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How to eat your way to recovery – Part 2: Migration Stage

When you suffer an injury, your first thought might be to seek treatment from a doctor or physiotherapist. And while that's the correct action to take, people often forget to think about how their diet can impact their recovery process.

We sat down with nutritionist, Kate Jeffries from Katalyst Nutrition to talk through how you can eat your way to recovery.

Based in Brisbane, Kate holds a Bachelor of Behavioural Science (Psychology) and an Advanced Diploma of Nutritional Medicine and she uses her background in both of these areas to work to achieve optimal health and nutrition for her clients.

Read on to see her insights and find out what food you need to be eating and when.

If you missed Part 1 in this series, click here to view it. 


What are the signs and symptoms of this stage of recovery and how long does this stage last for?

Injury healing involves processes that (1) fill in, (2) seal and (3) shrink the wound or injury. 

These characteristics of healing vary in importance and duration dependent on the different types of injuries. 

Injury healing, following the inflammatory response, involves a process known as the migration or proliferation phase.  This phase begins 3 – 4 days after injury and continues from between 2 – 10 weeks dependent on the type and severity of injury. 

For example, a paper cut or sutured surgical wound will heal within a couple of weeks because the edges of the wound are in close proximity and the injured area has suffered minimal tissue loss. 

A fracture, on the other hand, can take up to 10 weeks in the migration phase as there are more complicated processes involved in an attempt to restore bone tissue and strength.  

Within 48 hours after an injury, a process called angiogenesis takes place in which new blood vessels begin to form from surrounding soft tissue which increases the blood flow to the site of injury.  Any dead red blood cells are cleared away and other cells known as fibroblasts infiltrate the injured area and start laying down collagen.

This is a vital component of this process as collagen is the most abundant protein found in our bodies and acts as the ‘glue’ that holds together the tissues of our:

  • joints,
  • muscles,
  • tendons,
  • bones,
  • blood vessels,
  • hair,
  • skin,
  • nails, and
  • Digestive system...

…the list goes on.  


What foods should you be eating at this time?

During the migration phase you will probably find that you are exercising less so your appetite decreases. 

Although your energy requirements during recovery are less than when you are consistently exercising, they are still higher than your day to day energy requirements when sedentary (your basal metabolic rate).  This is due to the work your body is undertaking to repair injured tissue.  Failing to meet these energy requirements by not eating enough coupled with lack of exercise may result in a loss in muscle mass as well an increase in fat stores.  

Proteins are the building blocks for all of the cells in our body so consuming adequate protein is vital during recovery.  The minimum amount of protein that should be consumed in a day is 0.8 gm of protein per kg of body weight. 

So, for a 70 kg person this equates to approximately 56 gm of protein each day. 

The needs of athletes are higher and they should be consuming closer to 1.5 – 2 gm of protein/kg of body weight each day. 

Your protein intake should be broken up over the course of the day and will ideally come from a variety of different sources. 


Protein

Protein sources include (but are not limited to):

  • meat,
  • tofu,
  • tempeh,
  • eggs,
  • nuts,
  • seeds,
  • nut or seed butters (almond butter, peanut butter, tahini etc),
  • lentils,
  • chickpeas,
  • beans or
  • a good quality protein powder. 

Healthy Fats

The inclusion of healthy fats such as:

  • extra virgin olive oil,
  • nuts,
  • seeds,
  • fish or fish oil,
  • avocado, and
  • flaxseeds/flax meal/flax oil

…remains important during this phase due to their anti-inflammatory properties (refer to previous post for more information).  

Carbohydrates

Minimally processed carbohydrates should also be included for energy from wholefood sources such as:

  • wholegrains,
  • pseudograins (quinoa, buckwheat etc.),
  • legumes,
  • fruits and
  • vegetables.  

Are there any other considerations we should be making at this time?

The main considerations during this period are ensuring you are eating enough each day to meet your energy requirements.

This may mean that you ensure you eat every 3 – 4 hours even though you may not be feeling that hungry. 

Avoiding inflammatory foods such as high amounts of animal protein, alcohol, caffeine, sugar and highly refined or processed foods will also support the recovery process. 

It is also important to include variety in your diet to ensure you are obtaining a wide range of different nutrients to optimize your health and functioning of the body. 

Thanks Kate. 

If you missed Kate's first article in this series, be sure to check it out below. 

Eat your way to recovery – Part 1: Inflammation
When you suffer an injury, your first thought might be to seek treatment from a doctor or physiotherapist. And while[...]

In the meantime, if you have any questions relating to this article or more general questions around nutrition, don't hesitate to contact Kate on 0423 493 330 or click the button below. 

Eat your way to recovery – Part 1: Inflammation

When you suffer an injury, your first thought might be to seek treatment from a doctor or physiotherapist. And while that's the correct action to take, people often forget to think about how their diet can impact their recovery process. 

We sat down with nutritionist, Kate Jeffries from Katalyst Nutrition to talk through how you can eat your way to recovery.

Based in Brisbane, Kate holds a Bachelor of Behavioural Science (Psychology) and an Advanced Diploma of Nutritional Medicine and she uses her background in both of these areas to work to achieve optimal health and nutrition for her clients.

Read on to see her insights and find out what food you need to be eating and when.

What is inflammation?

Inflammation is a normal anatomical and physiological response to injury that helps with tissue repair and wound healing.

The acute inflammatory response is self-limiting and usually takes 8 – 10 days from onset to healing.  This is the most commonly encountered inflammatory response and one that most people would be familiar with.  

 

How does inflammation work?

The process of inflammation involves different cellular components and biochemical mediators that move to the site of injury and promote the classic symptoms associated with inflammation: redness, swelling, heat and pain.  Inflammatory responses as a result of injury can be rapid, occurring within seconds to minutes – depending on the location of the injury.  The diameter of the blood vessels surrounding the injured area increases, slowing blood flow and increasing the volume of blood flow to the injured site.  This allows an increased number of inflammatory cells and chemicals to reach the injured area.  

During the initial response the blood vessels also become more permeable which means that gaps appear between the cells that make up the blood vessels.  This allows plasma to leak out of the vessels, which in turn causes swelling at the site of injury.  Consequently, the circulating blood becomes thicker and flows more slowly.  The increased blood volume and increasing concentration of red blood cells at the site of inflammation cause the warmth and redness observed in inflamed regions.




On the Road to Recovery...

Inflammation is important during the first stage of recovery as it initiates healing through the removal of bacterial products and dead cells as well as activating mechanisms of repair.  However, if the acute inflammatory response proves inadequate, chronic inflammation may develop and persist for weeks or months.   When this occurs, it can cause cellular and tissue damage and can then actually delay recovery and impact mobility.

 

What can I do to ease the symptoms?

One of the ways to help modulate the inflammatory response is through diet.  Anti-inflammatory wholefoods such as extra virgin olive oil, nuts, seeds, fish or fish oil, avocado, and flaxseeds/flax meal/flax oil are all high in Omega-3 which is an essential fatty acid that helps to fight inflammation and should be consumed daily during the recovery process.  These foods are all sources of unsaturated fat (the healthy fat!) which is necessary for the optimal functioning of our bodies and which many people are severely lacking in their diets.  Other anti-inflammatory foods include turmeric, garlic and fruits and vegetables for their antioxidant properties, particularly berries as well as pineapple for its bromelain content.  

Some of these foods are available in supplement form which can further aid the recovery process as they are formulated so that their healing properties can be consumed at higher dosages than what you can practically eat in a day.  However, nutritional supplements (like medication) should be taken under the direction of a professional in the industry to avoid any potential interactions or side effects.  Foods to be avoided during the inflammation stage of recovery include vegetable oils, processed foods and large amounts of animal meat, alcohol, salt and sugar.  All of these foods contribute to inflammation in the body and can hinder and prolong the injury recovery process.



Thanks Kate

Stay tuned for Kate's next article in January. 

In the meantime, if you wish to get in touch with Kate phone 0423 493 330 or click the button below. 

Part 2: What to do at each stage of your recovery: The next 2 weeks

Whether you have rolled your ankle, broken a rib or torn a ligament, your body goes through the same painful and uncomfortable process to repair itself. 

We sat down with Nick Marshall from Surf Life Physio in Miami, QLD earlier this month to get a better understanding of the recovery journey. Nick has over 17 years' experience as a physiotherapist, having practised both privately for his own practice Surf Life Physio and as a senior outpatient physio for Tweed Heads Hospital.




This article continues our injury recovery series. If you missed the first article on the inflammation stage, read it here.

Nick gives his insights on the next two weeks of an injury and provides tips on how best to manage this stage.

Keep an eye out for the next article on what happens after the first 2-3 weeks and for Nick's advice on how to speed up the recovery process, next month as well. 

What is the Proliferation phase?

The proliferation phase occurs following the inflammatory phase.

Just to remind you, in our analogy of a house fire, the inflammatory phase is like our emergency services  who, put out the fire, cordon off areas and stop an area being touched or moved.

The proliferation phase commences after about 3-4 days post injury.

This phase is the beginning of the rebuild. In our analogy, it is the phase where you contact the insurance company and builders to start the process of the rebuild.

Insurance Company

Much like the insurance company will (hopefully) provide resources to help rebuild the damaged house, your body will maintain increased blood flow to bring cells called fibroblasts and other nutrients required fro repair. These cells are essential to starting the process of rebuilding the damages muscular, skin or bone tissue. Fibroblasts provide the structural framework of collagen for new cells to develop.

Builders

Collagen cells are like our body's builders. They are deposited into the injured area to re-build all ligaments, tendons and muscle tissue. This new tissue is commonly called 'scar tissue'. 

At this stage your body doesn’t lay the collagen down is a neatly fashion. Instead, the collagen strands runs in all kinds of directions. This leaves the tissue weak and more susceptible to further injuries.





How long did this stage last for?

The proliferation phase commences around 3-4 days post-injury and then lasts until 21 days after the injury or about 2 weeks.


How would an injury feel in this stage?

The biggest difference between this phase and the inflammatory phase is that the injury is no longer sore at rest. It will be sore and restricted with movement and activity. But inflammation is characterised by constant pain without movement.

At this stage the pain should be much less, swelling should have reduced and bruises become darker.





What is the best treatment plan for this stage of someone's recovery?

This phase is about stimulating the blood flow to the area so the collagen and elastin forms and matures into its normal shape.

The body’s cells arrange themselves in a way so that they are best designed to resist future load and prevent damage. It’s in this phase that those early building blocks of the ligaments, tendons and muscles can be designed to reduce the risk of re-injury.

You should be aiming for controlled movement.


Should you see a physio during this middle phase?

This would be the most important area to see a physio.

As the injury is no longer sore all the time there is a tendency to get moving too soon. If your movement is not guided properly then a large amount of injuries develop scar tissue which leads to inelastic tissue and a very real cause of future re-injury.

It is also this phase where far too many people grit their teeth and get back to do normal activity. But unfortunately doing that in an inappropriate way during this phase can cause the injury to relapse into the inflammatory phase and stall healing.


Thanks Nick.

If you missed Nick's last article on the Stage 1 of injury recovery, click the link below. It's well worth the read.

Part 3: What to do at each stage of your recovery: The final phase
Whether you have rolled your ankle, broken a rib or torn a ligament, your body goes through the same painful[...]
Part 1: What to do at each stage of your recovery: The first 3 days
Whether you have rolled your ankle, broken a rib or torn a ligament, your body goes through the same painful[...]

Stay tuned next month for Nick's interview on the final stage of the recovery process in February. 

In the meantime, if you have any questions regarding these tips, injury recovery or other health issues please do not hesitate to contact Nick and his team at Surf Life Physio on (07) 5527 7830 or click the button below. 

Dietitian vs. Nutritionist: What is the Difference?

Many people mistakenly use the terms ‘dietitian’ and ‘nutritionist’ interchangeably. Although these two professions are undoubtedly related, they maintain distinctive qualities. 

We sat down with nutritionist, Kate Jeffries from Katalyst Nutrition to uncover the key differences. 

Based in Brisbane, Kate holds a Bachelor of Behavioural Science (Psychology) and an Advanced Diploma of Nutritional Medicine and she uses her background in both of these areas to work to achieve optimal health and nutrition for her clients.

Read on to see her insights and some top tips when choosing a dietitian or nutritionist. 

So, what's the difference between dietitians and nutritionists?

Dietitians in Australia are predominantly found in hospital settings and in government and community-based roles.  

In the medical setting, dietitians work heavily with disease states and conditions such as diabetes, cardiovascular disease and kidney disease to assist their clients to manage their medical conditions through diet.  

In government and community settings, the role of dietitians is to plan meals that meet the nutritional needs of the entire community, organisation or population that they serve.

Dietitians also practice privately with clients on an individual basis but will generally focus on food intake alone as opposed to a holistic approach focusing on whole body treatment.  This is where dietitians and nutritionists differ most. 

What does a nutritionist do?

A nutritionist generally works more one on one with clients in a clinical setting. 

Most nutritionists adopt a holistic approach to case taking and treatment.  This means that they will look at the functioning of all your body systems including areas such as digestion, metabolism, hormones, energy levels and sleep to name just a few.  

Nutritionists will also look at diet, lifestyle and levels of stress to assess the nutritional requirements for their clients.  This individualised assessment and treatment stems from the concept of bio-individuality - that there is no ‘one-size-fits-all’ approach when it comes to achieving optimal health.  Every client is viewed as a unique individual with highly individualised nutritional and energy requirements, body compositions, metabolism, backgrounds and lifestyles that all influence their overall health and the foods that make them feel at their best. 

What are you top tips when choosing a dietitian or nutritionist?

It is important to note however that these are general guidelines and there will be dietitians who adopt more of a holistic approach as well as nutritionists that tend to adopt more of a dietetics approach.  

When looking for the appropriate practitioner for you it is important to ensure that the dietitian or nutritionist has a professional membership with an appropriate association.  This will ensure that they have the necessary qualifications, are held to specific legal and ethical standards and have ongoing Continuing Professional Education requirements.  

Some people may call themselves a nutritionist or nutrition consultant when they have in fact only undertaken a few nutrition subjects.  This is why it is imperative to ensure your practitioner is appropriately qualified so that you can be sure that you are dealing with someone who can provide you with the most accurate and up to date nutritional information. 


Thanks Kate.

Stay tuned for Kate's next article in January. 

In the meantime, if you wish to get in touch with Kate phone  0423 493 330 or click the button below.