Injury Recovery and Soft Tissue Support

May 7, 2018 | Linda J. Dobberstein, Chiropractor, Board Certified in Clinical Nutrition

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Injury Recovery and Soft Tissue Support
Athletic injuries, falls, trauma, and overdoing it with chores and work can often lead to various soft tissue injuries. Soft tissues injuries affect tendons, ligaments, and muscles. It might be the low back or a shoulder that gets stiff or sore. Maybe its repetitive ankle sprains. When these injuries happen, often the thought is to just take a break from the activity and let the injury get better on its own. Symptoms might subside, but many will find it turns into a nagging problem. Pain medications might make it feel better for a short time, but it keeps coming back.

Smart nutritional support during an acute injury is like starting a savings account early in life. The dividends pay off the more proactive you are earlier in the game rather than starting late. Nutritional support just after an injury can make a substantial impact on recovery and getting back to work or back in the game.

When an injury of any type of occurs, there are three phases of healthy recovery. Phase I is the acute phase and occurs within the first 3-5 days after the injury. The body is in a protective mode during the acute injury with lots of inflammatory chemicals released.

Phase II is the subacute phase and usually takes 4-8 weeks for the body to repair and remodel damaged tissue. Less inflammation is present than the acute phase and the body is working hard to repair damaged tissue. These are general time patterns seen with common injuries.

Phase III is considered wellness care if inflammation and tissue repair has been managed well and healed. Tissues may still be microscopically remodeling, but tissue integrity and function has been restored.

If the injury is not fully repaired, for example an athlete running on a partially healed sprained ankle, then the body goes into Chronic Phase. Chronic phase means that the initial injury has not fully healed and scar tissue and adhesions build up and connective tissue become fibrotic and inflexible. Spasm, weakness, or tightness in tissues occurs. This phase can last for months or years with the eventual outcome of arthritis or degenerative joint disease.

Lack of pain doesn’t always mean that the injury has fully healed. Signs of incomplete healing may be felt as loss of strength, impaired range of motion, stiffness, soreness, changes in balance or agility, or simply a nagging ache that flares up from time to time.

The goal is to intercede and support the body with adequate nutrition during the acute and subacute phases of care. If the body fails to have the right nutrients, then incomplete and delayed healing occurs, i.e. Chronic Phase.

Tissue injuries cause significant amounts of immune-inflammatory compounds to be released. This is what causes the swelling, redness, and pain. Several different immune-inflammatory chemicals are released with tissue injury, such as matrix metalloproteinases (MMPs), interleukins (IL-1, IL-2, IL-4, IL-6), other enzymes (Cox-1, Cox-2, 5-Lox) and prostaglandins (PGE1, PGE2, PGE3).

Some amounts of these compounds are needed to help the body heal as they are involved with tissue healing and remodeling. However, high levels and chronic output of these compounds lead to chronic pain, tissue degradation or breakdown within cartilage cells, tendons, ligaments, and bone. Repair deficits, chronic inflammation, and ultimately degeneration occurs. The goal is to help the body complete the natural healing process and tissue remodeling so it doesn’t go into degeneration.

Natural Support Options

Several nutrients help the body modulate these immune-inflammatory compounds with soft tissue injury and athletic recovery. These include bromelain, papain, boswellia, curcumin, ginger, grape seed extract, omega-3 fish oils EPA/DHA, hyaluronic acid, MSM sulfur, glucosamine, chondroitin, B vitamins, vitamin D, minerals and proteins. Different stages of healing and types of injuries require intake of diverse nutrients.

Bromelain and Papain

Proteolytic enzymes are perhaps some of the most critical nutrients at the time of acute injury and tissue trauma. They also provide benefit during later stages of recovery. Bromelain and papain are proteolytic enzymes that eat up cellular debris from injured, worn-out tissue and assist the body with pain management and swelling. Bromelain and papain help the body eat up damaged proteins. Any time a tissue tears, there is bleeding, seen as bruising. These enzymes help break down these clots and clean up the bruising caused by the injury.

Bromelain and papain support healthy prostaglandin function driving it towards recovery and completion of the inflammatory cycle, unlike common pain-relieving medications. Medications like Ibuprofen, Advil, Motrin, and other NSAIDs block various parts of the prostaglandin pathways like a stoplight. Pain relief is felt, but when this pathway is blocked the natural completion of repair process is thwarted.

Bromelain and papain are great choices and work well with other compounds that help natural prostaglandins reduction. Other necessary nutrients for prostaglandin inflammation management include vitamin B2, B3, B5, B6, biotin, vitamin C, zinc, magnesium, carnitine, omega-3 EPA, DHA, and omega-6 GLA.

Plant Based Support

Plant based nutrition like boswellia, ginger, curcumin, and other herbal compounds are known to help the body manage inflammatory chemicals. Grape seed extract excels at supporting skin collagen and is often helpful for inflammation management as it helps support the skin post-injury in ways we may not realize. Many times, a tissue injury like a badly sprained ankle affects the skin due to the swelling and stretching of the skin. The joint swelling around the joint puts significant stretch and strain on the skin’s elasticity. Grape seed extract helps support collagen cross-links and tissue strength, especially in the skinCurcumin also helps tendon repair.

Healthy Essential Oils

Fish oils (EPA and DHA) and the good omega-6 oil GLA (black currant seed, borage oil, cumin) are also required for healthy prostaglandin pathway function and completion of the inflammatory cycle. Fish oils are also needed inside cartilage cells. Too much of the wrong types of oils in the cartilage cells sets the stage for cartilage tissue breakdown. Likewise, if there is too much omega-6 vegetable oil in the diet, then the prostaglandin pathways are diverted to a pro-inflammatory path rather than omega-3 anti-inflammatory path.

Hyaluronic Acid

Hyaluronic acid is versatile nutrient as it helps tissues repair and helps the production of synovial fluid which essential to keeping cartilage cells hydrated. Recent research published April 2018 in the journal Connective Tissue Research shows that hyaluronic acid “promoted human meniscus regeneration” by blocking cell death while helping to bring new cartilage cells into the area and grow. Cell death caused by prostaglandin PGE2 was suppressed by hyaluronic acid. This cellular study showed that torn knee cartilage was repaired with hyaluronic acid which is crucial to prevent the injury from progressing into osteoarthritis. Hyaluronic acid also helps tendon repair. Wellness Resources uses the natural low molecular weight hyaluronic acid (HA) rather than then synthetic sodium hyaluronate. Low molecular weight has better absorption due to its smaller more natural form and it does it without added the addition of salt attached.

Vitamins, Minerals, and Protein

Compounds like proteolytic enzymes, hyaluronic acid and curcumin often get the spotlight in tissue support. However, we must remember some basic support with minerals and vitamins for tissue healing. These nutrients are essential to acute and subacute care.

B vitamins are essential for nerves, muscles, mitochondria. Every organ in the body needs B vitamins to function and is involved with inflammation management. Vitamin C is involved connective tissue strength and is needed as an antioxidant.

Collagen supplements also help support connective tissue repair and rejuvenation. Vitamin C and grape seed extract also support blood vessels that are stretched or torn with injuries which cause bruising. Vitamin D is a powerful vitamin and hormone needed by every single cell in the body for repair and inflammation management, especially bone injuries

Other key nutrients to help with acute and subacute injured tissues rebuild and repair include calcium, magnesium, zinc, iron, copper, selenium, manganese, silica, and MSM sulfur. Mild insufficiencies of these nutrients, especially iron and zinc can impair healing responses and lead to repetitive injuries.

Athletes who seem prone to injury are often lacking in one or more of these nutrients. Identification of nutritional deficits and appropriate supplementation can often help keep athletes healthier with shorter recovery times. Dietary protein or protein supplements like whey protein especially help muscle tissue recover from trauma and overuse.

How much nutritional support you need depends on many different factors. The goal is to use enough support to manage pain, swelling, and wear-and-tear. Significant injuries and acute recovery require higher dose intake than subacute and minor injuries. Acute needs may require repeated dosages every two to three hours to help tissue recovery, whereas subacute needs may require dosing only two to three times per day.

If the old injury has progressed to degenerative joint disease or osteoarthritis, nutrition is still helpful and warranted. Glucosamine, ginger, boswellia serrata, and hyaluronic acid are popular choices. Several resources are available on our website:

Mitochondria and Osteoarthritis: An Exciting New Frontier

Osteoarthritis is a Metabolic Disease Related to Leptin

High Levels of Omega 6 Fatty Acids Found in Bones of Osteoarthritis Patients Worsens Joint Breakdown 

Vitamin K, Leptin, AGEs, and Arthritis 

Advances Solutions for Osteoarthritis 

New Research Shows PQQ Benefits Arthritis, Brain Inflammation and Diabetes 

Steroids and Local Anesthetics Kill Cartilage Cells and Mitochondria

Rotator Cuff Disorders Linked to Antibiotic Use and Steroid Shots

Tylenol Causes Liver Damage and Is Ineffective for Low Back and Neck Pain

Fisetin Benefits are Stellar and Far-Reaching 

Boswellia – Helping Joints, Killing Germs & Even Boosting Your Brain 

Nutrients for Joints & Cartilage 

Young and old athletes, individuals injured on the job or in motor vehicle collisions, surgical recovery, falls, or any other manner of injury can use this information and nutritional support to help recovery. We have heard numerous stories of individuals surprising their physicians at how well and quick they recover compared to others. Our body needs many different types of nutrients for function. Aggressive support can often help the body heal in remarkable time.

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