In this episode, Rebekah discusses how nutrition can help in rehab and return to performance. Rebekah has worked at the Melbourne Rebels, Melbourne Storm, and the ACT Brumbies. She has completed her PHD on the topic of nutrition support for connective tissues in athletes at the Australian Institute of Sport, and currently consults to Western United Football Club, and is also consulting to the emerging athletes program at Latrobe University (LEAP).
Highlights from the episode:
- Tips for early stage rehab in a nutrition perspective
- Advice to athletes low in motivation
- Ingredients and foods for healing during rehab
- Vegan athlete’s nutrition during rehab
- Common nutrition mistakes during rehab
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Jack: Rebekah is now on the panel. So, Rebekah will be discussing how nutrition can aid rehabilitation and return to performance. Thanks for jumping on, Bek.
Rebekah: It’s all right. Thanks for having me.
Jack: We’ll dive straight into it. Tips for early stage rehab from a nutrition perspective.
Rebekah: So, just as your physical intervention is going to go through different phases, your nutrition intervention is going to go through different phases to follow this as well. Obviously, it’s going to depend on the type of injury, the severity and also the individual.
In the initial phase, what we’re really trying to do is support tissue regeneration, and this may be ongoing through rehab. So, having sort of a constant, and more about this later, but having a constant touch point with the medical team and physiotherapy is really important, so we can actually see how the athlete’s progressing through their injury. Because that’s essentially going to inform our intervention.
Then we’re also going to try and attenuate the effects of immobilization. This is essentially changes in body composition. And again, this is going to be covered by Ben a little bit more later down the track as well. So, we’re wanting to minimize increases in fat mass and also prevent or minimize losses to muscle mass.
I would argue that probably a bigger focus on minimizing losses to muscle mass, because that’s going to be a lot harder to get back. Obviously, preventing significant increases in fat mass is important, but making sure that we focus on how nutrition can support the injury and rehab phase as well is more important than getting into this restrictive mindset.
On this restrictive mindset, not being too restrictive with energy. We know that post-injury we’re going to have a slight increase in energy requirements. So, it’s really important not to go too aggressive on that because that may also impact on your nutritional intake and lead to poor nutrient intake as well, which is going to lead to poor healing.
We also want to make sure that we allow that initial information phase to occur. That’s going to signal repair and remodeling, so really important that we don’t try and blunt that too much. So, not being too excessive with anti-inflammatory supplements, for example. And then as the athlete progresses through those goals, we tailor nutrition strategies towards that.
Jack: Amasing. Thank you for sharing that. So, there’re milestones, like a stepping stone process that you go through. If an athlete, and, no doubt, you’ve experienced this before, where they’re low in motivation and they understand the importance because you’ve educated them, but they’re just really finding it tough to do it. What would be advice for athletes that are in rehab at the moment? Maybe it’s long-term and they’re just in a bit of a low in terms of motivation.
Rebekah: Yes, that’s really common. And there’s obviously going to be a component of it, but really, again, going to that, how can we support our body to heal and return to play quicker? So, framing it around being able to progress through those phases more quickly, I think helps to support an athlete. And, obviously, being sympathetic to what they’re going through. But then just trying to sell that, if we get this on point, then, hopefully, we can progress you through these stages quicker.
Jack: And then specifically what type of ingredients do you want? People that are trying to accelerate that healing process, what are some good food groups and ingredients to purchase when you’re doing your grocery shopping during rehab?
Rebekah: Again, that’s going to depend on injury type and how long the injury’s going to go for, as well. So, having really good conversations with your dietician around how to support the different phases. For example, your muscle tissue is going to have different makeup than collagen tissue, which is in your connective ligaments and tendons. And then also bone is going to be a different makeup as well. So, really finding out from your dietician how you are going to tailor it towards those specific tissues.
I would say the big thing that I would suggest athletes to focus on when they are going through injuries, is their diet quality. There’s no magical supplement that’s going to speed up the healing process. It really is going to come back to having that good diet quality. So, for example, if you’re thinking of something like bone tissue, if you’ve had a fracture, obviously, that’s quite a long recovery period. If you’re consuming things like high protein, dairy, or yogurts, for example, you’re going to be hitting multiple goals.
You’re going to be getting that protein to help prevent losses to muscle tissue. And then also your minerals that are going to help support bone repair as well. So, obviously, your protein-based foods rather than supplements are going to be really important. Because you’re going to be getting different essential amino acids and, as I said, minerals, and things like that.
And then things like vitamin C. So, something as simple as making sure you’re keeping your fruit intake up. As I said, you have different tissues. Collagen is a predominant tissue within your body. Vitamin C is involved in collagen synthesis. So, something as simple as picking up your fruit intake is actually going to support whatever tissue type it is that you’re trying to heal.
And then things like vitamin A and Zink are found in seafood and meats and then vegetables as well. So, again, really just making sure you’re focusing on eating with purpose and making sure that everything you’re eating is really nutrient-dense as well.
Jack: I love that. So, it’s tailored to the type of injury, just like the rest of the rehab process. It makes a lot of sense. What about for athletes that are vegetarian or vegan-based, how does that differ, if, let’s say, they’ve had a bone fracture?
Rebekah: That’s where it can become a bit tricky, kind of putting the puzzle pieces together for the dietician. From our standpoint, it would be trying to get those really high calcium foods or calcium-fortified foods. If we can’t get it through dietary sources, then that’s when we might look to go to supplemental sources.
Jack: Okay. And what would be some good supplements for them to look out for?
Rebekah: If it was vegan, for example, and it was a fracture, something like calcium. And then we’d also want to look at their current nutritional status as well. So, do they have any deficiencies? Is vitamin D an issue? Because, obviously, with bone healing, vitamin D is involved in that. So, we want to make sure that there’re no current deficiencies, so we’re not going to impair healing through that.
Jack: Okay. Amazing. And then in your experience working with athletes and specifically footballers, what are some common mistakes that you’ve seen, when they’re in rehabilitation?
Rebekah: The key one would be that being really restrictive with their energy. I think there’s a bit of a concept and fear around fat mass and skin folds and those kinds of things. Often athletes will think, ‘Okay, I’m injured, I’m not exercising as much. And I need to be really restrictive with my intake.’
But, obviously, we’re trying to heal the body. We need to provide it with everything that it needs. So, being too restrictive is going to potentially interfere with that. Making sure that that is not the mindset going into it, and again, seeing what we can actually do with our nutrition to support our body’s healing is one of them.
Another mistake might be being too aggressive with anti-inflammatory supplements and things like that. So, obviously, it’s got a bit of a bad breath, that, as I said, is involved in the healing process. We don’t want to blunt that too much in the initial phases.
And then the third one would be maintaining your protein intake. So, again, just kind of a thought process that, ‘Oh, I’m injured, so I don’t need to eat as much.’ But that’s one of those really key things that’s going to help you maintain that muscle, which is going to help you return to training and then, eventually, return to play quicker.
Jack: And I’ll throw you a curveball, just because you’re on form. COVID. We’ll throw that in as a rehabilitation process. How should athletes be approaching their nutrition, if they’re just coming out of isolation? They’ve done their seven days of isolation and they are returning back to training. What would be some important things to focus on from a nutrition perspective?
Rebekah: Ideally, or hopefully, they’ve got a really good dietician that supported them through that process. They’re trying to attenuate any of those negative impacts, such as reduced training, trying to help with the immune system. Actually, I recently did a post on that. So, things that are going to help with your immunities, like again, that diet quality, vitamin C, vitamin A, things like that as well.
The key theme the whole way along is maintaining that good diet quality and not losing track of those goals and just making sure that you, obviously, in isolation it’s a bit more difficult, but having good conversations with your nutrition support. Your dietician seeing what you need to help support your immune system and also if there’s a reduced activity or you’re worried about losses to muscle mass and things like that.
Jack: Fantastic. Thank you. Thank you for sharing all your knowledge with us, Rebekah. For those that want to find out more information from yourself, where’s the best place to get in touch?
Rebekah: Probably my Instagram. That’s just @dr_bek_alcock.
Jack: We’ll check them all in the show notes as well. If you haven’t written them down, head to the show notes for everyone’s socials.
Thank you again, Bek, for jumping on and helping us out in terms of those going through rehabilitation. It probably is the hardest time for an athlete, being in rehab. So, to have support from nutrition perspective and, no doubt, if you can accelerate your rehab by a few days, or you just feel better on a game day from performance perspective, then it’s a great competitive edge to get. So, thank you.
Rebekah: You’re welcome.
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