Episode 233: Breaking the Injury Cycle (Part 2) - The Role of Nutrition
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Scott Tindal - Co-Founder of FuelIn and Performance Nutrition Coach
In part two of our three-part series on injury prevention and management, Matt Welcomes to the podcast leading performance nutritionist Scott Tindal of FuelIn for a discussion on the role of nutrition in injury prevention, mitigation, and recovery.
Together Matt and Scott frame the topic of injury through the lens of under-fueling or improper fueling and its impact on soft tissue and bone health.
The conversation covers:
Low Energy Availability (LEA), Relative Energy Deficiency in Sport (REDS), Over Training Syndrome.
Chronic vs. Acute LEA
(7:06) "What I think tends to happen is athletes see the results of...taking in limited amounts of fuel. They see the body composition improve, they see the weight drop, they see maybe some improvement in these performance parameters, maybe because of reduced weight, and then they get oh, maybe if I lose more, maybe if I go further. Maybe if I drop more fat, maybe if I don't eat as much here, I can continue to improve, and then you start to see those changes, you know. Not just from a physical standpoint, but also a mental standpoint as well. And that's when I think if we're talking about soft tissue injuries and bone injuries, that's when it starts to occur."
Caloric intake and the balanced consumption of carbs, protein, and fat
Proper hydration
Navigating dietary restrictions
(30:24) "I fully respect the decision to go vegan or vegetarian. And I think you just need to be aware of the implications of those diet types, especially when trying to perform high volume, high intensity, you know, lots of load training, I think it just needs to be -- you need to be aware of protein intake, carbohydrate intake, fat intake, and total caloric intake when doing that, along with all the micronutrient potential deficiencies that could exist with a poorly designed vegan or vegetarian diet."
Matt and Scott also discuss the most common nutritional mistakes athletes make that promote injury, and the practices that lead to bone resorption - the shrinkage or loss of bone.
Scott Tindal also explains what it means to “feed the injury” as well as the habits athletes should avoid during injury recovery.
(40:59) "When injury occurs, I think the most common mistake is that athletes will drop caloric intake. So they all say, sh**, I'm getting fat, because I can't move. But if we look at acute muscle damage...induced through exercise, we see an increase in resting metabolic rate. And that will occur for at least up to 72 hours. So if you get an injury, certainly don't restrict caloric intake for at least the first 72 hours. That would be something that we would absolutely stress that actually, if anything, increase your energy intake during those first three days post-injury, to allow the body to recover."
The purpose of this episode is to provide an understanding of the negative physiological challenges that occur due to improper nutrition and how to leverage nutrition in a well-balanced and well-rounded approach to injury prevention, care, and rehabilitation.
Episode Timestamps
0:00 - 02:39 Welcome and Episode Introduction
2:47 - The Meat and Potatoes - Episode 233: Breaking the Injury Cycle (Part 2) - The Role of Nutrition
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Full Transcript
Matt Dixon 00:00
I'm Matt Dixon, and welcome to the Purple Patch podcast. The mission of Purple Patch is to empower and educate every human being to reach their athletic potential. Through the lens of athletic potential, you reach your human potential. The purpose of this podcast is to help time-starved people everywhere integrate sport into life.
Matt Dixon 00:29
And welcome to the Purple Patch podcast. As ever, your host Matt Dixon, and today it is part two on our series of injury prevention. Now for today, we are welcoming back our very special guest Scott Tindal of FuelIn. Scott is our key partner when it comes to supporting athletes and executives through great life and sports performance. He is one of the world experts in nutrition and fueling. But today, I asked Scott to take a little bit of a detour and not just talk about performance enhancement for athletes through the vehicle of great fueling nutrition and hydration. But some of the key aspects and strategies to reduce risk or navigate through injuries. Now the focus today was mostly around tissue injury and bone injury, stress fracture, stress reactions and that component. And it proves that Scott is a world of knowledge when it comes to this. And so if you are someone that as consistently having to navigate little niggles or injuries, when you've been training for your 5k, or 10k, or marathon or Ironman or half Ironman, whatever it might be, injuries often feel like they are a part of life, and they don't have to be for an athlete. Now nutrition is never going to be a cure-all. It's not going to be THE fix. But many people fail to understand the role that proper fueling hydration and nutritional strategies can have in both risk reduction, as well as accelerating the return to the playing field when it comes to navigating injury. And so we have a great discussion, Scott and I. We're not going to do any Matt's News-ings today. We're not going to do Word of the Week, we're going to keep it very, very simple. And without further ado, I'm going to introduce Scott Tindal. Now if you'd like to find out more around Scott and his work with FuelIn, simply head to the FuelIn website. We're going to leave that into the show notes. But without further ado, I'm going to say it is time for The Meat and Potatoes. And I get to introduce Scott Tindal of FuelIn. It's a great episode. I hope you enjoy it.
Matt Dixon 02:47
Yes, guys, welcome to The Meat and Potatoes. And once again, we are on part two of our series of injury prevention and management. And today, the focus of the conversation is a deep dive into the connection between the role of nutrition when it comes to injury. And we welcome back to the show once again. Scott Tindal. Scott, welcome back, the man from FuelIn.
Scott Tindal 03:09
Thanks, Mattie. Thanks for having me. I'm looking forward to this one. Takes me back to my physiotherapy days and talking about injuries.
Matt Dixon 03:17
It does indeed. And you know, you're dangerously close to becoming a regular, we almost need to give you a regular spot on the show. So I think you are now the most welcomed guest on the Purple Patch podcast ever.
Scott Tindal 03:29
Oh, thank you very much. Careful what you wish for.
Matt Dixon 03:32
I know, I'm not sure if it's something to be proud of or to hide off your resume. But we want to go into three things today, if possible, and keep it really as tight and as applied for the audience as we possibly can. The first thing is we're going to try and give an overarching set of principles around nutrition as it relates to injury, something that's really not sort of discussed too much. Most people are so driven on performance. But many people forget the role of nutrition in both in prevention and treatment, we're then going to try and get into some action steps. So our audience can actually take some applied approaches to this with their nutrition so far as risk and mitigation of injury. And then finally, the what ifs. What if it does happen? What if injury strikes? Some of the actions that the audience can take to return to full strength as quickly as possible. So I think we're ready to go you're ready.
Scott Tindal 04:26
Yeah, Let's do it.
Matt Dixon 04:27
Good stuff. Well, my main aim here is to have a coach's conversation in many ways. So I'm going to -- I have deliberately set this up to not be overly structured not just be a series of bullet point questions. So hopefully that will sort of draw out of you and maybe a little bit of contribution for me some really deep dive education. So let's start with the real basics. At a high level. Can you explain really the role that nutrition has in tissue health?
Scott Tindal 05:00
Yeah, I think if we if we just take a very high-level view that probably the overriding factor that could contribute from a nutrition perspective would be -- I'd be focused on low energy availability. And I'd be thinking, If the athlete is not taking in adequate amounts of fuel, then are they predisposing themselves to the risk of soft tissue injury or bone injury?
Matt Dixon 05:27
And that's that -- you sort of say that, and as a coach I see, at least I perceive -- maybe it is my observation I think more than anything, it's incredibly common amongst training athletes and time-starved athletes as well, not just professional athletes, but all athletes that are training for an event, Marathon, half Ironman, whatever it might be, that almost accidentally athletes or intention, of course, athletes under fuel under consume calories relative to energy demands, do you think it's a it's a very common thing?
Scott Tindal 06:02
Yeah, I think also, we should separate, you know, chronic versus acute low energy availability. Because low energy availability in the acute setting is sometimes done on purpose, we do that to reduce body composition to reduce body weight. And that's important. And then manipulating that over the course of the training period through a cycle that the coach delivers is something that we do all the time as nutritionists, as dietitians, as whatnot, in order to meet the purpose of what the athlete is doing. It's when we talk about chronic under fuelling, and in particular, chronic -- so low energy availability, but potentially low carbohydrate availability, in a chronic sense, that's when the risk of injury starts to occur. And I think that's really important, again, for everyone to understand is you don't need to be stuffing your face at every session if your goal is to improve body composition, improve health markers, for a short period of time and under control, and under guidance, that that's certainly a very meaningful tactic. However, what I think tends to happen is athletes see the results of low -- taking in limited amounts of fuel, they see the body composition improve, they see the weight drop, they see maybe some improvement in these performance parameters, maybe because of reduced weight, and then they get, oh, maybe if I lose more, maybe if I go further, maybe if I drop more fat, maybe if I donate as much here, I can continue to improve, and then you start to see those changes, you know, not just from a physical standpoint, but also a mental standpoint as well. And that's when I think if we're talking about soft tissue injuries and bone injuries, that's when it starts to occur.
Matt Dixon 07:46
And that's, I'm so glad that you make that differentiation because obviously this topic came up and I immediately go to so many athletes under fuel. And this is the big challenge. This is what we're going to dive into you bring me right back on, on track and, and paint a better picture there. When an athlete moves into chronic and I guess, can you define sort of the duration? I know that it's very individual. I know it's not all if you like this for six weeks, whatever it might be. But there is this sort of potential Golden Wave of feeling better, maybe performing better, and then things -- what type of -- is there a general middle of a ballpark sort of duration where we can start to identify it as a chronic issue, or is that hard to define?
Scott Tindal 08:33
I think it probably is individual variation. I think you can read the literature and sometimes they will report things as early as six weeks of chronic under fuelling can start to bring about these physiological changes. So again, from an athlete's perspective, if they start to see inconsistent performance, if they start feeling low energy, if they have reduced libido, if -- poor sleep patterns. What else -- then starting to get niggles -- irritability, things like that, and maybe menstrual dysfunction if you're female, then you know that that level of fuel is probably not in line with what the training level or the training load is. And so it can vary. I mean, we did a Q & A the other day with Elizabeth Inpyn, who works with us and you know, she was very open about her struggles in her 20s with you know, disordered eating and eating disorder and low energy availability and but we're talking years where she developed stress fractures, years after doing this and you know, whether she just managed that energy availability but then, in the end, it tipped over. That's when those signs or symptoms can begin to present.
Matt Dixon 09:52
And when it -- here we go -- here's me going down a rabbit hole here, but when it does tip over, and I am personally really interested in this because as an athlete, I always say I am a prime example of how to do a professional triathlon career really poorly. And my biggest, in retrospect, my biggest challenges were: massive work ethic - so overtraining in the classic sense, like I was just doing too much work, particularly too much high intensity at big volume. Under recovery - obviously, the other side of the balance there. And certainly under-fueling. And once I sort of proverbially went over the edge, it took a long time to get back. Now, again, it's individual, but it is a murky, some would say dangerous, not very pleasant journey, that once you do fall into chronic, many of the symptoms and physiological challenges and cycles of injury. It's not just a quick return, typically, for athletes is it, it's really a landscape that they don't want to fall into.
Scott Tindal 10:58
Yeah, I think it can be a very big downward spiral. And I guess you've also got to look at that -- the psychological aspect of what drives LEA as well, low energy availability, and then REDS, the relative energy deficiency in sport and then ultimately overtraining syndrome. It's like, there is so much psychology involved in that, from the athlete that to get out of that hole as well. If they get into it in a big way, then it can take a long time to break those, those habits. So it's yeah.
Matt Dixon 11:33
Yeah, I think it's -- I think it's at this point is that also, there is a common I think misperception that it's -- we're talking about female athletes here, but you know, I just mentioned mine, I certainly went through this -- one of my favorite athletes I've ever coached, Jesse Thomas has been very open about his struggles with this in his former life before triathlon in running and then less so in triathlon. But it crosses genders for sure, doesn't it? As well as all levels.
Scott Tindal 12:03
Yeah, look, the prevalence --What's really interesting, again, with this is the prevalence in the literature to do with LEA. Low energy availability and REDS is more prevalent with female athletes yet this could be because of the way in which the studies are structured, because if you look at the prevalence of overtraining syndrome, and how they define that the prevalence is higher in males, yet the majority of the overtraining syndrome studies don't take into account low energy availability. And so you have this and Trent Stellingwerff and his group did a really great report on this and a really great sort of
Scott Tindal 12:43
whether you call it investigative, you know, paper about it that like looking at the signs and symptoms of REDS and overtraining syndrome and saying, Are they effectively very similar, they certainly present with very similar signs and symptoms. The definition of overtraining syndrome is done through a series of exclusions, but there is no definitive set of markers or set of definitions that will define how to classify an athlete in either of those syndromes in terms of that REDS in the overtraining. So I think what you've got is you've probably got a bunch of athletes that are athletes actually suffering from low energy availability and then being pushed into overtraining syndrome. And that's what they're talking about in that paper. And I think it makes complete sense is, if you don't look at that overarching factor, which is chronic low energy availability, then you're probably missing, missing a vast majority of individuals and I think lumped into that is males. And, you know, if you're looking at males, and you're wondering, like, probably one of the biggest take-home factors is morning erections for males, if they don't have I think it's four, four morning's a week, then you potentially, you know, you should be sort of going, okay, do I have an issue here is my fueling appropriate. And a lot of men, you know, again, probably people are snickering and laughing about that, but it's like, it's a real thing. And men need to be aware of the risk of under-fueling. And, again, if you read some of the literature, and you're talking about how much fuel an athlete should be looking to take on, and again, a lot of this is laboratory studies and research where it's talking about, you know, 45 calories per kilogram of fat-free mass. You then read research about professional cyclists taking in as low as eight to 10 calories per kilogram of fat-free mass, and then you do the math on that and you're like, how are they doing that? And then you wonder why they're developing all these issues. And those issues then stem into you know, your endocrine system, bone respiratory and the libido and mood, psychology states, you know, there's all these signs and symptoms that these athletes are presenting with and not just female athletes.
Scott Tindal 15:11
So it is something to be very, you know, cognizant about. But again, bringing it back to what we're talking about is chronic low energy availability. It's not the acute. And I think it's really important for people to understand that because I think sometimes, again, like we do in as human beings, we tend to grab onto something and run with it, like to the extreme. So I'm not saying everyone needs to go and stuff their faces every single session because that's not required either. But I think it's looking at your overarching program and going okay, do I have enough energy to support the training? I'm trying to do?
Matt Dixon 15:49
Yeah, that's great. How about hydration? Can you outline the role? You know, if we, if we think about the three macronutrients carbohydrates, perhaps fats and proteins of which we will talk about today, obviously, and their role in injury prevention and injury treatment, for lack of a better phrase, what about hydration and its role in body function and health?
Scott Tindal 16:11
Yeah, I mean, again, hydration there. I don't think there's any definitive studies to say if you are dehydrated that you're going to become more at risk of soft tissue injury. However, I think when you think of the constitution of muscle, and it being around 70%, fluid or water, it sort of makes sense that if you are dehydrated, then you potentially could run the risk of becoming more susceptible to soft tissue injuries. But again, I don't think off the top of my head, I can't recall any definitive research related to that. But I think it's sort of from a tissue compliance standpoint, I think it makes sense to certainly be hydrated. And I think if you look at, again, some of the literature will talk about this 2% marker in terms of physiological changes. So you know, whether it be muscular contractions, power output, and whatnot, I think that could stem then into soft tissue injury. So you certainly and that's something we talked about it FuelIn a lot is, you know, understanding your hydration status. And then what, at what level can you function and I think everyone is very aware that if you finish a 70.3 here, an Ironman at under 2%, hydration, so you probably haven't gone hard enough. Because I think a majority of those athletes are finishing, are probably well over 2%, dehydration and performing very, very well. So again, I take a little bit I take, you know, an excuse the pun, a pinch of salt, when we're talking about like 2% is the definitive marker to keep yourself within, I think you can go well beyond 2% dehydration and still function very, very well. There is a lot of individual variability with that.
Matt Dixon 17:53
For sure. How about coming back to the three macronutrients? You mentioned carbohydrates earlier now. I'm guessing this is related to so much of the common trends in broader nutrition. But when we think about injury, can you maybe just do a little dissection, if it is possible, or even Intel smart to do so breaking down carbohydrates, proteins, fats? It -- The reason I'm asking this, by the way, is the very common sort of carbohydrate is the devil mentality, which is that the biggest culprit? Do you think of many athletes under-fueling and carbs? Can you break those three apart if there is anything to break apart there?
Scott Tindal 18:39
Yeah, I think what we, what we see is there's going to be intentional and unintentional sort of energy availability from an athlete. So there's the intentional restriction of calories because they're trying to lose weight or improve body composition. And then you have the unintentional where by they may be restricting a certain product, ie, let's talk gluten, for instance, someone might go gluten-free. And then as a result, invariably, they're going to reduce carbohydrates. So unintentionally, they're reducing their total carbohydrate intake. And as such that could result in low carbohydrate availability. So but then you have the flip side of that of exactly what you're talking about, of intentional low carbohydrate availability, because everyone went on this high fat, low carb, sort of, you know, shift because it was going to be good for fat oxidation and whatnot. I think everyone's coming around to their senses and realizing that you can still improve fat oxidation by just manipulating total amount of carbohydrates based on the work being done, and duration of session obviously has a huge impact on the body's ability to utilize fat as a fuel source as well in as well as intensity.
Scott Tindal 19:57
But if we talk about low-carb carbohydrate availability, I think what we're seeing now in the research is the relationship between a resorption of bone and formation of bone. And this is probably the thing that I think is most important for athletes to understand is that when carbohydrates are restricted and you have high-impact exercise, then the markers that relate to bone resorption increase, and the markers that relate to bone formation are reduced. And again, this can occur in the acute setting. But again, over chronic periods of time, this is when you're going to end up having issues with the bone and potentially ending up with stress reactions, which then will go to a stress fracture, and then obviously, through to a full-blown fracture if it got really bad. So carbohydrates in that sense. And again, this relates to low energy availability, and REDS in the chronic senses, is low carbohydrate availability, again, just an extension of that low energy availability and how important it is to bone and potentially soft tissue? Potentially very important. And I think there's going to be more research coming out about this.
Matt Dixon 21:14
Well, I can't help but dance into something, I don't want to distract us too much, or take us down a different journey. But there are a lot of performance experts, a lot of longevity doctors, promoting intermittent fasting, removal of carbohydrates or high sort of restriction of carbohydrates globally, and leaning into various forms of research or observational studies or case studies and testimonials of people having great improvements in body composition, enhanced energy, better function throughout the day. Now, they are dealing less with athletes more with general population, I think it's important to point out, how does someone listening, manage highly respected people on that side, promoting that side of stuff and their needs as an athlete, within a time-starved life often for our audience, where we're saying, Hey, you really need to fuel their energy demands?
Scott Tindal 22:18
Yeah, I think, again, you touched on it there is what population are we talking about? If you're referring to, you know, longevity and fasting, and I know, like, you know, many very intelligent people have promoted this. However, it's in relation to obese middle age, individuals, majority of the time who were pre-diabetic already have diabetes. And so I think, again, when a when an athlete is listening and reading, you know, books like lifespan, listening to David Sinclair listening to potentially, you know, Peter Attia, and these guys who you know, they're very intelligent people. But I think about the population that they're talking about. And yes, there is in there are individual athletes who have benefited from manipulating carbohydrates and fats, in particular, I think, if we take protein out of it, and we just keep protein at a high level, which is beneficial for an athlete, and I think everyone can start to agree on that. If we then match carbohydrates and fats in terms of total caloric intake, there is no difference in body composition or weight loss at that when you look at the studies.
Scott Tindal 23:29
And that's I think, a really important thing for athletes to think about as well is that when you match energy, if you match, sorry, if you match protein intake, and then you match carbohydrates, or fat as a fuel source, in terms of just looking at weight control and fat loss, as long as they're in a caloric deficit, then you will get similar amounts of weight loss and fat loss. If you then talk about an athlete, it's an I had this conversation, actually, last night in a pub with an athlete who says they always do faster training, and I was like, Why do you do faster training? And they're like, oh, it's really good for you know, my longevity. And I was like, Is that why you're doing triathlon training? And they're like, What do you mean? I said, Is that why you do triathlon training for longevity? And they went, sort of, but now want to go really fast? And I said, Well, then why are you fasting? And again, it's weird comment, but like, why are you fasting before trying to go really fast? If we know that if we improve your fueling and ie fuel with the appropriate fuels, ie carbohydrates when you want to go quick, why wouldn't you do that? And he sort of had that aha moment. He's like, okay, I guess I haven't really thought about it that way. And again, I'd always bring it back to the athlete. Think about what the purpose is for what you're trying to do. If you're really really big and fat and have poor metabolic health and so on, then maybe fasting is very beneficial for you. Maybe you need to think about the type of training you're doing as well, maybe you need to be lifting weights more than doing a lot of cardio training. You know, again, I know we're talking about triathlon. But is triathlon, the best thing for that individual athlete at that point in time, maybe not, maybe they need to have an extended offseason of a lot of weights training, high-intensity interval training, short, but every day doing something to maximize caloric expenditure whilst managing caloric intake. And then you'll probably see really good results, including some fasting within there, and you'll see improvements in blood glucose control and that. But if you're not in that category, and you just want to drop a bit of weight, and you're actually trying to perform really well in 70.3, or an Ironman, then, you know, I would think about your fasting, but we're probably a little bit off-topic in terms of...
Matt Dixon 25:54
I think it's important to go down there as we're going down there. So let's bring it back to your point because we want to talk about injury risk. And what I want to do now is get really applied really basic of the Do Not Miss or maybe the most common pitfalls. And maybe the way I'm going to ask this question is, is suggest a couple of components to get you going so that you can sort of appreciate the lens that I took, with this question. The most common nutrition mistakes that you see working with the broad range of athletes that you do that end up promoting injury risk. Now I know there's not a great scientific correlation direct, I'm not looking for that. But in the broad lens, a great example to start might be skipping breakfast, or highly restricting carbohydrates, just because we talked about that, like some form of macro elimination, there's some things that we can say to the audience right now, no matter what your approach is, these are things that are going to help ensure that you can do the best job you can knowing you can sabotage in other ways, tissue and bone health, and therefore maybe reduce your exposure to injury without making big bold claims, of course.
Scott Tindal 27:15
Yeah, I mean, you're talking about like, the non-negotiable habits that you want to try and get into or to reduce injury risk, or you're talking about like the most common general mistakes that people will make,
Matt Dixon 27:28
I think a bit of both, maybe start with, maybe start with the most common mistakes, and then we're going to go into non-negotiable habits. How's that?
Scott Tindal 27:36
Okay. Well, I think there's let's take it back and just very quickly revisit what we talked about that unintentional intentional under fuelling, and I think that's the most common mistake is, people either intentionally will, they'll increase their exercise demand that type like exercise energy expenditure. And they'll take in the same amount of calories. And so inadvertently, they result in a net deficit now that could be unintentional, or perhaps intentional. So they don't realize that their energy volume or their exercise volume is going up, but they're eating the same amount. So that puts them in a deficit. So that potentially is somewhere where they're making that mistake, they're not matching their volume, and their intensity to actually their intake. And, again, and Trent Stellingwerff's group talks about this is that humans aren't very good at matching exercise load with energy intake, it's quite odd. And maybe there's a bit of positive reinforcement there is because as exercise intensity and, and volume goes up, and you're eating the same, but you start to see reductions in body weight and body comp, you're like, Oh, this is good. So then you don't actually want to increase it. So there might be a little bit of intentional, unintentional sort of going on there. I think you then got, obviously you reduced food intake. So intentionally reducing food intake with a steady volume of exercise. So volume doesn't go up. But people start to actually intentionally reduce. I think that's it's not necessarily a mistake, but it's just certainly something that can result in this chronic under-fueling. And then as I mentioned, like, You've either got exclusions of certain things like occlusion of gluten, which results in exclusion of carbohydrates, or you have intentional types of diet type, low carb, high-fat diets, which obviously is going to result in low carbohydrate availability as well. So they're probably the most common, not necessarily mistakes, but certainly issues we see with athletes who start to run into problems in that high-level sense.
Matt Dixon 29:37
Under the banner of gluten. Can I add one that I think is important? Because we get a lot of questions around this with people taking on a plant-based diet or becoming vegan. So it's very popular. That probably lends itself to that unintentional side where they are doing it -- for whatever reason, it might be, ethical environment, health, etc. But they are -- it becomes a real challenge and a consideration, particularly people that are eating on the go to get the right type of calories to support their training. If they're making that choice. I think that's another common issue sort of relate to that gluten side of stuff as well. Yeah.
Scott Tindal 30:18
Yeah, I think we've had this discussion with many athletes, it's, I fully respect the decision to go vegan or vegetarian. And I think you just need to be aware of the implications of those diet types, especially when trying to perform high volume, high intensity, you know, lots of load training, I think it just needs to be -- you need to be aware of protein intake, carbohydrate intake, fat intake, and total caloric intake when doing that, along with all the micronutrient potential deficiencies that could exist with a poorly designed vegan or vegetarian diet. And so yeah, I think it's just important to know, in that sense,
Matt Dixon 31:02
And what about some, let's transition to habits then we talked about sort of the common mistakes or issues that you see. What about the non-negotiable, every athlete looking to minimize their risk? Let's put it that way. What are some of the steps that everyone should go away from today? Say, yeah, it's probably good. If you do this, are there three or four things we might take away with us? Yeah.
Scott Tindal 31:30
I mean, if we're talking bone risk, then I think the non-negotiable was go and get a DEXA scan, and have a look, I'm not -- it won't give you a risk reduction in terms of soft tissue injury. But certainly, in terms of bone injury, I think everyone should go. And anyone over the age of 30, in my opinion, should probably get a bone scan and have a look. And I can't tell you how many 30 to 40-year-old males and females I've seen with low bone mineral density, and I had one well two days ago, who has, you know, a low T score. And I think if you if you're less than minus one and T score, you're indicating osteopenia. Less than two, less than two as a T score, you have full-blown osteoporosis. And I think it is just something so easy to check. You know, if you're on the West Coast, very, very simple to go and get a DEXA scan through DEXA FIT or what's the other one, Body Scan, I think they are, you know, $40-$50. And they will give you body composition as well as bone mineral density, I just think there's so much value in it.
Scott Tindal 31:30
I think the other non-negotiable in relation to potentially soft tissue injuries, certainly bone injury would be their vitamin D status. And I think for athletes, they should be looking at, you know, having a minimum standard of around 70 milligrams per deciliter as they're reading. And I think you want to get that done at least twice a year, I think just before winter, so probably around October, you want to look to get it done to see what your level is going into winter. And then at the back end of winter, probably around March, March, April, getting it done again, so you can see where you're at, and then what's required over the summer months. So I'd certainly be looking at those as two non-negotiables to help reduce the risk of, you know, potentially bone stress injury in particular. And then the relationship between vitamin D and soft tissue injury and muscle injury is you know, there is a link there. And I think it's certainly worth having it as an optimal status.
Matt Dixon 33:33
So how about if injury strikes, and, you know, pulled hamstring, Achilles, whatever it might be, in fact, you can extend into bone injuries as well. And there any actions that an athlete should take around nutrition? What are some actionable actions that people should take?
Scott Tindal 33:54
Well, I think if we even if we go back just again, so one step, just about to the non-negotiables. And I think we can like look at that in terms of soft tissue and bone injury. So I think like, let's think pre-pre-session. Okay, carbohydrates required, I think, for me, if you're doing a weight session, if you're doing a swim session, I would certainly consider eating something, you're going to have a better session if you're doing that, especially, I think so many people go into a weight session, like just having not eaten anything for extended period of time, and you just won't perform as well if you're trying to maximize lift. So you know, piece of toast even or a bowl of cereal or whatever it could be, it doesn't have to be a huge amount of carbohydrates, but just something to make you feel better. I think you're gonna have a much better weight session. And the payoff between consuming say 30 grams of carbs, whether it's a banana or a piece of toast, whatever, with some protein before that weight session, I think is certainly worth doing, same with a swim. Caloric expenditure in the water is going to be higher because of the density of water. I think so many people go into a swim session underfed. And again, you don't have to stuff yourself, it's just giving yourself something to be in there. I think bike and run anything over 60 minutes, you certainly could consider eating something just simple before that run, you don't have to eat during the run for a 60-minute session. But certainly eating something beforehand is going to make you feel much better and get you going, especially if the intensity of that session is going to be very good. So that's probably in relation to effort. And also, I think in terms of fueling the body with those carbohydrates and or, and a little bit of protein could reduce the risk of that soft tissue injury and certainly bone injury. I think the post-exercise period is probably where majority of studies have looked at. Just to note that high protein intake is not going to reduce the risk of muscle injury. And that's really important for people to understand is there does not appear to be any evidence to say that if you take in a high protein diet, the risk of muscle injury is going to be reduced. I think when we look at muscle injury, there's so many factors outside of nutrition, probably in relation to the training program that is going to predispose you along with biomechanical factors and all that. But yeah, high protein diet won't exclude muscle injury from occurring. Certainly, post-session, if we're talking non-negotiables protein, yeah, depending on your size, but somewhere between 30 and 40 grams of protein per feed, for me is a very sensible recommendation if you're performing any athletic sort of activities and having that protein pulse throughout the day. So looking at, you know, some athletes get very hung up on this, oh I need to eat every three hours. Well, it depends on how big you are, and how much total protein you need. If you're aiming for roughly, you know, your weight, whatever you weigh in pounds is roughly the amount of protein you're taking, you could probably get that in three to four feeds in a day. And that's very simple. I think in terms of post-session, carbs, carbs are very important. Now, again, they're not bad. Just think about how much you need. So I know there's a lot of research, there's a lot of recommendations in terms of which are, you know, I've talked about this before, I think some of the recommendations around the total amount of carbohydrates required is very, very high in the literature, you know, they're talking to grams per kilo body weight and post-session feed. And, you know, I weigh 85 kilos, I'm not going to go and eat 170 grams of carbs after a 60-minute run, I'm sorry, it's not going to happen, because I want to control my body composition as well. And my total weight, I'll turn into a blimp if I do that. But yes, certainly thinking of the intensity taking in maybe 30 grams of carbohydrates in that post-session feed depending on the intensity, depending on what other sessions you've got moving forward, but certainly, as a minimum, probably taking around that 30 grams of carbs at least. And getting something into the system would make sense that you know, you can go as low as I mean, again, from two grams per kilo body weight all the way up to eight grams per kilogram body weight, depending on the volume of training. So there's no easy answer there. I think the most important thing is to just consider having some carbohydrates in a post-session. So post session feed, I think that's really important.
Matt Dixon 38:33
I just want to put a spotlight on something you said your weight in pounds, that's give or take how many grams of protein an athlete is consuming a day. That's when people get their calculators out and start doing that for themselves. They're going to raise an eyebrow and be like, Wow, that's probably more than you. The many athletes that consuming but that's very important.
Scott Tindal 38:55
Yeah, I think again, we say this a lot. And it's probably I think it's probably with endurance athletes, probably one of the biggest game changers in terms of dietary manipulations we can do is increase their protein intake. And certainly, you know, I know we're going to talk about when injury does strike, but I think protein intake for an athlete can be somewhere between that two and three grams per kilo body weight, depending on total caloric requirements as well. You can take in more protein, it's very satiating, you probably won't -- extra protein certainly won't turn into extra body fat, you'll lose it in the form of heat or you'll lose it through the toilet. It's just a way of getting extra calories into you and feeling very satiated and feeling having that feeling of being able to eat a lot of food and still potentially lose improved body composition and lose body weight. So I think there is a lot of value to protein and I think historically we see endurance athletes under consuming in protein, and that, again, it won't stop you from getting a soft tissue injury. But I think if you're under consuming protein, then you potentially run the risk of predisposing yourself to soft tissue injury. So I think there's some sort of middle ground there with protein intake. If we think of protein, and we think every cell in the body is made from protein and amino acids, a crucial cellular structure, and whatnot, then I think it makes complete sense to, to take in adequate amounts of protein when you are training at a high volume.
Matt Dixon 40:36
Great, well, you've talked about bathroom habits, you refer to daily erections. So let's move on to injury striking, shall we, we'll finish off the show with this soft injury, soft tissue injury or bone injury occurs --actions that folks should think about taking around nutrition.
Scott Tindal 40:59
Look when injury occurs, I think the most common mistake is that athletes will drop caloric intake. So they all say shit, I'm getting hit because I can't move. And they drop injury -- and they drop their caloric intake, biggest mistake you can make. So if we look, again, there's no definitive studies on this, because it's very hard to do a randomized control study where they induce an injury and then restrict calories, it would be pretty unethical to do that. But if we look at acute muscle damage, then and that's induced through exercise, we see an increase in resting metabolic rate. And that will occur for at least up to 72 hours. So if you get an injury, certainly don't restrict caloric intake for at least that first 72 hours, that would be something that we would absolutely stress that actually, if anything, increase your energy intake during those first three days post-injury, to allow the body to recover. And just on that, if you're going into surgery, it's a really cool, there's some really cool research to show carbohydrate loading, going into surgery has benefits for post-surgical outcome, as well. Because if you think about it, your body is just under an extreme, if you're talking about that type of trauma, I mean, your body's been cut open, you're gonna need a lot of energy to repair. So I think that's super cool to think about. So and same with like, if we again, we look at Spinal Cord Injury Research, acutely increases in resting metabolic rate, I think we can apply that to soft tissue injury and bone injury. That's how I would be thinking about it. The other factor is that using crutches, if you are on crutches actually requires more energy than walking. So that's another factor that you could, although you're probably not doing as much, but the energy expenditure will be higher when you're on crutches. So I think that's really important to think about. The other factor to consider is that none of the researcher is sort of isolated a particular macronutrient to be better than the other. And I think that again, makes sense is think about food. The combination of, you know, protein, carbohydrates, fats, and then the micronutrients and what's going to actually be beneficial. So, again, if we're talking a bone or a soft tissue injury, you're thinking protein and carbs are absolutely crucial. You're thinking calcium, certainly from food, or food first, if you can't get through first, then certainly, and we're talking bone, potentially supplementing, although I'm not too keen on supplementation with calcium. And then vitamin D, obviously, you're going to be supplementing with that, again, because you can't really get your Vitamin D from food. So don't isolate a particular macro or micronutrients, think about them in combination and throw everything at it would be a better approach. Without going without going mad. I think the average -- want me to keep going?
Matt Dixon 44:00
Yeah, no, I think it's good. I've heard you say something before -- feed the injury. And that's, that's, that's a good I think it's a really nice way something catchy for people to hang on to and remember,
Scott Tindal 44:11
Yeah, and feed the injury but don't feed the injury indefinitely. Again, if we go back to what we talked about the start in terms of chronic versus acute low energy availability, at some point in that injury, Injury recovery, you're going to have to be mindful of total caloric intake because energy expenditure at some point is going to be low and so you need to factor that in. I think, you know, thinking food first food first should always be the first line of thought but not always food only. So yeah, sources of protein we're thinking if you're if you can eat everything, obviously chicken they fish plant-based sources. If you're a plant-based athlete, plant-based sources, leucine may be really important. So Leucine is one of the key amino acids, thinking about it. Certainly getting multiple sources and a decent amount of Leucine in your diet in that injury. Somewhere between two and three grams per kilo bodyweight would be the recommendation for protein at that point in time. I think carbohydrates in that early stage and absolute minimum of three grams per kilo bodyweight, which would still feed the injury but allow you probably to manage total caloric intake. And remember that carbohydrates come from vegetables and from fruits. And I think athletes again, like if you get so shocked or so scared of carbohydrates, remember that vegetables will supply you with carbs, and you can eat a hell of a lot of vegetables, and still get that amount of three grams per kilo body weight. So feel very satiated. It doesn't have to be pizza, bread, pasta, and rice. Diet really rich in polyphenols. So they're active ingredients within all compounds within fruit and vegetables. Another great reason to consume carbohydrates in fruit and vegetable form. But Polyphenols are antioxidants. And certainly, you know, it's probably the best strategy to augment recovery from, you know, injury or damaging exercise. And I think that's, that's really important to think about. I think in terms of fat intake, it generally looks after itself, I don't think you have to go mad on fat. In this case, I think your protein and your carbohydrates and the sources of those from food, such as if you are eating meat, if you are eating, for your protein sources, you're going to get some fat from carbohydrates. If you're eating nuts and seeds and beans and pulses, you're also going to get some fat there as well. So don't think you have to go mad with adding it in. I think in terms of you know, then extending beyond food first, you're thinking, okay, as I said, calcium, if you've got a bone injury, you want to be hitting 1500 milligrams a day of dietary calcium. And that's an absolute given, you should be able to get that through your foods. So again, grains, dairy, leafy greens, you will get calcium, small, oily fish, so on nuts, you should be able to get that calcium intake. But if you did need to supplement with it, then certainly do that vitamin D in early injury, probably throughout for an athlete somewhere between 4010 1000 iu a day, depending on their actual marker that they've had tested. I would be thinking omega threes again, if you if you're not eating fish, and small oily fish because of your dietary preference, then I would be aiming for 3000 milligrams of EPA DHA per day. soft tissue injury, bone injury, collagen type 120 grams a day with at least 500 milligrams of vitamin C, taking that before any loading. Even if you're not loading the injury at that point in time, it's certainly consider doing that. And then potentially someone could look at something like chondroitin sulfate. Again, there is some research, it's not huge amount of research, But again, you know, if I had a major injury, would I be throwing this out? Yeah, I wouldn't. We've done that with athletes, and they tend to recover pretty quick. So 1500 milligrams a day of Chondroitin sulfate I'd certainly be sort of throwing it at the mix as well. It's not indefinite, you know, you're taking this for a shorter period of time. But certainly, in that acute healing phase, I think you're trying to maximize, you know, the body's ability to heal. And I think that's really important as well. And as I said, we're not going to have a heap of randomized controlled studies on this because the ability to induce an injury and then either restrict or provide those participants with the appropriate care would be sort of unethical. So you look at what works in practice, and then you know, you take it from there.
Matt Dixon 48:57
Well, that last five minutes, I think folks are going to need their pens and papers and but it was a blizzard of, of goodness there. So I really appreciate it. And I think it's a great way to wrap it up. So, Scotty, I know that we're planning some regular features with you were gonna have, whether it's the FuelIn corner or whatever we might be calling it but as we as we emerge to the podcast, I think you always bring so much gold to the show that we're going to have a regular spot for you which thank you for volunteering that but for everyone out there if you need more information, obviously through the show notes, you can reach out to Scott and the team at FuelIn. Pretty simple stuff you can you can actually find it at the Purple Patch fitness page, just head to purplepatchfitness.com head up to services, you go to nutrition, and Scott and the FuelIn team are right there if you want an individual consultation, a broader program. But I think all that's left for me to do Scott is to say thank you very much. Thanks for being such a great resource. A great educator for people listening to the show and watching the show now, and also so much care and support that you give to the Purple Patch athletes, I know that everyone on the team are so thankful for your internal education and of course services that you provide those guys. So thanks so much for being on the show.
Scott Tindal 50:12
Oh, thanks, Mattie. I really enjoyed that. I think I know, we probably went a little bit off tangent at times. And there's so much to talk about in this. And I think, you know, if people do find this useful, we could probably get a little bit more into the weeds around tendon injuries, in particular bone injuries, and then, you know, specifically around love supplements and weird things you can do for, you know, specific injuries. So I'm sure we could do a quick sort of 20 or 30-minute talk about that sort of stuff as well, and what the research shows and, and potentially save athletes a lot of money as well because I think there's so much crap out there, there's so much crap, and it's you trying to keep it simple. I think keeping it simple is, is certainly one of my mantras, and try and certainly stick within, you know, the guidelines or what the research says. But, you know, as we say, as well, there's not research for everything and lack of evidence isn't evidence of lack of effects, that little bit of clinical practice always comes into it as well. But yeah, I really enjoyable and thank you so much. It's always fun to sit down with you, Mattie.
Matt Dixon 51:19
All right. Take care. We'll see you next time.
Scott Tindal 51:21
Thanks. mate.
Matt Dixon 51:24
Guys, thanks so much for joining. And thank you for listening. I hope that you enjoyed the new format. You can never miss an episode by simply subscribing, head to the Purple Patch channel of YouTube, and you will find it there. And you could subscribe. Of course, I'd like to ask you, if you will subscribe, also share it with your friends. And it's really helpful if you leave a nice positive review in the comments. Now any questions that you have? Let me know. Feel free to add a comment and I will try my best to respond and support you on your performance journey. And in fact, as we commence this video podcast experience, if you have any feedback at all, as mentioned earlier in the show, we would love your help in helping us to improve, simply email us at info at Purple Patch fitness.com or leave it in the comments of the show at the Purple Patch page. And we will get you dialed in. We'd love constructive feedback. We are in a growth mindset as we like to call it. And so feel free to share with your friends. But as I said, Let's build this together. Let's make it something special. It's really fun. We're really trying hard to make it a special experience. And we want to welcome you into the Purple Patch community. With that. I hope you have a great week. Stay healthy, have fun, keep smiling, doing whatever you do. Take care.
SUMMARY KEYWORDS
athletes, injury, carbohydrates, soft tissue injury, talking, protein, people, bone, important, availability, body composition, nutrition, energy, potentially, fueling, terms, eating, reduce, scott, research