Nutrition for the Prevention and Treatment of Muscle Injury
Injuries to skeletal muscle account for over 40% of all injuries, and as nutrition is regarded as the single most complementary factor to any individual in promoting optimal recovery and physical performance, it is no surprise that there is growing evidence to suggest a role in injury prevention and rehabilitation.
Depending on the severity, it is likely that after sustaining a muscle injury, your training and/or other affected activities will be reduced (if not stopped completely) to allow the muscle to repair in the early stages of recovery. Any reduction in activity levels consequently requires a reduction in energy intake to prevent unwanted gains in body fat. As your carbohydrate needs are closely tied with the fuelling requirements of your physical activity (which is intensity and volume dependant), it makes logical sense to reduce carbohydrate intake during periods of forced inactivity. However, it needs to be stressed that like all biological processes in the body, there is a substantial energy cost to the healing process and therefore, it is crucial that individuals do not become too focused on preventing weight gain, leading to under-feeding during an important part of the recovery process and inhibiting optimal healing.
Energy needs are likely reduced during injury, however, the magnitude of the restriction required is less than expected due to the substantial energy cost of healing and repair – for this reason, under-fuelling when not injured may also increase injury risk.
Given the crucial role of dietary protein in muscle protein turnover, from a nutritional perspective, it has been become the primary focus in the prevention of muscle injuries. It is accepted that the provision of dietary proteins enhances the adaptive processes to both resistance and endurance-based exercise and therefore, it seems logical to assume that increasing dietary protein may alleviate markers of muscle damage. However, the research suggests that despite increases in protein synthesis and anabolic intracellular signalling (a genetic trigger to build new proteins), protein supplements taken acutely provide no measurable reductions in exercise-induced muscle damage and enhanced recovery of muscle function.
However, this might be different for individuals who are not consuming adequate amounts of protein in their general diets. Guidelines for adequate protein intakes vary across active populations and are related to the how much muscle damage is induced by the mode of exercise or training.
Given sufficient dietary protein is provided in the general diet, additional protein intake will not prevent muscle injury or reduce post-exercise muscle soreness.
What about to treat an injury?
Often serious muscle tears or surgical repairs require a period of complete immobilisation. Unfortunately, limb immobilisation reduces resting muscle protein synthesis (i.e. building new proteins/muscle) as well as inducing an anabolic resistance to dietary protein - this means the consumption of protein is less effective at stimulating the genetic pathways responsible for maintaining and building new muscle. However, these negative effects can be reduced by increasing protein intake.
An increased protein intake which is equally distributed throughout the day can also reduce the loss of muscle mass during reduced calorie intake; a strategy that could also prove useful for an injured individual.
Whilst additional protein may not prevent a muscle injury, increased dietary protein may be beneficial after an injury, both in terms of minimising muscle loss and promoting repair.
Many studies have investigated the effects of Omega-3 polyunsaturated fatty acids (n-3 PUFA) on the loss of muscle function and inflammation following exercise-induced muscle damage, with the balance of the literature suggesting some degree of benefit. However, in order to see detectable increases in Omega-3 composition in the muscle, research shows that supplements need be taken for a minimum of 2 weeks with 5 g per day of fish oil capsules, providing 3500 mg EPA and 900 mg DHA. This level of n-3 PUFA supplementation is in far excess of what would be consumed in a typical diet and much greater than most suggested supplement regimes.
It could be suggested that active individuals should take n-3 PUFA supplements on a regular basis, however, the long-term daily dose should be discussed with a nutritionist.
Vitamin D is a fat-soluble vitamin produced in the skin, is essential for calcium absorption and bone health, and plays an important role in many physiological processes. It is well established that there is a high prevalence of vitamin D deficiency in the both the general public and athletic populations in the UK. This is due to a lack of skin exposure to sunlight, especially in the darker winter months, and is further exacerbated by year-round indoor working and training. Emerging evidence suggests that vitamin D deficiencies can impair muscle regeneration following damaging exercise, and so beyond the effects on the immune system and muscle function, maintaining healthy levels of Vit D should be a priority for any injured individual.
Daily supplementation over the winter months is suggested to ensure blood levels remain optimal – with sensible sun exposure in the summer. Clinical deficiencies may require high dose supplementation and regular monitoring of blood levels.
Creatine monohydrate is probably the most widely used supplement to support gains in strength and power, with decades of supporting evidence. In the context of muscle injury, creatine supplementation can be utilised following limb immobilisation to assist in muscle growth and return to peak strength. Furthermore, supplementation has been shown to reduce the loss of muscle and strength during immobilisation. Creatine is found naturally in meat and therefore, supplementation of creatine is particularly worthwhile in vegan/vegetarians.
How can we help?
If you are unfortunate enough to experience an injury, one of the key considerations and challenges is to ensure muscle loss is minimised and that sufficient energy is consumed to allow repair, without significantly increasing body fat. At the White House Clinic, we have invested in sophisticated gas analysis technology to enable our nutritionist to perform a scientific procedure called ‘indirect calorimetry’ to accurately analyse resting metabolic rate and provide bespoke nutritional guidance.
Dietary Analysis and Guidance
Our nutritionist uses research standard nutritional software to analyse the nutrient content of your existing diet, which includes a detailed report of the nutrient breakdown, and can provide feedback to not only ensure that your nutrient requirements are met, but strategies to optimise your diet to promote injury recovery.
Our partnership with of one the UK’s top laboratories means we can offer literally 100’s of blood tests, which includes screening for important nutrients such as Vitamin D. Unlike many of the online services, we don’t want you wasting your money on unnecessary screening; our nutritionist and sports medicine doctor will be able to advise you on suitable tests based on your current health and symptoms, family history & nutrition goals.
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