We have all experienced that ironic moment where you annihilate the most intense weight bearing, muscle burning and sweat dripping workout; to then leave the gym, body in tact and head held high in triumph, to only go and injure yourself on your way home whilst curling your 5kg shopping bag full of your intended grocery gains.
The fact is, we all get injured at some point in our life and whether it’s a result of ego inflicted deadlifts or a third party slide tackle, as an athlete, sportsman or fitness enthusiast, injury is probably one of the most frustrating scenarios to be faced with, other than witnessing someone curling in the squat rack.
So in a world where working out has become a healthy addiction, how do we overcome injury and ensure we are once again fighting fit fast? Well the fact is if you want to increase lean muscle mass, protein synthesis has to exceed protein degradation and if it doesn’t, you will face the dreaded “A”, atrophy, that’s the wastage of lean body tissue (muscle)… I appreciate I might have lost you there, so let me break it down, that’s breakdown the concept NOT the muscle (I’m proud of that pun); protein synthesis is what we always want to strive for, it is a biological process in which cells generate new proteins, muscle is made up of proteins and therefore increased protein synthesis is critical for lean muscle growth. So just like the battle of Troy, we need to formulate a smart, subtle and strategic plan to overcome the tyrannous muscle wasting and fat gaining dictator, atrophy.
Unfortunately, just like pancakes and maple syrup, injury and atrophy come hand in hand and within as little as 2 weeks of immobilisation or injury, you can lose up to 5% of hard earned muscle mass, which could equate to a whopping 3kg in one limb alone. One more reason to not skip leg day. Even in as little as 7 days of bed rest from the common cold, negative adaptations can be induced, fat mass increased, lean muscle mass reduced, VO2 max reduced, and a reduction in the effectiveness of signalling and amino acid transport. To simplify things, getting injured can undo all your hard work which totally sucks.
As the saying goes, use it or lose, you have to constantly stimulate your muscles to promote protein synthesis and adaptation because if you aren’t exercising as a result of an injury or illness, you will likely be subject to negative muscle adaptation and come back worse for wear. Now despite the almost futile picture I have painted above, there is light at the end of the treadmill, but that’s going to take a scientific approach to both exercise and nutrition.
First and foremost, always have your injury diagnosed by a professional, not some bro-science boffin in your local gym. Once diagnosed professionally, have your physiotherapist or personal trainer ensure you are performing your injury rehabilitating exercises correctly to stimulate muscle contraction, promote protein synthesis and minimize atrophy. In some cases, you might not be able to exercise at all and before you know it you find yourself succumbing to the dark side of couch potato life; inevitably overwhelmed by the physiological effects of injury, influencing you to comfort eat your way through a box of assorted Krispy-Kremes or drown your sorrows with your good friend Jack Daniels, basically a university students diet or at least it was mine, which will certainly increase body fat and reduce protein synthesis.
Clearly nutrition is going to play an important role in both preserving as much lean muscle mass as possible and reducing fat gain whilst injured; but more importantly, ensuring that when you return to exercise you can overcome any negative adaptations and begin recuperating any muscle wastage and burning excess and unwanted body-fat. When it comes to nutrition, I like to refer to TTT (timing, type and total), because we want to be eating the right type of food, in the right amount and at the right time to maximize our health related goals.
The first steps to take upon returning to exercise are to get the muscles contracting again to promote muscle protein synthesis and then overcome anabolic resistance; when a limb becomes immobilised from injury, resting muscle protein synthesis is reduced and as a result induces anabolic resistance to amino acid ingestion. For example, you could feed both a mobilised and immobilised limb 20g of protein and get two completely different responses; therefore, we need to ensure we have a source of protein with every meal, increase our portion size and frequency (every 3 hours) and increase the amount of protein previously consumed to overcome anabolic resistance. Combine this increase in protein consumption with muscle contraction and before you know it, you will be right on track to an upgraded version of yourself, I like to think of it as evolving from Squirtle to Blastoise.
Up your Omega 3 game with oily fish and eggs. Omega 3 is directly correlated to a healthy heart, brain function, improved joint mobility and can increase the rate of protein synthesis. What’s that famous saying about apples and doctors? Oh yeah, an apple a day keeps the doctor away, well I can do one better. A study by Texas A&M University showed that subjects eating 3 whole eggs a day whilst following a weight lifting exercise programme over the period of 12 weeks gained twice as much muscle mass and muscle strength in comparison to subjects eating no eggs or just one whole egg per day.
Regulate your carbohydrate intake around your activity whilst injured or immobilised, as well as making health conscious decisions to reduce excess sugar and high GI carbohydrate intake which can make you fat. The body can store approx. 400g of glycogen from glucose in the muscles and 100g from fructose in the liver, any excess will be stored as fat. So if you aren’t exercising and depleting muscle or liver glycogen there is no point in loading your body with carbohydrates.
It’s not just about the quantity of carbohydrates, it’s about the type, especially with regards to the GI (glycemic index), as high GI carbohydrates will cause the hormone insulin to be released. If your looking to reduce your body-fat, you want to keep your insulin level low throughout the day and when you start exercise as you will get a greater increase in free fatty acid availability for energy during exercise; this will also then improve insulin sensitivity when you do require a fast acting bout of energy boasting high GI carbohydrates. If your insulin levels are high throughout the day then your ability to burn body-fat will be reduced, so the best times to consume high GI carbohydrates are immediately post-workout to replenish muscle glycogen and promote muscle repair, growth and recovery.
Supplementing your meals with the amino acid Leucine which is the main regulator to activate protein synthesis can also increase protein synthesis and therefore aid injury rehabilitation. HMB is another amino acid that is renowned for its muscle wastage reducing properties, it acts like an ozone layer around your muscle, protecting them from being broken down and is a great addition to your diet when you’re both unable to exercise or your training at very high intensities.
These evidence based nutritional strategies can help you to preserve lean muscle mass and reduce fat gain when injured as well as increase lean muscle mass and reduce fat gain upon returning to exercise. I guess the golden rule to adhere to when it comes to overcoming an injury is:
Contraction + protein = increased protein synthesis.
The best thing you can do is keep your muscles stimulated throughout your injury where safe and possible to do so and ensure you are eating a well balanced, nutritious and high protein diet.