When injury hits you, it often presents a challenge, especially when it comes to fitness. An injury can range from a small knock or muscle pull which causes discomfort to something more severe which can have far reaching complications, both physically and mentally. Recovering from an injury can be really difficult, especially for someone with diabetes.
Regular physical exercise is a wonderful tool for any person with diabetes’ glucose management. If you suffer an injury, which stops you from doing your usual exercise, it can lead to some frustration and, more significantly, stress about how to manage your sugar levels.
I experienced this frustration and stress myself for 11 months during 2016 while recovering from an injury. When I was 14 (now 28) I slipped two discs and trapped a major nerve whilst playing football (soccer, for my American friends across the pond), leaving me with a very weakened spine whilst I was growing up. Fast-forward 13 years, and the injury came back to bite me in the butt – literally.
Physio, regular muscle massages and a lot of rest was the prescribed treatment, as well as a strongly worded recommendation of zero exercise for 2 months over the summer.
When it comes to living with and recovering from an injury, there are usually several initial worries for those of us with diabetes. Fears around gaining fat, losing muscle and how to adjust insulin to match the level of inactivity you experience around said injury are common. In some cases, we also not only experience a lack of training, but a lack of normal movement. Immobility increases the rate at which muscle is broken down and it is widely proven that the more lean muscle mass you have, the better your sensitivity to insulin.
Having an injury as serious as mine was, requiring complete rest and zero exercise, only highlighted how important exercise was for my normal diabetes management. My blood sugar levels became far less predictable, and it was almost like starting at square one again.
It was a difficult and stressful time, but I learned a lot. Here are my four main recommendations for dealing with injury alongside diabetes.
Test. A lot. If you’re usually active and are now facing a prolonged period of inactivity, you’ll need to gather as much data as you can to understand how your body is reacting to this. The more information you have, the better you can adjust your insulin requirements.
It was almost like the first days of becoming a diabetic for me, but regular testing eventually reduced peaks and troughs in my glucose levels and evened out to within range. I noticed a significant rise in both basal (33% increase) and bolus (100% increase) insulin, so be prepared to up your dosage if you spot patterns of consistently rising sugars.
Once the injury has subsided, I would also recommend continuing stricter monitoring of levels to ensure that, once you’re back to exercising as you were pre-injury, you’re not at risk from hypos.
It is vital that you are more aware of what you are eating as your caloric intake requirements may change.
You have to find a balance, which can depend on where and how severe the injury is. A reduction in calories is probably going to be required if there is a period of inactivity – you’re just not expending as much energy as you used to, so your calorie requirements are less. Using a calorie and carb tracking app like ‘MyFitnessPal’ will help you calculate how much you’re eating.
It comes down to pretty simple math: less energy goes out, so less energy needs to come in. However, the body needs fuel to replace damaged tissue – so this requires some consideration.
Protein is the most vital macronutrient when you’re healing and recovering from an injury. Try to make sure that each meal has a protein element (fish, chicken, beef, eggs, lentils, protein powders etc.), as this will assist your body in recovering from its injury. As healing is largely based around laying down new body tissues, protein is incredibly important. Aiming for the usual 1.5-2.0g per kilo of bodyweight is a good starting point – which is approximately the norm if you weren’t injured. There is little evidence to suggest that ‘super-dosing’ on protein has any additional benefit.
Besides protein, Vitamin D and Calcium are important for bone reformation, whilst Zinc, Vitamin C, and Vitamin A have shown benefits in decreasing healing times.
However, the vast majority, if not all, of these requirements can be met with a well-balanced diet of predominantly whole foods. Lots of nutrients from good, whole food is key.
Being injured can be highly stressful and often leads to times of demotivation and melancholy. If the injury is particularly severe it can even lead to depression. Support is a key factor here — it’s vital to have regular contact with people and professionals who are there to help you and keep you on track to recovery. It’s easy to sit back and eat large amounts of calorie dense foods when motivation isn’t high, but this will only complicate blood sugar management. Keep a positive support team around you to keep spirits high during this time.
Using trained professionals, like a physiotherapist, doctor or a nutrition coach, is always a great recommendation if you’re looking to get over a more severe, long-term injury that is causing you great discomfort or if you’re particularly concerned when it comes to your health, carb-counting calculations and/ or body composition.
Training whilst recovering from an injury ultimately depends on how severe the injury is. Some activity is always encouraged, but only if it doesn’t put any strain on the injured area. Walking, swimming, cycling and even resistance training around the injury can all be beneficial (for example, walking if you have a broken arm).
If the injury is a serious one, proceed with caution. Exacerbating the injury will only increase recovery time and we want to get you back to 100% as soon as possible. Find out what works for you and take it slow. The body needs time to heal.
My advice overall would be to be patient, listen to your body and gather all the data you can to understand exactly how to manage your diabetes as best you can while you’re recovering.
Unfortunately, injury creates more work for us diabetics than it would for most other people. That being said, having a positive support team to motivate you and help you with your recovery, combined with the four recommendations above, can only put you in a good position to get back out there fighting fit as soon as possible!
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