When Disaster Strikes Part 1 - Nutrition To Support/Accelerate Injury Recovery

The Fall That Did Me In

So I managed to break my leg/ankle (technically a "spiral fracture of the fibula") on the inaugural Run For Water Trail Race yesterday.  I was absolutely flying (for a 205 lb., 5'7" non-runner!), on pace to finish the race somewhere between 1h30m and 1h45m, and it happened.  Just a single misstep on a very slick section of the trail (it was the wettest day of the year so far yesterday - just my luck!), my right foot trailed behind me, and I went down HARD.  Lots of snapping/popping as I went down, race over.  X-rays confirmed the break, so now I'm in a cast for 6 weeks, but on the upside, I "probably" won't need surgery according to the ER doc.

So, that race, over.  My crack at the Run For Water 5K this year in under 20 minutes, over.  My first Spartan Race of the season, the Vancouver Sprint next weekend, over.  Needless to say, I'm pissed off, and the impact this is going to have on my preparation for the Spartan Race Sun Peaks Beast in late September is potentially really bad.

At 42 years old this year, my body likely isn't going to be a rocket ship when it comes to recovery, and I've never broken a bone before so I have nothing to really benchmark it against.  All I know is, after the cast comes off in 6 weeks, I have only 6 weeks to prepare for the Spartan Super and Sprint in Red Deer, and 9 weeks for the Beast in Sun Peaks.

Not good, but we have to play the hand we're dealt, so I'm going to do as much as I can to accelerate/improve my recovery.  A big part of that will be on the nutrition and supplement side of things.


Precision Nutrition "Nutrition for Injury Recovery"

Precision Nutrition has put out a great series of videos (actually 5 parts of a seminar that PN founder John Berardi put on in the UK back in 2012) on nutrition for injury recovery that I'm using as the basis for much of my recovery nutrition plan.  Here are the links:

Using some of the information from that series, plus other things I learned as part of my Precision Nutrition Level 1 Certification and various bits of research I've done today while laid up, I've put together a fairly comprehensive plan.


The Plan

Overall - Things You Should Be Doing Anyway

It goes without saying that for the best health results, never mind recovering from an injury, you should be eating real food, not processed garbage.  Focus on a wide variety of fresh or frozen fruits and vegetables, lean meats, poultry, fish/seafood and eggs, and a moderate amount of starchy carbohydrates, preferably in the form of whole foods like potato, sweet potato, legumes and pulses, but also from whole grains or pseudo-grains like quinoa, barley, millet, rice, etc.

It's also important to eat ENOUGH on a day-to-day basis to properly support your body's maintenance and any activity on top of that.  During your regular, non-injured life, we recommend using PN's hand portioning guide as a baseline rather than counting calories. From there, you adjust up or down based on activity levels, and whether you're meeting your targets for weight loss, weight gain or maintenance.  Basically what I tell our nutrition coaching clients is that, as long as you are eating real food, you should be eating as much as you can while either staying the same weight (if maintenance or body recomposition is your goal), or losing/gaining weight at a rate of no more than about 1-2 pounds per week.

When you're injured, your body requires anywhere from 5-50% more calories above maintenance for repair, depending on the severity of the injury.  For a bad sprain/strain, figure on 10-15%, or for a broken bone maybe 20-25%.  50% would be for widespread burn damage, or something on that scale.  If you're normally active, chances are your activity levels will have dropped off with your injury.  Depending on how big a difference in activity that is, you may end up eating the same or just slightly less than you normally do during your recovery.  It's also possible you'll need to eat more - just make sure you're not losing or gaining weight during your recovery.  Save getting lean or bulking up for when you're healthy!

You may find that your appetite will drop off as you cut back activity, so you may have to consciously make yourself eat enough.  If you have to increase your calories, do so by adding additional lean protein first (add 1 palm portion of protein to any meal per day).  Your body can use the extra amino acids to help with repair.  If you still need to increase calories (I.E. you're still losing weight), then increase your healthy fat intake by 1 thumb-sized portion per day at any meal.

On top of that, there are a few supplements that I already take on a daily basis (and you should too!) that will aid in my recovery:

  • Omega 3 Fats (from fish oil or algae oil; 2 tsp / 9 g fish oil daily in the morning)
  • Vitamin D (4,000 IU daily in the morning)
  • ZMA (3 capsules daily before bed for 30 mg zinc, 450 mg magnesium and 10.5 mg B6)

OK - so there's the stuff I should already be doing.  Now, what else is there I can use to speed the process along?

Stage 1 - Pain Management

So, beyond the injury itself, I have a couple of complications.  First, I'm allergic to most pain and anti-inflammatory medications, including all NSAID's (Non-Steroidal Anti-Inflammatory Drugs, like Advil, Aspirin, the natural pain reliever white willow bark, and a whole spectrum of prescription pain/anti-inflammatory medications).  Second, I am susceptible to gout attacks (an acute inflammatory type of arthritis) which for me affects one or both feet.  My worst-case scenario right now is if I end up with a gout attack in my left foot, I will be completely immobilized.

For normal people who aren't allergic, over-the-counter NSAID's are an option to both manage pain and reduce inflammation.  However, while they can provide some acute relief, these drugs have actually been shown to inhibit the healing process, so you don't want to take them too frequently, or for too long a duration.

For Pain During the First 5-7 Days Post-Injury:

  • To acutely manage pain and inflammation, you can take NSAID's (like Advil or Aspirin) for up to 5-7 days post-injury.  After that, you're best to stop taking them.
  • If you can avoid taking them at all, healing should be slightly faster.

For me, basically I just have to suck it up at this point.  Getting the inflammation under control will help ease that off a bit, so that is really my priority.

Stage 2 - Inflammation Management

Inflammation is an important part of the body's natural healing process, to help bring nutrients and repair materials to the injury site, and remove waste products.  You don't actually want to "stop" it completely, even if you could.  This is part of why NSAID's and the like can inhibit healing.

A lot of inflammation, however, is a big component of the pain in an injury, and also delays the return to normal movement / range of motion (which is a key to effectively rehabbing soft-tissue injuries correctly in particular).  The pain can affect sleep and mood, which in turn can suppress your body's self-repair ability.

So, what we want to do is moderate the inflammatory response, and help our bodies most effectively get through the repair process.  The supplements I am adding in for the first few weeks of my recovery to help with inflammation are:

  • Copper (4 mg once daily)
  • Jamieson Vitamin A (10,000 IU once daily)
  • Jamieson Vitamin C (1,000 mg, 2x daily
  • Jamieson Garlic Extract (500 mg tablet, 2x daily)
  • Jamieson BodyGuard Anti-Inflammatory (2 tablets, 3x daily for 500 mg curcumin, 10 mg boswellia and 10 mg ginger per dose)
  • Genuine Health Fast Arthritis Pain Relief+ (2 tablets daily, primarily for 200 mg bromelain and 500 mg natural egg membrane for both anti-inflammatory and pain reduction effects)

Because of my susceptibility to gout, which is a chronic inflammatory condition, I may continue with some or all of these supplements after the initial 3-week period.  The Jamieson BodyGuard Anti-Inflammatory and Genuine Health Fast Arthritis Pain Relief+ in particular sound promising on that front.

Stage 3 - Tissue Repair / Remodelling

Tissue remodelling is really when the magic happens.  Our bodies are incredibly effective at repairing themselves, given the right conditions, so the aim here is to provide your body with the best possible conditions, nutritionally, to support this process.

Two specific amino acids, arginine and glutamine, and HMB, a metabolite of the amino acid leucine, have all been shown to work well together to improve the healing process by supporting the synthesis of new tissues.

What I am taking for the duration of the healing process is:

  • Allmax Arginine (1.5 tsp / 7.5 g, 2x daily)
  • MuscleTech Clear Muscle HMB (3 capsules / 1.5 g, 2x daily)
  • Ultimate Nutrition Glutamine (7.5 g, 2x daily)

Putting It All Together

 My injury-recovery supplement regime - 2 months' worth, for $600...ouch!

My injury-recovery supplement regime - 2 months' worth, for $600...ouch!

I know, it seems like a LOT of supplements, right?  It's not inexpensive either, as I spent nearly $600 for two months' worth (so about $10 per day in supplement cost), but if it can help give me the best possible outcome in the shortest possible time, it's worth it to me.

Here's the daily routine, in case anyone is wondering:

Breakfast:

  • In 1/2 cup (dry measure) steel-cut oats
    • 1 tsp coconut oil
    • 1/2 cup almond milk
    • 1 scoop Kaizen or Genuine Health vegan protein powder (I'm using the vegan powders because I have issues with dairy, and had problems the last time I used whey protein regularly)
    • Mixed raw nuts (2-3 TBSP) and fresh or dried fruit
  • In a shaker cup with 300 ml water:
    • 2 tsp liquid fish oil
    • 1 scoop Greens+
    • 1.5 tsp Arginine
    • 1.5 tsp Glutamine
  • 3 capsules HMB (1.5 g)
  • 1 tablet vitamin A (10,000 IU)
  • 1 tablet vitamin C (1,000 mg)
  • 4 softgels vitamin D (400 IU)
  • 1 softgel vitamin E (400 IU)
  • 1 softgel garlic extract (500 mg)
  • 2 capsules Genuine Health Fast Arthritis Pain Relief+
  • 2 tablets Jamieson BodyGuard Anti-Inflammatory

Lunch:

  • 1 tablet vitamin C (1,000 mg)
  • 2 tablets Jamieson BodyGuard Anti-Inflammatory

Dinner:

  • 2 tablets Jamieson BodyGuard Anti-Inflammatory

One Hour Before Bedtime:

  • 3 capsules ZMA

I'll report back with updates as to how my recovery is going.  If you have any questions regarding the info here, or if you're interested in what we can do for your nutrition when you don't have a broken leg, please feel free to Contact Us!