Underfueling — A Bigger Problem Than You Think
Before looking at specific nutrients, it's worth addressing the most fundamental issue: not eating enough.
Underfueling — consuming insufficient calories for your activity level — is a significant risk factor for both bone and tendon injuries. When energy availability is chronically low, the body prioritises essential functions over tissue maintenance and repair. Bones become more susceptible to stress injuries, tendons lose their tolerance to load, and recovery from training slows significantly.
This is particularly relevant for active people who are consciously restricting calories for body composition goals while maintaining a high training load. The combination of high output and low intake creates a physiological environment that is genuinely hostile to tissue health.
The counterintuitive truth about injury and calories
One of the most common mistakes after an injury is reducing food intake because activity has been reduced. This seems logical — less movement, less fuel needed — but the research tells a different story.
Tissue repair is metabolically demanding. Depending on the nature and severity of the injury, the body may require up to 20% more calories above normal maintenance levels to support the healing process. Cutting intake at exactly the time the body needs more resources to repair is a mistake that significantly slows recovery.
The Role of Macronutrients
Protein is the primary building block of muscle, tendon, ligament and bone. It plays a central role in tissue synthesis and repair — making adequate intake essential both for preventing injury and recovering from it.
For active individuals, research supports a protein intake of around 1.4 to 2.0 grams per kilogram of body weight per day. During injury recovery, aiming toward the higher end of this range helps minimise muscle loss and support tissue healing.
Equally important is how protein is distributed through the day. Consuming protein evenly across three to four meals is significantly more effective for muscle protein synthesis than consuming the same total amount in one or two large servings. Spreading intake — a protein source at breakfast, lunch, dinner and a post-training snack — maximises the anabolic stimulus for tissue repair.
Carbohydrates are the primary fuel source for moderate to high intensity exercise. Muscle glycogen — the stored form of carbohydrate in muscle — is depleted during training and needs to be replenished for subsequent sessions.
Chronic glycogen depletion is associated with fatigue, reduced performance and increased injury risk. When the muscles are running low on fuel, movement quality deteriorates and protective reflexes slow — a combination that increases vulnerability to both acute and overuse injuries.
Beyond energy, carbohydrates influence the central nervous system through their effect on neurotransmitter synthesis. Inadequate carbohydrate intake can impair sleep quality, cognitive function and mood — all of which affect recovery capacity and injury risk.
For most active people, carbohydrates should make up a significant proportion of daily intake, with timing around training prioritised for performance and recovery.
- Fats — particularly the type
Total fat intake is less important than the quality and type of fats consumed. This is particularly relevant for managing inflammation — a key component of both acute injury and chronic pain.
Highly processed foods — seed oils, fast food, refined snacks — promote a pro-inflammatory environment in the body. For someone with a recent injury or chronic pain, a diet high in these foods can contribute to prolonged inflammation and increased pain.
Conversely, anti-inflammatory fats and foods can help modulate the inflammatory response and support recovery. Foods with good evidence for anti-inflammatory effects include:
- Olive oil and avocado — rich in monounsaturated fats and polyphenols
- Oily fish (salmon, sardines, mackerel) — high in omega-3 fatty acids
- Flaxseed, chia seeds and walnuts — plant-based omega-3 sources
- Nuts and seeds generally — mixed anti-inflammatory compounds
- Turmeric, ginger and garlic — well-studied anti-inflammatory properties
- Pineapple — contains bromelain, which has evidence for reducing inflammation and bruising
This doesn't mean avoiding all processed food forever — but being mindful of the inflammatory load of your diet during periods of injury or flare-up is a practical and evidence-supported strategy.
The Role of Micronutrients
Micronutrients — vitamins and minerals obtained from whole foods and supplements — play specific and important roles in tissue repair and injury prevention. Key ones to be aware of:
- Vitamin C — essential for collagen synthesis, which is critical for the repair of tendons, ligaments and cartilage. Also supports immune function and acts as an antioxidant during the inflammatory phase of healing. Found in citrus, kiwi, capsicum and leafy greens.
- Vitamin A — supports the early inflammatory phase of healing and immune function. Found in liver, eggs, dairy and orange and yellow vegetables.
- Zinc — involved in over 300 enzymatic reactions in the body, including those governing tissue repair and immune function. Found in meat, shellfish, legumes and seeds.
- Calcium — the primary mineral in bone. Adequate calcium intake is essential for bone health and fracture healing. Found in dairy products, leafy greens, almonds and fortified foods.
- Iron — essential for haemoglobin synthesis and oxygen delivery to healing tissues. Iron deficiency is common in active women and can significantly impair recovery. Found in red meat, legumes, leafy greens and fortified cereals.
- Copper — works with Vitamin C to form elastin and supports red blood cell formation. Found in shellfish, nuts, seeds and wholegrains.
- Vitamin D — increasingly recognised for its role in musculoskeletal health, immune function and muscle strength. Deficiency is common in Australia despite our sun exposure. Worth checking with your GP if you haven't had your levels tested.
Overall Energy Availability
Underpinning all of the above is a simple principle — you need to eat enough. Chronic underfueling slows every bodily process, impairs tissue maintenance, compromises immune function and reduces the body's ability to adapt to training stress.
This doesn't mean eating without awareness — it means ensuring that your calorie intake is genuinely sufficient to support your activity level, training load and recovery demands. For most active people, this is more food than they think — particularly on training days and during periods of injury recovery.
A Note on Scope
Nutrition for injury prevention and recovery is a topic that sits at the intersection of physiotherapy and dietetics. At Active Balance, we can discuss the general principles outlined in this post and help you understand how nutrition might be affecting your recovery.
For personalised dietary advice — particularly if you have complex health needs, a significant injury, or are an athlete with specific performance goals — we'd recommend working with an accredited practising dietitian (APD). We're happy to refer you to the right person if that's what you need.
If you're dealing with an injury that isn't progressing as expected, or want to understand what else you can do to support your recovery, book online or call us on (08) 7123 4148.
