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1 14 | nata news | JULY 2018 After an injury occurs, patients trust that an athletic trainer is working quickly to design a comprehensive rehabilitation plan that will produce a complete recovery in the shortest time frame possible. Research continues to emerge as to how nutrition fits into this recovery plan. Optimal nutrition can play a key role in controlling inflammation, providing key nutrients for rebuilding injured tissue, minimizing muscle atrophy and support-ing strength preservation and gain.

2 The following will help you integrate nutrition into your rehabilitation programs and start discussions with patients about when and how nutrition can make an FIRST 48 HOURSD epending on the severity of the injury, there could be a lot of action in the first 48 hours from briefing parents and learn-ing how to ambulate to scheduling imag-ing and preparing for surgery. If you can only impart a few nutrition sound bites to your athletes, let it be these five:1. Fuel the Healing Process: Under-fueling during this period is common dueto busyness of adapting to an unexpectedsituation and the misconception thatbecause an athlete is not training, they donot need to fuel.

3 Trauma or surgery mayrequire up to 20 percent more Additionally, crutching requires two tothree times more energy than energy intake (80 percent oftotal requirements) for 10 days can reduce muscle protein synthesis by 20 percent, thus impacting rate of complete recovery. 2. Manage Surgery Side Effects:Early nutrition is key to the recovery pro-cess, but postoperative nausea can pres-ent a barrier. Nauseous athletes shouldtry bland foods (banana, rice, applesauce,toast), smaller and more frequent mealsand nutrient-dense liquids (smoothies).

4 Constipation is also common after sur-gery. Increasing fluid and fiber intakeoften improves these symptoms. If this isnot effective, athletes might try adding asmall amount of prune juice to their antibiotics are critical for preventing infection, but unfortunately they also kill some of beneficial gut bacte-rial involved in our digestive and immune health. Restore the beneficial bacteria by including prebiotic and probiotic rich foods. Probiotics are live, good bacteria that contribute to a healthy gut environ-ment.

5 Probiotic rich foods include yogurt, kombucha, sauerkraut, miso soup and kimchi. Prebiotics are plant fiber that feed the good, probiotic bacteria. Prebiotic rich foods include jicama, onion, garlic, aspar-agus, oats, wheat, barley and Battle Anabolic Resistance withProtein and Leucine: Immobilizationdecreases the ability of myofibrillar pro-teins to respond to amino acid phenomenon is called anabolic resis-tance, which makes the muscle buildingBY KATIE KNAPPENBERGER, MS, RD, CSSD, ATCP hoto iStock/Arx0ntHow to make sure your patients are receivingoptimal fuelingNUTRITION FOR INJURY RECOVERY & REHABILITATION | 15process more difficult.

6 In order to over-come this, researchers have established higher protein recommendations ( g/kg/d) and emphasize consuming leucine-rich The amino acid leucine has been named the anabolic trigger as it has the power to stimulate muscle pro-tein synthesis faster than other amino acids. Leucine from food sources may have the ability to aid in injury recovery. Leucine rich foods include cheese (Swiss, fontina, provolone, Colby, mozzarella), meat (pork chops, chicken), fish (tuna, trout, salmon), nuts and seeds (soybeans, pumpkin, peanuts, almonds) and tempeh.

7 For best results, consume 20 to 35 grams of leucine-rich protein every three hours during the day and before bed. Casein-rich foods (milk and dairy products) before bed provide a competitive healing edge as they take longer to digest and are slowly released into the blood stream. This pro-vides a slow and steady supply of amino acids that can be used to build muscle while catching some Zzzs. 4. Control Inflammation by MakingSimple Fat Swaps: Anti-inflammatoryfats are found in olive oil, avocado, fish, fla x,nuts and seeds.

8 Pro-inflammatory fats arefound in fried and greasy foods, processedmeats (pepperoni, salami, bologna, hotdogs) and vegetable oils. During the initialinflammatory stage of healing, swapping agreasy hamburger for a turkey burger withavocado would support healing. Instead ofsnacking on fried potato chips, encourageyour athlete to grab some almonds anddried tart cherries to help control theirinflammation and move him/her closer tomeeting his/her rehab Speaking of Fruits and Vegetables: Antioxidant-rich fruits and vegetablesalso help control inflammation, whichcan speed healing.

9 Some of the highestsources of antioxidants include goji ber-ries, blueberries, tart cherries, dark choc-olate, pecans, artichoke, elderberries,kidney beans, cranberries, blackberriesand green tea. Pineapple, turmeric, garlicand ginger have also been shown to havebeneficial anti-inflammatory athlete may try to start his/her their morning with a cup of green tea, cooking up a curry (turmeric) dish for dinner or whip-ping up an anti-inflammatory smoothie for a snack (see Anti-Inflammatory Tart Cherry Smoothie recipe).

10 CONTINUED RECOVERYA fter your patients have integrated the pre-vious tips into their lifestyles, and the inflam-matory stage of healing has come to an end, you may want to reinforce these four facts:1. Continue to Fuel the HealingProcess: It is very easy for athletes tounder-fuel, and this is probably the mostcommon way athletes negatively impactthe healing process. It s becoming morecommon for athletes to reduce carbo-hydrate intake in order to control bodyweight, but whole grains provide manynutrients that fuel and support rehabil-itation and healing.