Alexander Zverev was playing against Rafael Nadal in the semifinals of the French Open. No one, not even Nadal, could have predicted the outcome of that gruelling match — Alexander had to retire hurt. This retirement had him taken off the court in a wheelchair due torn ligaments in his right ankle. Every day at my nutrition clinic, I am constantly counselling players to eat diligently and to eat with a plan based on their blueprint. I keep saying “You cannot get injured! You have to train to eat precisely and scientifically!”.
Players train hard and prepare their bodies to push the boundaries of human endurance. Whilst endurance is one parameter, there are a host of other areas that a player works on. Flexibility, strength, mental grit, sweat loss, and heat exhaustion are all examples of what’s pushed even in normal training. There are two other parameters that frighten me as a sports nutritionist in a player’s life: 1. Sickness and 2. Injury. They are always lurking in the sidelines and can hit the athlete out of the blue. You cannot stop it once it starts. You have to plan in advance to help reduce the risk elements of both these parameters.
In sickness, we rely on the immune system. In players, the training and competition load is so high that the immune system which is also responsible for healing and repairing of damaged muscle, blood and other soft tissue, is stretched to its limit. We call it chronic training syndrome. In such situations the body recovers very slowly and the immune system can get depressed or lowered to levels such that it cannot protect the body against universal presence of bacteria, viruses and other pathogenic organisms (disease-causing). During this time a player can fall sick and upset his or her schedule in training or competition.
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With an injury, it is a completely different game. The flowsheet in the human body to track injury possibilities will go into pages of reasons. By using diagnostics and counselling to acquire data on the players schedule, choices and behaviours, we can forecast probable weak points in an athlete and plan for fortification.
Injuries can happen due to one or many of the following reasons:
- Genetically poor ligament and tendon strength and therefore more prone to soft tissue damage.
- Genetic predisposition to lower bone mineral density and therefore higher risk of fractures.
- Genetic predisposition to higher lactic acid formation and higher blood pH (the acidic and alkaline levels), leading to acidic environments in the blood that cause calcium to leach out of bones rendering them more brittle.
- Genetic predisposition to heart, liver, kidney health and high intensity training causing organ damages.
- Genetic predisposition to lowered vitamins and minerals absorption (Example: Mutation in the MTHFR gene leads to lower absorption of folic acid and is shown closely to be linked to depression. Depression is injury to the brain in a non-physical but biochemical way and that to me is also a key injury to an athlete).
- Genetic predisposition to carbohydrate mechanisms like Type I diabetes or G6PD disease where glycogen storage is affected and athletes constantly feel tired.
- Improper diet leading to nutrition deficiencies such as:
Deficiency of iron leading to haemoglobin and ferritin being very low.
Deficiency of calcium, magnesium, chloride leading to poor bone health as well as heart stressors and poor muscle contractions or muscle cramping.
Deficiency of protein leading to catabolism of muscle.
Deficiency of Omega 3 fats leading to higher inflammation and poorer recovery on a day to day basis.
Deficiency of Fiber from fruits and vegetables leading to chronic constipation and a myriad of gut related disorders ( IBS, acidity, piles, hemorrhoids etc)
Excess of protein in diet leading to acidosis as well as bone leaching.
Excess of sugars leading to diabetic conditions and insulin resistance leading to higher fat deposition and hence weight management can be an issue. Higher fat weight to lower muscle weight can lead to external stressor loads on joints injuries.
Excess of Saturated fats and Omega-6 fats via canteen and restaurants leading to fat gain and inflammation markers in blood.
Deficiency of certain amino-acids. Leucine, an essential amino acid that can come only in the diet, is known to increase the MTOR gene which promotes muscle protein synthesis. Sometimes a diet culturally may be deficient in certain amino acids and the construct of the athlete’s body in tissue such as blood, muscle, ligaments, tendons and cells is weakened.
Anti-oxidants found in food such as Lycopene (tomatoes, watermelon and guava) help boost lung function. Post the covid pandemic, many athletes have lowered lung function. This results in lesser expulsion of carbon dioxide leading to a higher acidic environment in the blood.
Improper meal timing also play a role in dynamic recovery. Research has shown microscopic hypertrophy or muscle damage from resistance training in athletes. They will grow muscle provided the nitrogen or amino acid pool in the blood is high. Delivering nutrition within 90 minutes of a workout is key to recovering the muscles. As a nutritionist, many times my clients will see me asking them to post pictures of their post workout meal. I request the player to do it immediately. I have seen players who are very indisciplined about timing lose muscle in a season resulting in future imbalances that lead to an injury. Athletes train 2 -3 times in a 24 hour period. Healing takes 12 to 72 hours. Every minute counts.
Sleep is the new diet. Whilst everyone know you need eight hours of sleep, I seem to be finding the younger generation more interested in doing more and resting less. With my clients, we use state-of-the-art heart rate and sleep monitors that measure strain in an athlete as well as the recovery. Many a times, with 4-6 hours of training a day, the sensors return a 10-12 hour requirement of sleep. So please do not believe that you can cheat sleep. If you can sleep for seven hours, try to rob an extra hour by going to sleep an hour early. If you can sleep in a car or a bus, sleep. If you can sleep for an hour in the afternoon, sleep. Kill your internet, Instagram and other online distractions. Your body will love you more.
How can you know this? Check your resting heart rate every morning as you wake. Do this for 10 days on your normal schedule. After 10 days, sleep for 1-2 hours more and check your resting heart rate and watch how it has dropped. Then do your training and see a lowered heart rate in training. Sleep has all the parameters as it is the magic bullet which will help you heal faster as well as help prevent injuries. Research has even shown that deep Sine Wave Sleep or SWS sleep has ability to signal genetic repair and release of growth hormone in athletes.
I must mention that women are more prone to injury due to the monthly menstruation cycles and desire to eat lesser for trimmer figures. Careful dietary monitoring is required for the female athletes in sports as body image and image shaming is a huge psychological battle with women eating less to have slimmer figures.
Injuries are the reason athletes retire. Some have a long career like Indian tennis legend Leander Paes and some have a very short career. I appeal to the parents to get body diagnostics done for their children if you plan to get them started early. If you’re an older athlete and you want a longer shelf-life, get your recovery and sports diet scientifically planned for a longer innings.