Eating and Injuries: Nutritional Strategies to Support Your Return to Sport

This summer I had the privilege of hearing Dr. Charlie Weingroff speak at the Central Virginia Sports Performance Seminar (CVASPS). A point he made that really solidified the importance of consuming enough food to support your return to play was; “how can you expect your body to regenerate and restore tissue, when you deprive it of the raw materials to do so?”Often athletes will conclude that they are more sedentary, therefore their total energy intake should go down. Will that be the case? Yes, however, our body is in a state where it is longing for restorative building blocks or “raw material”, to repair the damaged tissue or structures which needs to be accounted for. This increased energy consumption combined with a more systemic approach to training is a perfect storm for accelerated restoration. While your training program may be modified around your limitation, we need to understand that you can get a very positive local healing response when we approach training systemical. For example, if I have an adductor strain but I am able to train my upper body, my torso, my unaffected leg, I can get more mitochondria, oxygen, IGF-1 and a ton of healing compounds circulating around the body, and ultimately to my injured adductor. Combine this with all of the high quality food you’re consuming and you have created an internal environment that is a lot more conducive to repair vs being sedentary and under-fuelling. With that being said, how do we go about steering the athlete towards the correct amount of food they need during this period in their return to play?

A very digestible (pun intended) way for athletes to visualize energy consumption during the return to play process is with The Bucket Approach. Dividing the athlete’s daily nutritional needs into different buckets that require precise filling each day, can help emphasize the importance of caloric consumption during the recovery process. The first bucket that we must fill is the athlete’s BMR or Basal Metabolic Rate. This is the amount of energy (calories) you need to sustain basic functions of being a human being each day without taking into account your activity level. For example, if I think of my body like a computer, the BMR is the amount of energy or in this case electricity, I need in order to run the operating system/software of my computer while it’s turned on, regardless of any task I try to perform on that computer. The software in your body is all of the systems that operate in the background. If I’m a 29 male, who’s 5 ’10 and 170 lbs, I require 1755 calories just to exist on the couch all day.

The second bucket we need to consider is the activity bucket. As a competitive athlete, you would typically be on the higher end of the general spectrum of human activity. However, when you’re injured, we can assume that the volume and intensity of your daily activity has gone down. In order to get more objective numbers for energy consumption we can use the PAL scale to determine your activity level. This scale references various activity levels from bedridden to highly strenuous work, which is then a multiplier for your BMR (National Institutes of Health, n.d., Table 1). I would likely recommend categorizing yourself as “moderately active” during your return to sport if you’re training around the injury. Which means you’d multiply your BMR by 1.55.

The final bucket we now need to account for is the injury bucket. This bucket is made up of the specific micro and macronutrients that are supportive to healing and reducing inflammation. If the athlete focuses on adding these nutritional interventions rather than substituting them for what they’re already eating, they can increase their energy balance to a surplus even further to allow for a more efficient recovery environment. Why is this surplus of energy balance important during recovery? According to Dr. John Berardi (founder of Precision Nutrition) “Energy needs increase during acute injury repair. In fact, basal metabolic rate may increase by 15 to 50% based on the severity of the trauma. For example, sports injury and minor surgery may increase BMR by 15-20% ,while major surgery and injury may lead to a 50% increase in BMR” (Precision Nutrition, n.d.). This is often one of the most overlooked factors in recovery due to the athlete’s psychological response. They’re likely to rationalize eating less to ensure they don’t get excess body fat when more sedentary during the injury. Reframing your mind to accept the fact that a lot of physiological processes are happening behind the scenes which require energy (calories) can be a game changer.

(when injured)

It’s easy to get overwhelmed with the sheer amount of information in the world today about what to eat for certain health or performance outcomes. From a return to play standpoint, there are some key nutrients and supplements that have been studied and proven to have positive benefits to the athlete’s recovery from injury.

Consumption of foods high in Omega 3’s has been linked to reducing inflammation in the body. Keep in mind we want a certain amount of inflammation in the body acutely to signal our natural recovery processes. However, we want this inflammation to be flushed out during the proliferation and remodeling stages of injury recovery. A few great sources of omega 3’s are: fatty fish like salmon, avocados, high quality olive oil and egg yolks (Precision Nutrition, n.d.). Supplementing omega 3’s is an option, but remember that extra calories, protein and other important micronutrients come from opting for whole food sources. On the other side of the spectrum we want to limit inflammatory fats from highly processed trans fats like vegetable oil found commonly in fast food. Too much of these can create more unnecessary inflammation systematically.

Foods high in antioxidants can help reduce oxidative damage and keep your brain and body functioning optimally during your recovery process. The easiest way to ensure you’re getting an adequate amount of antioxidants is to add more colour to your plate in the form of fruit and vegetables. Dark leafy greens, berries, root vegetables like beets as well as certain nuts and legumes, are all good sources of antioxidants (Perna et al., 2020). A good rule to live by is “eat the rainbow”. Aim for 1-2 servings of fruit and vegetables with every snack and meal.

As we know, protein and the amino acids that make up high quality protein, are the building blocks for tissue. The same way we break down tissue in the gym and want to rebuild it bigger and stronger, when we are injured we want to regenerate that tissue as efficiently as possible. Protein is essential for this. According to Precision Nutrition’s guidelines, “To ensure a quick recovery, make sure to get this higher protein intake consistently. At minimum, injured athletes should be taking in 1 g of protein per pound of body weight” (Precision Nutrition, n.d.).

More and more research is coming out in favour of creatine having cognitive benefits (beyond the mountain of research on its role on physical performance). One of those benefits is mitigating the length and severity of acute stressors to the brain and even pathological conditions of the brain. Supplementing with creatine in addition to getting trace amounts through animal products, can help provide the brain with higher levels of creatine concentration (PCr). Research is still unclear on the amount of creatine to supplement with for this but 5 grams per day is a good place to start until we have more clarity (Avgerinos, Spyrou, Bougioukas, & Kapogiannis, 2018).

It’s important to consider the context and barriers around nutrition for athletes. If we look at the professional setting or even many NCAA schools, athletes have sports dietitians to control these variables for them. This makes it a lot easier to have control over the athlete’s consumption during the return to play process. While we might not be as fortunate in some of our settings here in Canadian S&C, we can work with what we have and create actionable steps to making nutritional interventions possible for our athletes. Here are some suggestions for fuelling your return to play:

When you’re grocery shopping as an injured athlete, stick to the perimeter of the store as much as you can. The produce section, sea food department, butcher, dairy fridges, bakery and freezers full of frozen fruit and veg are on the perimeter of the store in most locations. This will ensure you’re avoiding a lot of high processed packaged food and choosing nutrient dense food sources for your recovery.

As much as it can deplete your bank account to go grocery shopping these days, there are some cheeky ways to cut your cost. Apps like “Too Good to Go” can show retailers and restaurants with very reduced items which they’d normally throw out or donate at the end of the day. Most grocery chains also have a rewards program where you can stack points to save on grocery hauls. In addition, collegiate athletes can often take advantage of a 10-15% discount on “student day” at grocery stores near campus.

Worst case scenario, if you’re unable to make significant dietary adjustments during your return to play, you can control all of the other variables associated with your lifestyle. Sleep lots, manage stressors, follow your rehab protocol and your modified S&C protocol and hydrate. Returning to performance is an all encompassing endeavor that requires effort and attention to detail in all areas, not just in the kitchen.

1. National Institutes of Health. (n.d.). Physical activity and thermoregulation. In Thermoregulation during physical activity (Table). Retrieved March 27, 2025, from https://www.ncbi.nlm.nih.gov/books/NBK279077/table/non-exrcse-thrmo-obs.T.physical_activity/
2. Precision Nutrition. (n.d.). Nutrition for injury: Part 3. Retrieved March 27, 2025, from https://www.precisionnutrition.com/nutrition-for-injury-part-3
3. Precision Nutrition. (n.d.). Nutrition for injury: Part 2. Retrieved March 27, 2025, from https://www.precisionnutrition.com/nutrition-for-injury-part-2
4. Perna, S., Alalwan, T. A., Al-Thawadi, S., Negro, M., Parimbelli, M., Cerullo, G., Gasparri, C., Guerriero, F., Infantino, V., Diana, M., D’Antona, G., & Rondanelli, M. (2020). Evidence-based role of nutrients and antioxidants for chronic pain management in musculoskeletal frailty and sarcopenia in aging. Nutrients, 12(11), 3473. https://doi.org/10.3390/nu12113473
5. Avgerinos, K. I., Spyrou, N., Bougioukas, K. I., & Kapogiannis, D. (2018). Effects of creatine supplementation on cognitive function of healthy individuals: A systematic review of randomized controlled trials. Psychiatry and Clinical Neurosciences, 72(5), 216–229. https://doi.org/10.1111/pcn.12719