I’m Injured. Should I Change My Diet?
“I’m injured. Should I change my nutrition plan?”
This is a common question WAG members ask their coaches (and if you’re a coach, it’s likely one or more of your clients will eventually ask this question, too).
The answer to this question?
Well, it depends on the client and their goals. We’ll outline some different scenarios below.
Let’s start by diving into what a client truly means when they ask about changing their nutrition plan due to injury. In most cases, they’re really asking:
“How can I maintain—or even continue to make—progress towards my body composition goals while I need to reduce my exercise frequency and/or intensity?”
How do injuries happen?
Injuries are complex. There are many pieces to the puzzle when it comes to healing.
How does nutrition fit into the puzzle?
Well, you won’t heal an ACL tear solely by eating broccoli—but your nutrition can absolutely make a positive difference in how quickly you heal.
It helps to have some background and understanding around how injuries occur, starting with this basic reality:
All injuries, whether acute or chronic, are a result of a load (or stress) exceeding a tissue’s capacity.
Have you ever been to Trader Joe’s and the person helping you check out loads that paper bag to the brim with your favorite canned goods—only to forget to double bag it?
You reach the parking lot and your hopes and dreams fall onto the pavement just like your favorite “no sugar added” pizza sauce.
The load of your groceries exceeded the capacity of the bag—and guess what?
The bag got injured!
For your body, a “load” is any stressor.
All of the items on the list below are stressors:
- Poor sleep
- Poor mobility
- Poor strength balance
- Poor food quality
- Poor caloric balance
- Poor professional or personal life
… and because these are all stressors, any one of them (or a combination of them) can contribute to injury.
Your client is injured. What next?
Now that we have some background on how injuries occur, how should you proceed when your client tells you they’ve been injured?
As nutrition coaches, when an injury presents itself, we should aim to accomplish two things:
- Help our clients continue working toward their goals (in a responsible manner)
- Ensure that the client’s nutrition works in adjunct to the healing process
Here’s the tricky thing to keep in mind, as a coach: those two goals may contradict themselves. We’ll explain why below.
Step 1: Focus on food quality
The first conversation to have with your injured client should be around food quality. This recommendation applies to all injured clients, regardless of their specific goals.
Food quality is important for aiding the healing process.
Here is some science around why this is true:
Many people hear the word “inflammation” and assume it’s always a bad thing. In truth, inflammation is a natural process needed to induce healing.
Without getting too deep into cellular physiology, inflammation is a “fluid cocktail”.
While this cocktail does contain pain-mediating molecules, it also contains molecules designed to heal by eating away damaged tissue and laying the foundation for rebuilding tissue.
Natural, normal inflammation = good
Unnatural, abnormal inflammation = bad
The best way to bring about a natural inflammatory process? Eating a natural diet.
What constitutes a “natural diet”? It’s a diet filled with:
- Fruits and vegetables
- High-quality, locally-sourced, ethically-raised meats
- Whole grains
Eating this way ensures that your body has just the right inflammatory response to support healing.
The more processed food included in your diet, the less effective the inflammatory healing process will be.
Think Goldilocks. The porridge has to be just right.
Step 2: Tailor your recommendations based on client goals
Now let’s dive into specific advice for individual clients based on their goals.
We’ll start with clients who are aiming to gain lean muscle mass (sometimes called “bulking”).
When aiming to heal an injury, in addition to focusing on nutrient-dense food, it’s important to pay attention to your client’s energy balance (in other words, their daily caloric consumption).
The goal should be to reduce the load that the client’s caloric consumption has on their body.
Cutting (eating in a caloric deficit) is a stressor.
Bulking (eating a caloric surplus) is also a stressor.
For the client who has been aiming to gain muscle (i.e. “bulking”), consider bringing them closer to maintenance-level calories.
Note: The goal isn’t to bring them to maintenance-level calories exactly, but instead to move closer to maintenance.
Why? Because a few extra calories will aid the healing process. Too many extra calories, however, may overstress the system.
Plus, these clients will inevitably be training less. When we’re injured and training less often (and/or less intensely), we need fewer calories.
The main point for coaches to keep in mind: when we reduce the overall stress on our systems, we recover from injuries more effectively and efficiently.
So for your clients who had been eating in a caloric surplus prior to getting injured, you will want to consider dropping their calories without going all the way to maintenance-level.
Clients who get injured while cutting
Clients who are aiming to lose body fat (i.e. eating in a caloric deficit and aiming to “cut”) can be split up into two categories:
- Clients cutting for optimal performance and aesthetics (i.e. the client is aiming to lose fewer than 15 pounds)
- Clients cutting for better health (i.e. for health-related reasons, they need to lose a larger amount of body fat than clients in the first category)
For those in the first category, a mental battle may ensue when they get injured.
Our instinct tells us that the less we train, the fewer calories we will need to consume. And, to some degree, this instinct is accurate. But there are risks involved with dropping calories too far down when a client gets injured.
Fortunately, it is possible to strike a balance between helping tissue heal while also mitigating the negative effects of a decrease in training.
This is an instance where it makes a huge difference to work with a skilled nutrition coach. The coach can help each client determine their “sweet spot”.
Here is an example.
Let’s say you’re working with a female client who has been eating at a 20 percent caloric deficit. She breaks her wrist. She can still train her lower body, but overall her workouts do not involve the same intensity as they did before the injury.
This client may tell you that she’s nervous she’ll gain body fat during the healing process. She may ask if she should cut her calories significantly to avoid this.
You can reassure her that dropping to a smaller calorie deficit (say, 10 percent) will allow her to achieve both of the following simultaneously:
- Continue making progress and losing body fat (albeit at a slower rate than prior to the injury)
- Heal from her injury at a more efficient rate (thanks to the extra calories)
If a client is aiming to lose body fat for optimal health (in other words, they need to lose more than 15 pounds for health reasons), the coach’s strategy should be different.
The client cutting for optimal performance and aesthetics isn’t necessarily chasing health.
Somebody that’s chasing health probably has more body mass. That body mass comes with consequences.
Think of it as a barbell. The more weight on the barbell, the more it’s going to bend and buckle.
Eventually, that barbell will snap.
For these clients, it’s more urgent that they reduce their body weight to prevent chronic pain than it is to promote a speedy recovery.
In this case, it may be best to hold steady with their caloric deficit while aiming to improve the quality of their food.
The stress of maintaining their calorie deficit will likely not outweigh the stress of too much bodyweight on their frame.
Clients aiming to maintain their progress
What about clients who aren’t trying to change their body composition (in other words, they are aiming to maintain their progress)? Should they change anything about their diet when they get injured?
The recommendation for these clients should be: keep things simple.
If their current nutrition plan isn’t causing them stress, there’s no need to make major changes to it.
Similar to the recommendations outlined above, these clients should ramp up the quality of their food and leave the quantity of their food consistent with their activity level.
Here’s a summary of all the recommendations above:
- For all injured clients: prioritize high-quality, nutrient-dense food.
- If your client is in a caloric surplus (aiming to gain lean muscle): reduce their calories to be closer to maintenance.
- If your client is in a caloric deficit (aiming to lose body fat), your coaching strategy should likely differ depending on their circumstances:
- For high-level athletes or clients aiming to lose body fat for aesthetic reasons: it’s okay to maintain a caloric deficit, but consider reducing it.
- For clients who need to lose body fat for health reasons: it should be sufficient to maintain their current caloric deficit.
- If your client is consuming maintenance-level calories: it should be fine to continue with their current plan.
It can be complicated to determine the right path forward for your clients when they are injured. The WAG Nutrition Coach Certification Program is jam-packed with all the nutrition science and the psychological information you’ll need to be a great coach—the type of coach who helps clients achieve results and sustain them long-term.