Episode 26 | Ask the Expert | Guest: Kate Shilland BSc, MSc, Registered Sports Nutritionist, ISAK Level 1, UKAD Advisor
When you’re injured and can’t train, the instinct is often to eat less. Kate Shilland, LBSM’s Sports Nutritionist, explains why that instinct is wrong – and what your body actually needs to recover well.
Injury is frustrating enough on its own. But one of the most overlooked aspects of the recovery process is also one of the most controllable: nutrition. Most injured athletes either don’t think about it at all, or instinctively cut back on food because they’re training less. Both are mistakes.
In this episode of the London Bridge Sports Medicine podcast, Kate Shilland – LBSM’s Registered Sports Nutritionist, who has also been through hamstring surgery herself – explains what happens nutritionally when the body is injured, what it needs to recover, and how to use food as an active part of the rehabilitation process.
Your body works harder when you’re injured than you think
The most important reframe Kate offers is this: being injured does not mean the body is resting. Quite the opposite. An injury triggers a cascade of internal activity – inflammation, immune response, tissue repair, new cell production – all of which require energy. The body is, as Kate puts it, “so busy on the inside behind the scenes.”
Research bears this out: calorie requirements can increase by 15 to 50% during injury, depending on severity. Post-surgery, where the body has sustained significant trauma, demands are at the higher end of that range.
The biggest mistake an injured athlete can make is falling into an energy deficit. Not only does it slow the repair process – every biological job requires energy to do it – it also suppresses immune function and increases the risk of setbacks. “Eat better, not less,” is Kate’s core message. “Otherwise you just prolong the rehab process, or you come back and get injured again.”
Signs you’re not eating enough
Without a fuel gauge, how do you know? Kate outlines the key signals to watch for:
- Persistent tiredness, even after adequate sleep
- Achiness and general low energy
- Poor concentration or brain fog
- Cravings for sugary foods
- Picking up coughs and colds frequently – a sign of a suppressed immune system
Some of these overlap with the general frustration of being injured, so context matters. But if several are present together, it’s worth reviewing what’s being eaten.
The key nutrients for injury recovery
Protein: the building blocks
Protein is the primary material from which the body rebuilds damaged tissue. During injury – and particularly post-surgery, where there is some degree of anabolic resistance – Kate recommends 2 to 2.2 grams of protein per kilogram of body weight per day. For a 60kg person, that’s around 120–132g of protein daily.
Equally important is distribution: protein should be spread throughout the day, roughly every three hours, to maintain a steady supply of amino acids for tissue repair. A single large protein hit at dinner is much less effective than consistent intake across the day.
One specific recommendation Kate makes is casein protein before bed. Unlike fast-acting whey protein (best taken after exercise), casein is a slow-release milk protein that supports muscle repair and recovery during sleep. A glass of milk is a simple, accessible source.
Healthy fats: managing inflammation
Some inflammation is a necessary part of healing – but excess or prolonged inflammation slows recovery. Omega-3 fatty acids, found in oily fish (salmon, mackerel, sardines), avocado, nuts, seeds, and olive oil, are particularly effective at modulating the inflammatory response. Kate recommends oily fish at least twice a week and considers omega-3 supplements a justified addition during injury recovery.
Vitamins and minerals: the repair toolkit
- Vitamin C and zinc – essential for collagen production and ligament and tissue regeneration. A reliable way to ensure adequate intake is five portions of fruit and vegetables per day.
- Iron – particularly important post-surgery, where blood loss during the procedure can deplete iron stores. Kate recommends blood tests before and after surgery to identify deficiencies and supplement accordingly. Dietary sources include red meat (paired with vitamin C to optimise absorption), and Weetabix – two of which provide 86% of the daily iron requirement.
- Vitamin D – recommended for everyone during winter months (WHO guidance), and especially important during injury recovery to support bone and tissue health.
- Calcium – particularly relevant for bone stress injuries; works in conjunction with vitamin D for bone repair and density.
Hydration
Often underestimated during injury, hydration supports virtually every physiological process involved in recovery – from temperature regulation to muscle contraction to nutrient delivery. Kate recommends an electrolyte tablet once daily during recovery, and offers a simple hydration check: urine should be light straw coloured. Anything darker is a sign to drink more.
A word on supplements
Kate is pragmatic about supplements: food should always come first, because whole foods provide fibre, micronutrients, and other compounds that isolated supplements don’t. But during injury, when requirements are elevated and appetite may be reduced, certain supplements are justified – specifically omega-3, protein (if food intake alone is insufficient), iron (if indicated by blood tests), casein protein, and vitamin D.
On the broader supplement market, her view is clear: “sometimes supplements are just expensive urine.” For competitive athletes, any supplement should carry the Informed Sport logo to confirm batch testing and freedom from banned substances. And for anyone, a long list of supplements without understanding what each one does is unlikely to help – and expensive.
Staying active during recovery: fuelling extra layers
Most injured athletes don’t stop moving entirely – and that’s fine. Upper body training, single-leg work, swimming, and similar alternatives help maintain fitness and mental wellbeing during a period that can otherwise feel very flat.
But doing additional training while injured means fuelling additional layers of demand. Kate’s framework: think of the body as having separate “compartments” – one for basic life functions, one for injury repair, one for daily activities, and one for any training on top. Each needs its own allocation of fuel. “You have permission to do that,” she says, “if you can guarantee you’re going to fuel your tank well so it doesn’t take away from your recovery.”
Young athletes: a population at particular risk
Kate flags young athletes as a group where injury risk and nutritional underfuelling intersect with particular consequence. Their energy demands are exceptionally high – they are growing, developing, studying, and training simultaneously – and yet under-fuelling is extremely common, usually unintentional.
The brain alone accounts for around 25–30% of total energy expenditure, despite being only 2% of body weight. For a teenager sitting GCSEs, playing two sports, and training before school, there are simply not enough hours in the day to eat adequately around all of those demands without specific awareness and planning.
The consequences of chronic underfuelling in young athletes include bone stress injuries, suppressed immune function, hormonal disruption (irregular or absent periods in girls), low mood, and poor performance. This cluster of symptoms is formally recognised as Relative Energy Deficiency in Sport (RED-S). Kate’s message: education of young athletes, their parents, and their coaches is the most important intervention available.
The bottom line
Injury is an unwelcome but often inevitable part of sport. What makes it less so – and what accelerates recovery when it does happen – is nutrition that matches the body’s actual demands. That means eating enough, not less. It means prioritising protein, healthy fats, and key micronutrients. And it means seeing food as an active tool in the rehabilitation process, not an afterthought.
“Food is your toolkit,” says Kate. “You’ve got different jobs going on when you’ve got an injury, so you require different tools to do those jobs – to rebuild so you’re repaired and ready to go once the rehab process is done.”
Kate Shilland (BSc, MSc) is a Registered Sports Nutritionist, ISAK Level 1 and UKAD Advisor with over 14 years’ experience across recreational and elite sport. She holds clinics at LBSM on Tuesday mornings, available in person and remotely.
To book an appointment with Kate or another member of the LBSM team, visit lbsm.co.uk/booking
Listen to the full episode below ↓
