Dr. Nancy Scheinost
Rheumatology of Brazos Valley
I ran across this article on the Thorne Research website and thought it would be helpful to my patients and readers.
Ah…summer! The summer months offer warmer temperatures, longer daylight hours, and more opportunities for outdoor training and exercise. But bummer — this time of year also brings increased risk of strains, sprains, fractures, and heat-related injuries.
Research indicates there are psychological and physiological factors associated with injury prevention and recovery. Understanding these factors and remembering the basics will lead to better outcomes with your clients.
1. Fatigue and Stress 101
Stress and fatigue are both directly related to the prevention of injury and recovery from injury. It’s often a chicken-and-egg syndrome where one begets the other.
Managing stress before injury: Overtraining syndrome. Overtraining syndrome can occur with every level of athlete. Overtraining syndrome affects the athlete mentally and physically and when not addressed can lead to serious injury.
Overtraining syndrome can produce mood disturbances that include depression, anxiety, anger, and irritability. Overtraining can also result in overall fatigue, decreased energy, changes in sleep patterns, and changes in appetite.
Managing stress after injury. Stress management is another key area for successful rehabilitation after injury. Stress management is a crucial component to recovery, especially in cases where the athlete is experiencing distress during the rehabilitation process.
Current research indicates that athletes who undergo stress management, including relaxation and imagery sessions, have less anxiety and better rehab outcomes. In addition, athletes who participate in stress management techniques have higher levels of overall positive mood and perceived readiness to return to their sport.
2. Proper Nutrition Support 101
Adequate hydration. Hydration for every athlete in every environment is obviously a no-brainer; this is especially true in warmer climates. Heat-related injuries are most often due to dehydration and electrolyte imbalance. Sports drinks loaded with sugar and energy drinks that contain caffeine increase the risk of dehydration. Adequate and proper ratios of sodium, potassium, calcium, and magnesium are essential to staying hydrated.
Dietary protein. Muscle atrophy usually occurs with conditions such as sarcopenia, severe burns, and cachexia. But muscle atrophy is also common in the injured athlete who is immobilized and inactive. During injury and immobilization negative protein balance can occur. Protein balance is the ratio of muscle protein breakdown and the rate of muscle protein synthesis. When injury and immobilization occurs the injured area experiences decreased myofibrillar protein synthesis, which results in atrophy. According to Leech and Andrew, mitigating atrophy requires eating 20-25 grams of highly biological protein at each meal and distributing protein intake throughout the day.
Essential Fatty Acids. In cases of serious injury where immobilization is prolonged, anabolic resistance can occur, and protein consumption alone is not enough. Blown ACL’s, dislocations, and severe fractures can result in anabolic resistance, the response resistance of the myofibriliar proteins to amino acids.
Overcoming anabolic resistance can be challenging; however, preliminary research indicates that omega-3 fatty acids can mitigate muscle loss due to injury and immobilization. Daily doses of 1.86 grams of EPA and 1.50 grams of DHA have been shown to increase muscle protein anabolic response in healthy young and middle-aged adults. Although the exact biochemistry and mechanism of action remain unknown, theoretically these results could be the result of the known anti-inflammatory benefits of essential fatty acids.
Click here to find out more about approved nutritional supplements to support performance and recovery.
Written by Melanie Sims Henning, MS, PsyD, for Thorne Research
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 Walsh A. The relaxation response: A strategy to address stress. International Journal of Athletic Therapy & Training 2011:16(2);20-23.
 Pocecco E, Ruedl G, Stankovic N, et al. Injuries in judo: a systematic literature review including suggestions for prevention. British Journal of Sports Medicine 2013:47(18);1139-1143.
 Leech J, Andrew K. The emerging prominence of nutrition in injury management. Sport Health 2013:31(1);57-61.
Dr. Nancy Scheinost,
Rheumatology of Brazos Valley