Sports Injuries: Effects on Physical and Mental Health and How Therapy and Nutrition May Aid in Recovery

As I was trying to think of what to write about next, life threw us a curve ball a day before the start of soccer season. Injuries can happen to everyone, not just athletes, and they can take a toll on our physical and mental health, as well as adversely impact our quality of life. First and foremost, I want to stress the importance of seeking medical care to determine the right treatment plan and to ensure proper healing. After all, the goal is to heal as fast as possible, so that you can get back to doing what you love and enjoy, without experiencing complications or injury-related physical limitations. 

The healing process is quite complex. Tissue repair starts within the first few minutes of the injury and can last for days or even weeks after. [1] Initially, inflammation, which can occur in both soft and hard tissues, sets in, lasting for a few hours or days; and although we tend to think of inflammation as something bad, it is a necessary step for the injury to heal properly. [1] Next, scars form, cells responsible for connective tissue formation rapidly increase, capillary networks grow, which eventually leads to a decrease in wound size. [1] And, finally, scar tissue is broken down and replaced by a stronger type of collagen, which is why the type of activity done during this phase determines how effectively the tissue will be repaired. [1] While the inflammatory response phase in bone tissue repair is similar to the one in soft tissue, the other processes are different. [1] Quickly after the injury occurs, the cells responsible for repairing bone tissue form, followed by the formation of a callus consisting of cartilage. [1] Initially, this cartilage is weak and soft but over time mineralizes and eventually, after several other processes, hardens. [1] Additionally, many sports-related injuries result in an immobilization of a body part, which can lead to a decline in physical activity. [1] Consequently, this can decrease muscle mass, strength, and function, as well as negatively impact bones, ligaments, and tendons. [1]  

While recovery can vary from person to person, depending on the type and severity of the injury, there are some things that you can do to help speed it up. Therapeutically, sports physical therapy is a great option to restore function and mobility and to improve sports performance. Additionally, therapists can help with drug-free pain management, teach you how to stretch, strengthen, and exercise correctly, as well as how to prevent future injuries, all while keeping you motivated throughout the whole process. Sports rehabilitation facilities can have a beneficial impact on recovering athletes, as being around people who go through similar things as them can positively affect their emotional state of mind. This is especially important, since athletes who sustain an injury can potentially exhibit negative emotional responses and while it is highly recommended to get help, many do not seek counseling for their mental health issues. [2] Therefore, it has become critical for coaches and athletic trainers to understand the problematic psychological responses to injury and what resources are available out there for student-athletes to receive treatment, if necessary. [2] Even as parents and student-athletes it is important to recognize problematic emotional responses, which can include loss or lack of appetite, disturbance in sleep and irritability, disordered eating, sadness and depression, loss of motivation or even apathy, disengagement or alienation, anger, rage, recurrent crying, emotional outbursts, as well as substance abuse. [2] Providing a supportive environment that allows them to get the emotional support that they need can help injured athletes cope and stay motivated during the recovery process. [2] 

While most people may think that energy needs decrease during the rehabilitation phase, they do not, instead an inadequate intake in calories may lead to adverse outcomes, such as slower healing and increased loss in muscle mass. [1,3] It is essential to consume a balanced diet while rehabilitating because the processes involved in healing require carbohydrates, proteins, unsaturated fatty acids, vitamins, and minerals. [3] These are especially crucial, if you undergo a surgical procedure, as poor nutritional status following surgery can have negative outcomes, such as longer hospital stays due to complications or infections. [3] It is vital to consume an adequate amount of carbohydrates, as these are converted to glucose that is then used to produce energy. [4] This is also your body’s main source of fuel and when it is not immediately needed, it is stored as glycogen in the liver and muscles to be used at a later time. [4] Muscles need a lot of energy to function and if they simply relied on the glucose circulating in the blood, they would run out of it rather quickly. [4] Hence, a consistent supply of energy is needed to maintain muscle glycogen storage and, ultimately, to retain muscle mass.  

A balanced diet consists of complex carbohydrates, proteins of high quality, unsaturated fatty acids, and various vitamins and minerals. Complex carbohydrates include whole grains, fruits, and vegetables, and consuming a variety of these can provide your body with the antioxidants and micronutrients needed to enhance healing and control inflammation. [5] Unsaturated fatty acids found in avocados, fish, seeds, nuts, and various oils, also have anti-inflammatory properties and can be beneficial in the healing process. [5] After an injury occurs, the requirements for amino acids increase to help heal wounds, rebuild tissues, and to improve glycemic control. [5] Leucine-rich foods, such as fish, milk, yogurt, cottage cheese, beef, eggs, lentils, and chicken can stimulate the production of muscle protein and help the injured heal faster. [5] Recovering from injury also increases your need for vitamins A, C, and E. [5] Vitamin A can be found in sweet potatoes, carrots, pumpkins, spinach, and squash. [5] Kiwis, grapefruits, oranges, strawberries, and broccoli are good sources of vitamin C, and sunflower seeds, almonds, apricots, as well as avocados are rich in vitamin E. [5] Additionally, vitamin D is important due to its role in regulating calcium, bone, and function of skeletal muscles, and may, therefore, improve recovery. [5] Keep in mind that unless prescribed by your healthcare provider, supplementation is not needed, and a balanced diet is sufficient to meet requirements. [1] However, since nutritional requirements vary among individuals, it is recommended to consult a registered dietitian for a personalized plan.  

Luckily, my daughter’s injury was not severe, and she was able to return to sports after a couple of weeks. I believe that the support she received from everyone and the continued involvement in sports helped keep her motivated and focused on recovering. My thanks go out to her sports therapy team, who did an outstanding job and had her game-ready after just such a short time. Thank you to her coaches, who continued to involve her and make her feel like she was still part of the team. And, of course, her friends and team-mates, who supported her during recovery and welcomed her back when she returned. Without all of them, I am sure this would not have been as smooth of a process.  

References:  

1. Nutrition for acute exercise-induced injuries. Tipton KD. Ann Nutr Metab. 2010;57(suppl 2):43-53.  

2. NCAA. Margot Putukian. Mind, body and sport: how being injured affects mental health - an excerpt from the sport science institute’s guide to understanding and supporting student-athlete mental wellness. National Collegiate Athletics Association. October 2014. 

3. Rehabilitation nutrition for injury recovery of athletes: the role of macronutrient intake. Papadopoulou SK. Nutrients. 2020 Aug 14;12(8):2449. 

4. Glycogen. Cleveland Clinic. Reviewed Mar 2022. 

5. Nutritional considerations and strategies to facilitate injury recovery and rehabilitation. Smith-Ryan AE, Hirsch KR, Saylor HE, Gould LM, Blue MNM. J Athl Train. 2020 Sep; 55(9):918-930.