For example, if you need to gain a certain amount of quad or calf size or strength, this will be a lot easier and quicker to do in a calorie surplus. At the end of the process though, you want to be near your peak body composition for your sport, if possible.

Since body fat will likely have increased a bit with this approach due to a combination of the reduced training stimulus and the calorie surplus phase, it likely makes sense to have a phase in a calorie deficit.

As mentioned previously, you do not want to spend much of the rehab process in a deficit. But the overall goal is to return to sport as effectively as we can, and that likely requires a certain body composition. One is that your calorie expenditure is likely lower due to being less active.

This means that maintenance calories will be a bit lower than they previously were. In most cases, the decrease in calories required to achieve maintenance calories is less than expected. But it is still a factor worth considering. Another aspect is that you might now be at home more often and have more time and access to food than you previously did.

The combination of these things can make it difficult to avoid accidentally overconsuming calories. One tool I would consider using to manage this if it is an issue is volume eating.

This concept involves eating a larger volume of lower-calorie food. Basically, it might make it easier to consume an appropriate amount of calories since you get to eat more food for the same amount of calories.

When an athlete who trains hard takes a break from training, it typically takes ~3 weeks before muscle loss is measurable. This is reassuring if you have got an injury where you are still able to move the affected area a bit.

Since getting the quads strong and balanced between sides is an important rehab outcome, any steps that can be taken to minimise that muscle loss in that phase is crucial. The current recommendation for protein intake during injury recovery is 1. The upper end of this range is particularly relevant when the risk of muscle loss is at its highest, such as during immobilisation.

The average athlete who is injured does not get anywhere near this level. You could significantly improve your recovery outcomes by doing this thing. The best approach to overcoming the first challenge is to add liquid protein sources in addition to regular protein-rich meals.

For the second challenge, you want to prioritise protein sources that are high in protein and relatively low in fat and carbohydrates where possible. While I would not aim to get a large percentage of your intake from supplements, adding some protein supplements can help with both of those problems.

Creatine helps with building muscle and strength. It has obvious applications for longer rehab protocols. There is also research indicating that during immobilisation creatine can help with lean mass retention and reduces loss of strength.

There is not a lot of research on this topic, but it looks promising. Another study on strength gains weeks after ACL surgery found that creatine significantly outperformed placebo.

It is worth highlighting that not ALL the research has shown positive outcomes. One study measuring strength after 30 days after knee surgery found that creatine did not improve outcomes. While the evidence is not overwhelmingly positive, it is enough that I think it is worth taking creatine.

Particularly because there is minimal downside to doing so. Dosage and how to take: 20g per day for 5 days, followed by 5g per day ongoing. This is a simplified protocol. If you want more details, check out our post on the topic. There are proposed mechanisms for how omega-3s can help due to enhancing anabolic sensitivity to amino acids as well as help from an anti-inflammatory perspective.

There is minimal research looking at fish oil and immobilisation. The research we do have is surprisingly promising. An example of this involved lower limb immobilisation for 2 weeks. The fish oil group maintained significantly more muscle than the placebo group. Although the research looks promising, I would keep an open mind on this topic.

I would not be surprised if more research came out showing it does not matter. I also heard the main author of that study on a podcast say an interesting line. A nuanced approach could involve taking fish oil leading up to and post-surgery if you have a serious injury and a surgery date planned though.

Collagen and gelatin supplementation have emerging research indicating they can help with recovery from musculoskeletal injuries. The mechanism that I propose involves the collagen peptides breaking down into amino acids, as mentioned.

But either way, collagen protein has a very different amino acid profile to other protein sources. It is a lot higher in proline, glycine, lysine and arginine than most other protein sources.

We have evidence that these amino acids peak in the blood ~ minutes after consumption. Theoretically, we can target the injured area by getting blood flow to the area with training. Even without that, some of the research looks promising anyway. There is also evidence of an increase in collagen synthesis in the body following supplementation and a targeted exercise protocol too.

In terms of the evidence, while the evidence is mixed, all the research fitting the following criteria has shown positive outcomes:. There also is not a lot of quality research on the topic. At the moment, my interpretation of the research is that it helps. But I am watching the space closely to see if anything comes along to change my mind.

One of the most promising studies, in particular, involved a patellar tendinopathy case study. The MRI footage showed complete healing of the patellar tendon, which is exceptionally rare. Often with tendinopathy that severe, MRI footage still shows a damaged area long after the pain has gone.

Dosage and How to Take: g of collagen or gelatin, minutes prior to training. If you have not consumed any vitamin C for the day, it makes sense to add that too. Vitamin C is required for collagen synthesis.

At a population level, supplementing those things, without further context e. dietary intake and blood levels leads to increased bone mineral density. Supplementing with calcium and vitamin D has evidence of improving fracture recovery.

It is not a large benefit, but it is worth being aware of. Adding some nuance, those who have low calcium intakes or low blood vitamin D levels would benefit significantly more from this.

A study identified that 3 months post ACL surgery, low vitamin D status was linked with lower levels of strength in comparison to those with higher vitamin D. Vitamin D can also be relevant from an inflammation standpoint.

Obviously, you could aim for a food-first approach. This would involve getting ~mg of calcium per day through food and minutes of sunlight per day. Some people might need a bit more sun than that if they have darker skin. From a supplemental perspective, if taking both, a supplement containing around mg calcium and IU vitamin D is often the gold standard.

Since calcium absorption is a bit limited in a single sitting, it is even more beneficial to split the dosage and have at both morning and night. If just supplementing vitamin D, IU is the most commonly recommended dosage. But if you have low blood levels, you could go a bit higher than that and address it quicker.

I sometimes recommend as high as 10,IU per day for short periods of time, for those who are deficient. We know that other nutrients like magnesium, antioxidants, vitamin K and zinc all play a role in injury recovery. Additionally, glutamine appears to have a role in leukocyte apoptosis, superoxide production, antigen processing, and phagocytosis, all with implications on the inflammatory phase of wound healing.

Vitamine A: Vitamin A assists in wound closure. Topically-applied vitamin A has been used to stimulate epithelial growth, fibroblasts, and ground substance. Vitamin C: Vitamin C is believed to influence collagen formation, immunomodulation and antioxidant functions during wound healing.

Vitamin D: Vitamin D induces the antimicrobial peptide cathelicidin to promote healing. Zinc: More than zinc-containing enzymes, including superoxide dismutase, are involved in wound healing. However, excess zinc supplementation can interfere with the absorption of other cations, specifically iron and copper.

Therefore, supplementation should be avoided unless deficiency is present. After suffering a musculoskeletal injury, the proper nutritional support can help the body regain optimal fuel for rehabilitation.

Here are some of her top tips Delayed onset muscle soreness, or DOMS, may not be as serious of an ailment or require a long recovery like wounds or musculoskeletal injuries.

Still, this natural result of regular exercise can be both healed and prevented by proper nutrition. In one review of nutritional intervention for DOMS , researchers reviewed four nutrients that have been suggested to aide sore muscles:.

As you can tell from these recommendations, maintaining a healthy, balanced diet is not only conductive to maintaining weight and building muscle. It is not as simple as just how many calories you are ingesting, rather quality, variety, and excellent macro- and micronutrient distribution is important.

A RDN can assist in building a plan that includes high quality foods. Hoogenboom is a professor and an associate program chair at Grand Valley State University, in the Department of Physical Therapy. She was one of the first Board Certified Sports Clinical Specialists in West Michigan in , and has since been recertified twice by the ABPTS, most recently in She has been a Certified Athletic Trainer since She maintains a clinical practice by volunteering at the GVSU Pro Bono clinic.

Barb is a member of the American Physical Therapy Association and a member of the American Academy of Sports Physical Therapy, where she has been honored with the Academy's highest award, The Ron Peyton Award, and is also a member of the Turner A.

Blackburn Sports Physical Therapy Hall of Fame. She also received the "Lifetime Excellence in Education" award from the AASPT.

She is a member of the Female Athlete Triad Coalition, and The Orthopedic Society for Sports Medicine. Barb enjoys clinical research, and has authored many research and clinical commentary articles on the female athlete, nutrition, functional movement, and movement analysis.

She has contributed to 10 textbooks and 5 Home Study Courses on various musculoskeletal topics. She is the editor of the therapeutic exercise textbook entitled "Therapeutic Exercise: Techniques for Intervention" the third edition of which was released in She is also the Senior Associate Editor for The International Journal of Sports Physical Therapy.

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Expert Nutrition Guidelines for Injury Recovery By: Rebecca Moore Add to Favorites. Nutrition Guidance for Wound Care While you might not view wound care as an energy-draining process, the body actually demands an increased amount of energy so the wound can heal correctly.

Macronutrients to Monitor During Wound Care Carbohydrates: In the proliferative phase of wound healing, carbohydrates stimulate insulin production, which is helpful in the anabolic processes. Here are some of her top tips:2 Post-Injury Nutritional Tips Trauma or surgery may require up to 20 percent more calories, and crutching requires two to three times more energy than walking.

If your athlete or patient is dealing with post-op nausea, recommend bland foods like bananas, rice, applesauce and toast, as well as smaller and more frequent meals with nutrient-dense liquids like smoothies.

Constipation can also occur after surgery, in which case you can recommend increasing fluid and fiber intake. If antibiotics are prescribed, include prebiotic and probiotic-rich foods to restore the beneficial bacteria involved in digestive and immune health that antibiotics can remove.

Prebiotic options include jicama, onion, garlic, asparagus, oats, wheat, barley and mushrooms.