FALLS CHURCH, Va. –
Musculoskeletal injuries, such as strains, sprains, fractures, and overuse injuries, are leading causes of limited duty or training restrictions among military personnel. Recovery from these injuries is multifaceted, requiring medical care, modified activity, rest, and an element that is often overlooked—nutrition.
According to Defense Health Agency–Public Health, more than 95% of active duty military personnel’s injuries are musculoskeletal and are the leading reason for military medical visits.
The most common type of musculoskeletal injury found in military health care records is cumulative microtrauma injury, often referred to as overuse injuries, said U.S. Army Maj. Shay Lopez, the Injury Prevention branch chief at DHA-PH. “It is important for service members to allow injuries to heal completely before returning to duty,” said Lopez. “If an injury is not healed properly, there is an increased risk for another injury. Prior injury is one of strongest predictors for future injury.”
Developing an intentional recovery plan is a key step to returning to full duty. “Service members need to modify their activities and follow an intentional recovery plan prior to returning to their full duties,” said Lopez.
An important element of the recovery plan is nutritional intervention, said Jennifer Meeks, DHA-PH nutritionist. “Nutritional interventions will help the injury recovery process by supporting optimal healing,” said Meeks. “The faster a service member or athlete recovers from injury, the quicker they can return to duty or the training field. Optimal nutrition should be the focus to get back to preinjury performance after a musculoskeletal injury.”
Proactive nutrition before an injury focuses on performance nutrition, disease prevention, and immune system enhancement, said Meeks. Reactive nutrition is specific to medical nutrition therapy after injury to control inflammation, rebuild injured tissue, minimize muscle loss, and prevent unwanted weight gain. “Even if your preinjury eating habits weren’t perfect, a focus on making more healthful choices during your recovery can have tremendous benefits,” said Meeks.
Here are some tips to consider.
1. Energy needs during recovery: During your recovery time, your activity levels will be lower than usual. Even if you're not as active, you still need enough calories to help your body heal from wounds and injuries. Not getting enough food can delay your healing, drain your energy, and lead to unwanted loss of weight or muscle. To learn how many calories you need, experts can measure your resting metabolism or estimate calorie needs using special formulas. Your body needs fuel to heal, but you may not need as many calories as you normally would. If you need to cut back on calories, focus on reducing carbohydrates and fats, but make sure you still eat enough protein to help your body repair itself. You might need to adjust what and how much you eat over time to avoid gaining weight. Talking to a sports dietitian can help you figure out the right number of calories and create a personalized eating plan that includes the right balance of protein, fat, and carbs.
2. Protein: The cornerstone of healing: There are numerous academic studies highlighting the importance of protein for muscle repair, immune defense, and maintaining lean mass. The Joint Service regulation, Nutrition and Menu Standards for Human Performance Optimization, recommends 0.8 to 1.6 grams of protein per kilogram (or 0.36 to 0.73 grams of protein per pound of body weight) of body weight for normal activity. This equates to a protein range of 68 to 136 grams per day for men and 55 to 110 grams per day for women.
How much protein do you need when injured?
When you're injured, it's recommended to eat more protein–about 1.5 to 2 grams of protein for every kilogram you weigh each day. The exact amount varies from person to person and depends on your activity level. Studies show that eating an increased amount of protein helps you recover faster. For example, someone who weighs 180 pounds (about 81 kilograms) would need around 122–163 grams of protein per day.
It's best to spread your protein intake throughout the day, eating some at breakfast, lunch, dinner, and in snacks. This helps your muscles rebuild. For a 180-pound person, aim for about 30 grams of protein at each meal and 15–20 grams in snacks. For example, 30 grams of protein equals 1.5 cups of Greek yogurt, 1 cup of cottage cheese, 5 large eggs, 5 ounces of salmon, a scoop of third-party certified protein powder in a smoothie, 1.5 cups of lentils, or 4 ounces of chicken breast. Some meal ideas might be a Greek yogurt parfait with berries, a bean and veggie burrito, egg muffin cups with chopped veggies, or salmon with avocado toast. To boost your protein intake, try some of these easy tips:
- Start your day with meals featuring eggs, yogurt, or cottage cheese to kickstart your protein intake early.
- Choose high-protein snacks to keep you full between meals: Options include raw nuts, yogurt, boiled eggs, or cheese.
- Add legumes to your meals: Whether it's a soup, stew, or salad, throwing in beans, lentils, or chickpeas can significantly increase the protein content.
- Swap out traditional carbs for high-protein alternatives: Replace rice or pasta with options like quinoa or legumes to add more protein to your plate.
- Sprinkle on seeds or nuts: Toppings like chia seeds, flaxseeds, or raw nuts not only enhance flavor but also provide a solid protein boost along with healthy fats.
It's also a good idea to have 15–30 grams of protein after rehab or therapy to help your muscles recover. Good options include chocolate milk, a turkey sandwich on whole grain bread, or a recovery shake.
3. Eat colorful fruits & veggies to help heal: Eating fruits and vegetables packed with antioxidants can help reduce swelling, control inflammation, and speed up your recovery. Great choices include goji berries, blueberries, tart cherries, dark chocolate, pecans, artichokes, kidney beans, cranberries, blackberries, and green tea. Pineapple, turmeric, garlic, and ginger are also good sources.
Vitamin C, zinc, calcium, and vitamin D are key nutrients for healing. While all nutrients are important, vitamin C and zinc are superstars for healing. Vitamin C helps your body make collagen, a protein needed to repair tendons, ligaments, and surgical wounds. You can find vitamin C in citrus fruits, strawberries, kiwi, baked potatoes, broccoli, and bell peppers. Zinc helps with cell growth and wound healing. Good sources of zinc include meat, fish, poultry, dairy, whole grains, fortified bread and cereals, beans, peas, nuts, and seeds.
Calcium and vitamin D are essential for strong bones. You can get vitamin D from milk, yogurt, fortified soy milk, dark leafy greens, sunlight, or supplements. It's a good idea to check your vitamin D levels after an injury to see if you need to increase your intake.
4. Fats: friend, not foe: While some fats can contribute to inflammation, healthy fats are critical during recovery. Omega-3 fatty acids may increase muscle repairs and prevent muscle loss during a time of recovery.
- Prioritize omega-3 fatty acids in your diet for their anti-inflammatory properties. Foods high in omega-3 fatty acids include salmon, walnuts, flaxseed, chia, olive oil, avocados, fish, nuts, and seeds.
- Limit excessive omega-6 fats (found in fried or processed foods) that may worsen inflammation.
5. Skip the alcohol and stay hydrated: While you’re recovering from an injury, it's best to avoid alcohol because it can slow down the healing process. Alcohol can interfere with muscle repair, wound healing, and can even lead to muscle loss.
Staying hydrated is also crucial for recovery. Dehydration can hinder healing, reduce the delivery of nutrients to your body, and make you feel more tired. Men should aim for 96–144 ounces of water per day (12–18 cups), and women should aim for 64–96 ounces (8–12 cups). Keep in mind that these amounts can vary depending on the environment, your activity level, and other factors. To make hydration more enjoyable, try adding fruit to create infused water, or opt for flavored sparkling water.
6. Supplements: use with caution: Some supplements may support healing. Consult with a registered dietitian and check out the resources on the Operation Supplement Safety webpage to find more information. Here are two supplements that may be helpful to consider:
- Creatine monohydrate: May help preserve muscle mass during immobilization.
- Vitamin D: Supplement if levels are low, especially in indoor or northern duty stations.
Only use supplements certified by third-party testing programs. Look for these seals: BSCG Certified Drug Free, Informed Sport, NSF Certified Sport, and USP Verified.
Getting back on your feet after a musculoskeletal injury isn't just about rest and rehab—it's also about eating right. Service members need to focus on their nutrition to shorten recovery time, stay ready for duty, and get back to full strength.
Nutrition is key to healing and rehabilitation. Following practical eating guidelines can help reduce problems after surgery and minimize muscle loss during recovery. Whether you're recovering from a stress fracture or surgery, what you eat can help you heal faster and stronger.
For personalized advice, reach out to a registered dietitian at your military hospital or clinic, or your local Armed Forces Wellness Center for assistance.
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