Accustomed to rigorous activity that burns many hundreds of calories daily, athletes hobbled by a broken ankle or strained knee ligament may think it wise to drastically cut calories to stay in shape.
But Casey says that will work against the athlete's ultimate goal - a speedy recovery and return to sport - by impeding the body's healing processes and sapping hard-earned muscle mass.
"A lot of injured athletes think, 'I'm not practicing, so I need to significantly cut back on caloric intake," Casey says. "But they forget that, when you're injured, your resting metabolic rate is higher than it would otherwise be."
When injured, the body's natural processes kick into a higher gear, and a body busy with recovery consumes more energy than a body at rest. A drastic cut in calories hinders that process and prolongs the injured athlete's time on the sidelines.
And for athletes with lower-body injuries that impose crutches, the effect is multiplied. As anyone who has to use them can attest, crutches wear you out, and those weary arms and shoulders are an expression of the extra work getting around on crutches demands.
"When you're on crutches, your energy expenditure is much higher than if you're walking," Casey says, "because you have to stabilize all the way through your arms and shoulders."
Crutches or no, fewer calories also can mean a precipitous drop in the athlete's strength and power.
"From a metabolic standpoint (the amount of energy needed to maintain a tissue), muscle is pretty expensive real estate. If you cut too many calories, muscle is one of the first things you lose," Casey says, adding that he prefers to monitor the injured athlete's weight fluctuation rather than the number of calories he/she consumes. "I'd prefer the athlete retains as much muscle mass as possible, even if they put on one or two pounds, especially if they’re in the middle of a competitive season."
So what is the proper nutritional tact for athletes recovering from injury? Casey advocates the following approach:
Eat a balanced diet, with an emphasis on fruits and vegetables
It may not be sexy, but the dietary habits athletes embrace during training and competition are every bit as beneficial when recovering from injuries.
"Everyone is looking for a specialized, 'injury-specific' nutrition intervention," Casey says, "but it all comes back to the same principles you use when you're training and competing."
Cut the carbs, increase the healthy proteins
Athletes tend to eat a lot of carbohydrates, which the body rapidly burns through while supplying energy for high-intensity activities. Injured athletes don't need quite as many carbs, and Casey recommends they focus on healthy proteins.
"Higher amounts of protein, similar to what one should be consuming during times of intense training, help retain muscle mass," he says, so make sure your diet has plenty of fish, lean beef and chicken, and cut back on the bread and potatoes.
Injured athletes don't sweat as much as athletes in training and they might not think about the importance of maintaining their hydration levels. But as a key component to overall general health, Casey recommends injured athletes remain diligent about liquid consumption.
“I recommend that injured athletes continue to drink fluids throughout the day, no different than what they’d be doing if healthy,” he says.
Don't look for the magic pill
"Mega doses" of vitamins and minerals or anti-inflammatories don't necessarily speed up the healing process. The initial inflammation that accompanies injury, in fact, serves as a catalyst for the body's healing process, so the introduction of large quantities of anti-inflammatories can actually deter, rather than encourage, healing.
As frustrating as it may be for athletes itching for competition, the best course is the steady and sensible approach, not an overnight quick fix.
"Give the body the building blocks it needs," Casey says. "Eat a wide variety of fruits, vegetables, lean proteins, and healthy fats, and be sure that you’re consuming enough calories to support the healing process. From there, add in appropriate physical therapy, if needed, and let the body do its job.”