Science Update

Recent Reviews Investigate Certain Nutrients for Rehabilitation of Athletes with Musculoskeletal Injuries

An estimated 3 to 5 million sports injuries occur annually and approximately 70% or more of them occur during competitive events (as opposed to during training sessions). Research indicates that sporting success has been linked with a lower frequency of sporting injuries. In a study analyzing the rate of injury to soccer players when comparing game frequency of weekly vs twice a week, more than 75% of injuries were found to be caused by overuse. Research shows that all levels of sports injuries to soft tissue (muscle, tendons, ligaments) are increasingly common, with up to 80% of sporting injuries affecting the musculoskeletal system.

A recently published systematic review by Giraldo-Vallejo and colleagues explored the potential for certain nutrients to help support the body’s response to musculoskeletal sporting injuries. Tissue repair and remodeling during the rehabilitation process after an injury may involve inflammation, the immune response, and an increased need to support antioxidative status.

Vitamin D has been shown to help support both the innate and adaptive immune response. Vitamin D has also been shown to help modulate the secretion of interleukin (IL)-10 and the production of certain pro-inflammatory cytokines in monocytes and macrophages through vitamin D receptor signaling. A narrative review reported that compared to non-injured athletes, those who had musculoskeletal injuries also had significantly lower vitamin D status. The authors also suggested that a decrease in injury recurrence may be linked to the mitigation of lowered vitamin D status. However, more research is needed before clinical conclusions can be made.

Giraldo-Vallejo and colleagues have reported on a narrative review/qualitative analysis that included more than 300 references regarding recovery from injuries in an elite sport setting. The authors report that nutritional considerations regarding the increased metabolic demand during wound recovery and tissue remodeling include addressing vitamin and mineral deficiencies, particularly in vitamin D, calcium, and zinc, along with ensuring adequate energy intake, particularly leucine-rich protein. Leucine is a branched-chain amino acid metabolized by the mitochondria in skeletal muscle.

Another publication included in this systematic review had more than 150 references regarding nutritional strategies for sports-related tendon injury. The authors of this review described the importance of nutrients such as omega-3 fatty acids, collagen, vitamin C, and amino acids to help support the inflammatory response, structural integrity, and a normal response to pain. Certain research indicates that collagen peptides may help some aspects of joint functionality.

More research is needed, and evidence suggests that certain nutrients, including collagen, vitamin D, and omega-3 fish oils, may help support the body’s response to athletic injuries. They may also help support a normal inflammatory response, antioxidative status, and immune health.   

By Dr. C Ambrose, ND, MAT