the crucial granulation process that occurs during the first few days after an injury has occurred.
The recommended dosage for Type II Collagen is 40mg daily.
6 Week Post-Injury Supplement Plan
As your recovery progresses, so should your nutrition strategy.
We assembled a week-by-week plan of exactly what to take (and when).
Download our free 6 week post-injury supplement plan here.
Without the proper nutrients and recovery protocols immediately following an injury, you may be slowing your recovery time and setting yourself up for future injuries.
Make sure you’re getting enough of the joint-specific micronutrients (vitamins and minerals) covered in this guide.
To see research breakdowns of the best supplements for collagen synthesis and connective tissue healing, continue reading here.
For muscular injuries or bone fractures, continue reading here.
And remember, your priorities are:
- Stay hydrated
- Consume adequate calories
- Increase daily protein intake
- Balance your macronutrients
- Avoid junk food
- Supplement smart
In other words, don't forgo drinking water and eating healthy food in hopes that some magic pill will fix your injury.
Finally, if you think you need medical attention, you probably do.
Use this list to determine if you should seek medical attention for your injury:
When to seek medical attention
• Abnormal bone, joint, or muscle positioning (e.g. it looks crooked or is misshapen)
• Excessive swelling, bruising, bleeding
• Sharp pain when performing previously pain-free movements
• Inability to bear weight on the limb or joint without it giving way
• A feeling of abnormal “looseness” in the joint
Medical Disclaimer: Nothing contained on this site is intended to diagnose or cure. Should you have any health care related questions, please contact your physician. You should always consult your physician before taking any nutritional supplements, making changes to your health or fitness regimens, or implementing any health related advice. See full disclaimer here.
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Author: Scott Hogan
I created SaltWrap to bring together the most practical ideas in sports nutrition therapy, injury recovery and functional fitness — with the goal of keeping you (and myself) strong, mobile, and built to last.
I've worked as an A.C.E. (American Council on Exercise) Certified Personal Trainer, Lifestyle & Weight Management Coach (A.C.E.), and nutritional supplement formulator.
But more importantly — I've spent most of my life battling injuries, joint pain, and just being plain beat up. So I know what it's like to struggle toward fitness goals.
SaltWrap is here to push you through injuries, setbacks and perceived physical limitations. To a place beyond what you think you're capable of.
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