Nutrition is an often overlooked part of good Physical Therapy and injury rehab. Most people understand the importance of the right exercises and training program, but we consult with so many people who are not getting where they want to be despite a good rehab program.

When progress stalls (or doesn’t happen at all), we look at nutrition. You need to put the right building blocks in your body if you are going to recover from an injury and train hard long term.

Think of it like this: If you want a garden to thrive, you need to make sure the soil is healthy and full of nutrients. It’s the same with your body.

We just recorded an amazing podcast with our friend Kate Daugherty of The Facility. She’s a functional nutritionist who really knows her stuff and supports patients in all stages of healing.

We absolutely recommend checking it out HERE, it will add tons of great context to this blog.

Ok, let’s dive into our recommendations for nutrition for injury recovery.

How To Eat When Injured: Overview

Here is the high level view of our recommendations. These are informed by evidence, experience and consultation with colleagues like Kate.

• Adequate protein intake

• Adequate calorie intake

• Adequate hydration

• “Anti-inflammatory” diet

• Potential supplements

  • Non-essential amino acids/collagen

  • Pro resolving mediators (high potency fish oil)

  • Proteolytic enzymes

  • Protein supplement

  • Collagen supplement

  • Anti-oxidants

We’ll dive into the specifics in each area below.

How Much Protein Do You Need When Injured?

Protein is one of the most important nutritional requirements during injury recovery. Many people we work with are not getting enough protein at baseline, which means they definitely aren’t getting enough protein when recovering from an injury.

Our recommendation is 0.8-1.2 grams of protein per pound of lean body mass.

Your lean body mass is everything except body fat (muscles, organs, bones, skin, body water, etc.). Basically, this is all the stuff we are trying to build when injured.

Here’s an example for a 150 pound person with 15% body fat:

• 150 pounds x.15 body fat = 22.5 pounds of body fat

• 150 pounds total weight - 22.5 pounds body fat = 127.5 pounds of lean body mass

Protein requirements:

• 127.5 pounds x .8 = 102 grams of protein (low end of recommended range)

• 127.5 pounds x 1.2 = 153 grams of protein (high end of range)

When you are injured, you are in rebuilding mode. Focusing on your protein intake is one of the best investments in your recovery you can make.

If patients are in post-op recovery or have a significant injury, we absolutely want them in this range.

If patients are dealing with a more chronic pain issue, we want to stack the deck in their favor. Protein is a big part of this.

If you are not injured or have a mild injury, you can probably get away with less protein, but the bottom line is this: If you are injured and/or highly active and nowhere near the 0.8-1.2 grams of protein per pound of lean body mass range, you should really think about adjusting your diet.

One important caveat here: if you have kidney issues be sure to consult your doctor before increasing/changing protein intake. Higher protein intake means kidneys have to work harder. But for a healthy person who is eating a balanced diet and hydrating well it should not be an issue.

How Many Calories Do You Need When Injured?

The conversation around overall calorie intake when injured is very similar to protein. Your body needs adequate calories to rebuild tissue and support recovery.

If people are injured or just had a surgery, their overall activity levels tend to go down quite a bit. This usually means they are not as hungry as usual, so their calorie needs are not being met.

Injury and post-surgical recovery is not the time to be in a calorie deficit. Nourish your body with good food and recover from your injury first.

The best way to understand your calorie needs is to use a good online calculator.

This one from Precision Nutrition is excellent. We recommend you use something like this to get a baseline idea of calorie and macro needs, then adjust for specific goals.

Below is an example for that 150 pound person above using the macro calculator.

I assumed they are 35, male, 5 ft 8 inches tall, moderately active and looking to improve overall health while maintaining their weight. I also assumed a balanced ratio of protein, carbs and fats and no significant dietary restrictions.

Here are the results:

If this person came in for injury rehab and after discussing nutrition and/or doing a food log we saw he was only getting about 2,300 calories per day, we would think about some ways to get more high quality, nutrient dense calories in. If he was about 500 calories per day short of recommendations, he just wouldn’t be giving his body the fuel it needs to recover.

Going through this exercise yourself can help you get a really good idea of how much you should be eating based on your goals. Then you can track your food intake for a short time to see how close you are and make adjustments as needed.

Are You Hydrating Well Enough?

It can be easy to forget, but hydration is part of your nutrition as well. Your body is mostly water, so hydration is not something you can ignore.

Our general rule of thumb is: Drink half your body weight in ounces of water per day.

So, for that same 150 pound person in the examples above we would recommend drinking about 75 ounces of water per day.

Getting lots of fruits and veggies helps with hydration too because they have a high water content.

This one is pretty straight forward. Carry a water bottle with your and/or track your water intake for a few days. Then adjust as needed.

When we ask about hydration, we typically get one of the following responses:

“I always have my water bottle with me, hydration is good.”

OR

Laughs nervously…”yeah I really don’t drink much water.”

If you’re one of those nervous laughers, this is a simple thing you can do to improve your recovery and overall health.

Some people also benefit from an electrolyte supplement. We like Nuun as a good starting point because it’s well balanced and less expensive but there are tons of good options out there.

Electrolytes tend to be good for people who are very active and sweat a lot. They can also support general hydration by providing the minerals necessary to regulate fluid balance.

What Is An “Anti-Inflammatory” Diet?

The term “anti-inflammatory” diet can get overused and overhyped. These kinds of diets have been touted as cure alls for everything from gut issues to headaches to back pain.

To be clear, we aren’t talking about some super strict, proprietary diet that will magically fix you. We’re talking about eating in a way that will limit negative burden on your system and provide the nutrients you need to heal. If you do this along with adequate protein, calorie and water intake you’re on the right track.

So, what do we mean by “anti-inflammatory?”

By the way, these recommendations are straight from Kate, so we highly recommend you listen to the podcast episode for the full conversation in context.

Here are the basic principles we recommend:

• Minimizing sugar, fructose, ultra processed foods, vegetable and seed oils

• More colorful vegetables and fruits (eat the rainbow)

• Increase Omega 3 fats: fish, flax, walnut and/or fish oil supplement

• Go organic and “clean” when possible (limit other burdens on your system)

Hopefully, these aren’t controversial. These are pretty simple and common sense recommendations. We realize not everyone can do things like eat organic, but just get as close as you can to these principles.

Basically, don’t eat crappy, processed foods and focus on high quality real food with lots of variety.

Here’s a link to another blog of Kate’s discussing lifestyle habits that can contribute to inflammation.

What Supplements Should I Take When Injured?

The conversation about supplements always comes up with anyone who is interested in dialing in their health. However, we saved this for last because it might be the least important.

If you are implementing the recommendations above, you should be in good shape. Supplements are for those who really want to optimize their recovery and/or those who need extra support because of a more significant issue, dietary restrictions, etc.

With that said, we know it’s fun to discuss supplements and they can be a valuable part of your diet. Just don’t let focus in this area get in the way of eating enough real food.

Here are some supplements that can support injury recovery:

• Non-essential amino acids (collagen/gelatin supplements)

• Collagen supplement

• Protein supplement

• Pro resolving mediators (high potency fish oil)

• Proteolytic enzymes

• Anti-oxidants

Here’s a bit more detail for each area based on our chat with Kate:

• Non-essential amino acids and collagen provide more building blocks for the healing process. Muscles, tendons, ligaments, bones, etc. need these.

• A high quality protein supplement can give you some “insurance” in terms of hitting your protein intake goals. How To Choose a Protein Powder Blog

• Pro resolving mediators are basically high potency fish oils that help resolve inflammation and interrupt inflammatory signaling.

• Proteolytic enzymes help clear cellular debris from the healing process.

• Antioxidants help clear free radicals from the body and protect against cellular damage. Examples are glutathione, vitamin C and curcumin.

If you have detailed questions about supplementation, we recommend reaching out to a qualified professional like Kate.

If you want to learn more about Kate and her practice, check out The Facility’s website

Other Nutrition Hot Topics

This blog was meant to give a general overview of how you can approach nutrition to support recovery from injury and surgery as well as general concepts for wellness.

We’ve covered a lot here, but want to make a quick note about other common questions we get.

Questions like:

• What should I do about food sensitivities?

• Should I avoid specific things (gluten, dairy, alcohol, caffeine. etc.)?

• What’s the deal with intermittent fasting? Should I be doing it?

These questions are beyond the scope of this article, but we cover them briefly in the companion podcast, which I highly recommend you listen to.

If you have further questions about these areas, especially food sensitivities, dietary restrictions and nutrition for other specific medical concerns, please reach out to a qualified nutritionist or dietician.

How This Fits Into A Full Plan

At Wagner PT & Performance, we take a holistic approach to patient care. We are a performance Physical Therapy practice. That means we don’t just work on one area of your body. We look at you as a whole person and support your overall wellness.

We do this through the 3 pillars of health:

• Exercise and movement

• Nutrition

• Stress management and recovery

Obviously, our bread and butter is the exercise and movement piece. We are experts at assessing and treating injuries and helping patients get strong and mobile so they can get the most out of their bodies. We’ve helped hundreds of patients to date.

As part of a normal plan of care, we are also assessing and creating plans for nutrition and stress management/recovery because if these areas aren’t dialed in, you can’t expect to get the most out of life. Discussions about protein intake, calories, macros, hydration and sleep happen on a daily basis in our clinic. This is what it takes to get lasting results and feel your best.

So if you’re ready to get the most out of your Physical Therapy, give us a call. We’d love to support you on your journey.