Healing injury to soft tissue and bone

Our research discovered so many facets of nutrition that enable better healing in bone and soft tissue. The conclusion was diet and supplementation can play pivotal roles in healing an injured athlete.

Shikhar Dhawan broke his thumb while scoring a century against Australia.   -  AFP

Scoring a century with a broken thumb is grit. Shikhar Dhawan is an athlete par excellence. When I learnt that a scan showed a broken thumb, I had my team at Qua Nutrition research overnight hundreds of studies across research domains that would allow for faster healing of a fractured bone. We discovered so many facets of nutrition that enable better healing in bone and soft tissue. The conclusion was diet and supplementation can play pivotal roles in healing an injured athlete.

As a sports nutritionist, I am always using diet to tackle two fronts in a programme for athletes. These are:

1. Prevention of damage to soft tissue and bone.

2. Recovery from injury to soft tissue and bone.

In injury management, I ask players: “How did you get the injury?” In sports like cricket, kickboxing, wrestling and judo, there is an element where the injury is inflicted upon the athlete. I consider this an occupational hazard. The bone in Shikhar’s thumb would have shattered had he not been wearing protective gear and also because of the immense experience he has on reducing the risk of injury in the sport. These injuries can be healed faster with the right nutritional protocols in place.

Our research threw up studies on bone remodelling and what we discovered were molecules like copper, zinc, calcium and magnesium, and vitamins D, A and B12, along with specific animal-based proteins like gelatin and collagen, which have shown rapid acceleration in tissue and bone remodelling. Simply put, the injury heals faster. We have since then advised Shikhar on many of the vitamins and nutrition elements that he could add to his diet for a quicker recovery.

The other injury is self-inflicted. This injury is due to the negligence on the part of the athletes in not taking care of their bodies. Specifically, their nutrition is never based on the science of sports nutrition, but on cultural or hearsay on what to eat. I can cite various examples of athletes inflicting injuries upon themselves.

Let me give you a few examples:

1. If an athlete does not hydrate well (the brain is 85 percent water), the athlete loses focus and concentration, and as a result is eliminated from the game. Even worse, the reflexes of this athlete are dulled, resulting in injury due to a slow reaction time.

2. When athletes sweat, they lose electrolytes (basically, salts). As the muscles work, they fire on and off consistently. With constant use, the muscles heat up. In over-exercised muscles, the response diminishes and in worst-case scenarios, cramping may happen, which results in an athlete being removed from practice or a game.

A muscle with lower electrolyte concentration (magnesium) becomes a tighter muscle when sprinting, running or combating. The athlete may have one tight muscle and another relaxed muscle that are not firing in tandem, and this may lead to extreme stresses and strains on the human body. In the worst-case scenario, this could lead to tearing of tissue such as a ligament or cartilage due to an imbalanced misfiring muscle.

Injury diet card

Pineapple, ginger tea, purple cabbage, jelly with gelatin, whole eggs, pumpkin seeds, dark chocolate (70% plus), sweet potato

Injury supplement list

Vitamin C, D, K, E, B12, omega 3, copper, zinc, collagen, glutamine, aginine, cissus quadrangularis, antioxidants, creatine

(Note: The above list has intentionally not advised quantities or time. This is crucial as customisation to body weight and blood tests will help arrive at more accurate recommendations. Please consult your nutritionist or rehab doctor before using any foods or supplements for injury recovery).

3. Athletes need to consume enough protein in their diet. Protein is the building block of muscles. When athletes strain, muscles break down due to metabolism. By eating the right amount of protein, you can recover the muscle by providing the building blocks called amino acids, which are the basic units of all proteins. The lack of these proteins/amino acids in the daily regime of food will lead to more microscopic trauma or destruction of muscle fibres, which ultimately can lead to injuries of the muscle or soft tissue.

4. A lack of carbohydrates can result in fatigued athletes. Glycogen (packets of glucose in the cells) is the main storage unit in muscles. When glycogen is depleted, athletes lose mental focus as the brain’s primary source of energy is glucose. When there is a complete depletion of glucose in the muscle as well as the liver, the brain decides to shut down its focus because it believes it is getting not enough glucose to function. When an athlete starts at the beginning of the week, the glycogen levels in the muscle are at peak levels. As the week progresses, glycogen levels drop over multiple training sessions. By the end of the week, glycogen is significantly depleted to 10-30 percent of its original level. Therefore, towards the end of the week, athletes are more prone to injuries in training due to the loss of focus or because a muscle is not holding enough glycogen. A muscle well stocked with glycogen holds an ample amount of water, thereby preventing injury because water attracts all the other nutrients that include amino acids, vitamins and minerals, which ensure a superbly hydrated muscle i.e. a well-performing muscle.

5. Athletes need to be fuelled with the right amounts of minerals and vitamins – calcium, magnesium, zinc, vitamin D, vitamin K and protein. The bone matrix is constantly being remodelled or broken down every day. The adult human skeleton changes over 10 percent a year, which means every decade we get a new skeleton. Athletes subject themselves to superhuman training. Nutrition in the form of vitamin D, vitamin K, calcium, magnesium and protein gets diverted to other parts of the body for survival during training. Hence, recovery is affected. In such extreme cases, bone, skin, hair and soft tissues may get a lower quantity of their recommended daily allowance. Over a period of time, this results in chronic deficiencies in the raw material being delivered to the muscle of the skeletal system. Hence, players are self-inflicting injury upon their bodies due to their lack of awareness of what the correct nutritional requirement is as well as a lack of knowing how to test for determining whether genetically, clinically or dietary wise they are in the right zone of fuelling the body.

In Shikhar Dhawan’s case, this injury was inflicted upon him. It is critical and instrumental that in cases of broken bones to torn ligaments and damaged organs, one has to work with their sports medicine doctor, their physiotherapist and their nutritionist for faster rehabilitation. Shikhar’s support team is one of the best in the world. I am super confident by the time this article is published, he will be back in the Indian cricket team with a bang!

Ryan Fernando is the chief nutritionist at Qua Nutrition Clinics. Get in touch at www.ryanfernando.in