The link between nutrition and physical therapy

AT PHYSIO ON THE RIVER, WE BELIEVE IN A ‘HOLISTIC’ APPROACH TO PHYSICAL THERAPY. YOU MIGHT ASK, WHY DOES A PHYSIOTHERAPY CLINIC OFFER SESSIONS WITH AN EXPERT NUTRITIONIST?

Well, making a few lifestyle changes can often have a very positive outcome and impact – beyond the obvious impact on your general weight – on other factors that may be either contributing to your particular ailment or preventing a speedy and long term recovery. We can offer a balanced rehabilitation plan to improve your health as part of your recovery from injury or illness

This could mean that our physiotherapists may advise not only engaging in a course of physical training (for example 1-to-1 Pilates with Fede Evola or Rehab Training with Dave Burnett), but suggest seeking the advice of a qualified nutritionist to review your nutritional intake and eating patterns. Ensuring these changes are effective, and maintained long term, can be challenging without support. We can offer that support and professional advice in the form of Sharon Kallos, who is our resident nutritionist.

Did you know that for every 1lb of weight lost, this removes up to 4lbs of pressure off your knees?

Good nutrition is not simply a matter of weight control

Nutrition plays an important part in injury recovery. It is well-known that a poorly-balanced diet can compromise your health (see the Eatwell Guide from the British Dietetic Society website to ensure your diet contains the best balance of foods from each group). However, changes to what you eat, when you eat it and how much, can play a pivotal role in the healing process after a musculoskeletal injury.

Eating too little (you may perhaps have lost your appetite) puts you at risk of losing lean healthy tissue and muscle mass. You may feel weaker and experience difficulty in rebuilding your strength – under-eating will only prolong recovery and make it more difficult to return to your “normal” levels of mobility. Often people are worried about gaining weight when injured, as they are no longer as active or able to follow their normal exercise routine. Eating the right nutrient balance will not only enable a quicker recovery but will also prevent unwanted weight gain.

The Inflammatory Phase of the healing process (1 to 3 days after injury)

Immediately after an injury, the body activates an inflammatory response in order to promote the healing process. This is a normal process and occurs naturally when the body is fighting infection or injury.  There is an increase in the permeability of blood vessel walls to allow drugs, nutrients, specialised cells, and water to flow in and out of the injured area.

While it is a normal and necessary step in the healing process, excess inflammation may have a detrimental effect on recovery and can impair blood flow. This may potentially cause cell damage to the healthy tissue surrounding the injury site. A diet such as the Mediterranean diet, which has a wide variety of fruit and vegetables combined with wholegrains and unsaturated healthy fats, can provide the right balance to support the healing process by providing the essential nutrients for tissue growth, cell renewal and repair after injury.

The following foods are considered to have anti-inflammatory properties and can help with the early healing process.

Omega-3 fats are essential fatty acids that our bodies cannot make so it is important that we get them from food. Studies show that omega-3s can reduce the production of certain inflammatory molecules and help dampen general inflammation. (1)
Aim to increase your consumption of omega-3 rich foods, such as olive oil, fish oil, avocado, pecans, walnuts and almonds. Our nutritionist, Sharon, can help you identify correct amounts for maximum impact by working through a nutritional plan with you. Conversely, it is advised that at the same time you limit your consumption of Omega-6 fatty acids, such as processed seed and vegetable oils, fried and processed foods. The ideal proportion of Omega-3 to Omega-6 fatty acids should be 1:1 (most of us currently consume a ratio of 1:10 per day, so this would mean a significant change in eating habits, at least during your recovery time.)
Fruits & Vegetables rich in vitamin C and antioxidants will also aid in controlling the inflammatory process because they are rich in antioxidants. When in doubt, choose brightly coloured produce. Some examples include broccoli, brussel sprouts, and cabbages, which contain Sulforaphane and may help prevent cartilage breakdown (2); citrus fruits, which contain vitamin C (3), which supports collagen production and proteoglycan synthesis (re-hydration and swelling around tissue); and red grapes, which contain resveratrol, which suppresses pro-inflammatory cytokines. Additional inflammatory mediators include turmeric and garlic, which could be added as dietary supplements.

Use Protein to Combat Muscle Loss

After an injury, the affected part of the body is often immobilised. As a result, this leads to a loss in muscle mass and corresponding strength. The goal by the second week is to prevent atrophy (a progressive degeneration or shrinkage of muscle or nerve tissue) and to promote soft tissue repair to get you back on your feet. While our physiotherapists work with you to increase muscle strength and mobility,  dietary protein consumption could help to decrease the severity of any muscle degeneration while you recover (4).

Protein provides the main building blocks for tissue growth, cell renewal and repair. A diet low in protein has been shown to contribute to poor healing rates and reduced collagen formation. Getting enough protein can help minimise the loss of muscle. Increasing your intake of protein can help rebuild that loss faster once you return to rehabilitation and training.

[Foods that are high in protein and collagen include meat, fish, poultry, tofu, eggs, beans, nuts & seeds.]

Other important nutrients to include in your diet while healing

• Zinc
Not getting enough zinc in your diet can delay healing (5). Zinc is a co-factor in many enzymes and proteins needed for healing, tissue repair and growth.[Zinc-rich foods include meat, shellfish, pulses, seeds, nuts & wholegrains.]

• Vitamin D and Calcium
As well as being an important component of bones and teeth, calcium is involved in muscle contraction and nerve signalling (6). Getting enough calcium is always important, and not just when you are recovering from injury. Sources of calcium include dairy products, leafy green veg, sardines, calcium fortified tofu and plant milks. Vitamin D is crucial to the body’s absorption of calcium. It plays a critical role in recovering from a bone injury. Unlike other vitamins (vitamin D is technically a hormone), the body makes vitamin D through the action of sunlight on our skin. During the winter months in the northern hemisphere, the sun is too weak and we need to take a supplement as there are very few sources of naturally occurring vitamin D in food.

Don’t stop eating

If you are used to a certain level of physical activity, and have experienced an injury or loss of mobility, you may also have a reduced appetite or not need the energy generated by a higher calorific intake. However, don’t stop eating. The right diet can improve your chances of recovery and reduce the time you spend rehabilitating.

Increase your protein intake

In other words, eat more protein to keep your strength up. Sharon can help you to optimise your dietary strategy by planning the timing of your meals; by paying particular attention to a more even distribution of protein throughout the day; by looking at the source of your protein (meat, fish, plant or supplements) and by monitoring the quantity of protein you consume. This will help to keep your muscle synthesis rates elevated and promote faster healing.

TO FIND OUT MORE & CLAIM A FREE 15-minute consultation with Sharon

* Visit us near Barnes Bridge station to find out more, or

* Email us for further information or

* Contact Sharon Kallos now by calling 020 8876 5690

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About Sharon Kallos

Sharon graduated from Roehampton University with a first class honours degree in Nutrition and Health and is a registered Associate Nutritionist (ANutr) with the Association for Nutrition (AfN).

Her approach is to provide easy to understand nutritional advice following the latest scientific based evidence to help individuals meet their health and nutrition goals.

Sharon also works as a Research Assistant and an an occasional Visiting Lecturer at Roehampton University. She often provides evidence-based writing and content for online and printed articles and Instagram posts. Clients have included the Surrey Dietitian’s blog on topics such as ‘How to eat well for busy lives’, and ‘How to eat well with a chronic illness’.

Link: www.kallosnutrition.com/blog

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Further Reading & References

1.  (Gammone, M A. et al. 2019 Omega-3 Polyunstaurated Fatty Acids: Benefits and Endpoints in Sport, Nutrients 11 (1) 46)
2.  (Davidson et al., Can sulforaphane prevent the onset or slow the progression of osteoarthritis? Nutrition Bulletin 41 (2) pp 175-179)
3.  Tipton, K D. (2015) Nutritional Support for Exercise-Induced Injuries Sports Med 45 pp93-104
4.  Wall, T W et al., Strategies to maintain skeletal mass in the injured athlete: Nutritional considerations and exercise mimetics European Journal of Sports Science 15 pp 53-62
5.  Lin, P H. et al., (2018) Zinc in Wound Healing Modulation Nutrients 10 (1) https://doi.org/10.3390/nu10010016
6.  Tu, M K. et al., (2016) Calcium signaling in skeletal muscle development, maintenance and regeneration. Cell Calcium 59 (2-3) pp91-97

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