It is reasonably well understood that diet and the associated nutritional content of our diets has a significant influence on health outcomes. Eating healthy has been associated with improvements in cardiovascular health, immune function, metabolic disease (such as diabetes) and risk for developing cancer. But does nutrition have any effect on the development or prevention of injuries?
Well this is the question that a team of international researchers looked to determine. They wanted to know from the current body of knowledge is there evidence to support certain types of nutritional or supplemental inputs to reduce the risk of injury in the sport of track and field.
With this in mind we should highlight that track and field tends to be divided across injuries that develop in the speed and power end of the events, compared with the endurance events. As you can imagine speed/power events tend to develop acute muscle strain injuries (up to 40% of all in competition injuries are muscle strains), and the outstanding work by Manuel Alonso across multiple world championships demonstrates that hamstring strain injuries (approx 17%) are by far the most common type of injury in this group. This explosive end of the spectrum also tends to develop tendon injuries such as jumpers knee (patella tendon) and achilles tendon pain.
Conversely middle and long distance athletes tend to develop both overuse injuries of tendons but also injuries that are associated with rates of bone metabolism, that is bone stress injuries. Within this bone stress injury group, females represent much higher risk of developing these injuries (relative risk is 3 times higher than males) and tends be associated with symptoms of REDs (relative Energy Deficiency Syndrome). REDs is typically associated with either a reduction in calorie consumption (undernourished) or higher activity levels demonstrating greater greater calorie expenditure than consumption, despite high caloric intake. Many of you may be familiar with discussion on some of the symptoms that appear to affect females at higher rates, including amenorrhea and increased incidence of bone stress injuries.
So what did they find, can injuries be prevented in track and field?
The first and most important factor to note is that there is a significant lack of controlled interventional trials. This means that although there are some associations with injury reduction in this area, there is just not a significant body of studies to be highly definite. What we do seem to understand is that there are associations between low energy availability and the development of bone injuries. This highlights that times of low energy availability should be limited throughout the training and competition year, even in events whereby managing lean body mass is key. The recommendation is that periods in which body mass and particularly fat mass loss is targeted should be limited to short periods and cycled prior to major competitions rather than spending significant periods of the competition season under low energy availability. With this in mind there is suggestion that working with a nutritional professional to manage the input of key micronutrients in these periods is crucial.
Which micronutrients count?
In bone stress injury management, monitoring and implementation of calcium, and vitamin D appear to be key along with co-factors such as Vitamin K and Copper. For injuries related to muscle or tendon there is a growing body of evidence that both adequate energy and particularly protein intake is key to maintain muscle mass during periods of inactivity following injury, despite no strong evidence at this time that increased protein intake reduces injury rates or speeds up recovery from muscle strain injuries. Further to this another key area that appears to be gaining momentum is the consumption of foods or supplements high in collagen content. And an interesting aside to this is that collagen production within the body, which is needed for healthy connective tissue, especially tendon function is enhanced by the intake of Vitamin C particular when paired with the collagen intake.
So can we prevent injuries in track and field with nutrition?
In short there are definite benefits to monitoring a healthy diet that provides adequate energy intake, protein (up to or above 2g/kg has been seen to be safe) and micro-nutrient factors such as Vitamin D, Vitamin C, Calcium, Copper and Collagen. Many of these can be consumed through a food first approach, without the need for supplementation, however if athletes do choose to use supplements, a great way to start is to work with a dietetics expert along with their other performance staff to test, monitor and implement strategies that are specific to the individual needs.