How Nutrition and Physiotherapy Work Together for Faster Recovery

The Biological Basis: Why Nutrition Matters for Tissue Repair

When you injure a tissue—whether muscle, tendon, ligament or bone—your body initiates a complex healing cascade. This process unfolds in overlapping phases: inflammation (days 0-5), proliferation (days 3-21) and remodelling (weeks 3-12+). Each phase has specific nutritional requirements that, when met, optimise healing speed and quality.

During the inflammatory phase, your immune system mobilises to the injury site. White blood cells clear damaged tissue and initiate repair signalling. This phase requires adequate energy and specific nutrients—vitamin C for immune function, zinc for cellular proliferation and omega-3 fatty acids to resolve excessive inflammation without suppressing the necessary healing response. Many patients instinctively reduce food intake when injured, especially if they're worried about gaining weight during enforced rest. This is counterproductive; your metabolic rate actually increases during early healing as your body diverts resources to repair.

The proliferation phase sees new tissue formation. Fibroblasts lay down collagen (the structural protein in tendons, ligaments and fascia), new blood vessels form (angiogenesis) and muscle satellite cells begin regenerating damaged fibres. Protein intake becomes critical here—you need 1.6-2.2g per kilogram of body weight daily to provide sufficient amino acids for tissue synthesis. Vitamins A, C and K, along with minerals like copper and manganese, serve as co-factors in collagen production. Inadequate intake during this phase results in weaker, less organised scar tissue that's prone to re-injury.

During remodelling, your newly formed tissue matures and strengthens in response to progressive loading—the rehabilitation exercises your physiotherapist prescribes. This phase can last months or even years for severe injuries. Sustained high-quality nutrition throughout this period ensures tissue adapts optimally, becoming as strong or stronger than before injury. This is where the synergy between physiotherapy and nutrition becomes most apparent: physiotherapy provides the mechanical signal for adaptation, whilst nutrition provides the building blocks to actualise that adaptation.

Research consistently shows that patients with optimal nutrition status heal faster and experience fewer complications than those with poor nutrition. A systematic review of surgical patients found that those receiving nutrition optimisation had 30-50% fewer complications and shorter hospital stays. Whilst most physiotherapy patients at our Surbiton clinic aren't surgical cases, the principles apply equally to musculoskeletal injuries.

Protein: The Foundation of Tissue Repair

Protein is the macronutrient most directly linked to tissue repair and recovery. Muscles, tendons, ligaments and even bone contain significant protein structures that require continuous renewal, with this demand heightened during injury recovery and rehabilitation.

How much protein do you need during physiotherapy? Research suggests 1.6-2.2g per kilogram of body weight daily for optimal recovery—considerably more than the UK's recommended daily allowance (RDA) of 0.8g/kg, which represents minimum intake to prevent deficiency, not optimal intake for tissue repair. For a 70kg person, this means 112-154g of protein daily. If you're simultaneously trying to lose body fat whilst recovering from injury, aim for the higher end of this range to preserve muscle mass during caloric restriction.

Distribution throughout the day matters as much as total intake. Your body can only utilise approximately 20-30g of protein per meal for muscle protein synthesis (the process of building new tissue). Consuming 100g of protein at dinner and little throughout the day is less effective than spreading four or five 20-30g servings across the day. This means including protein at breakfast (Greek yoghurt, eggs), lunch (chicken, fish, tofu), dinner (meat, legumes) and potentially snacks (nuts, protein shake).

Timing around physiotherapy sessions is also relevant. Consuming 20-30g of protein within 60-90 minutes after your physiotherapy appointment provides amino acids precisely when your tissues are primed to use them. This doesn't need to be complicated—a protein shake, Greek yoghurt or even a chicken sandwich achieves this goal. The post-exercise "anabolic window" is more forgiving than once thought (it's hours, not minutes), but providing protein reasonably soon after rehabilitation exercise supports optimal adaptation.

Protein quality also matters. Complete proteins containing all nine essential amino acids are ideal. These include animal sources (meat, fish, eggs, dairy) and some plant sources (quinoa, soy). If you follow a plant-based diet, combining complementary proteins (rice with beans, peanut butter on whole-grain bread) ensures you obtain all essential amino acids. Leucine, one particular amino acid, appears especially important for triggering muscle protein synthesis; it's abundant in dairy, meat and legumes. For more information on how nutrition strategies integrate with our physiotherapy treatments for common sports injuries, speak with our team during your appointment.

Carbohydrates: Fuelling Recovery and Rehabilitation

Whilst protein receives most attention in recovery nutrition, carbohydrates play equally important roles. Carbohydrates fuel the cellular processes of tissue repair, replenish glycogen stores depleted during rehabilitation exercises and support immune function—all critical for recovery.

Your energy needs don't plummet when you're injured. Whilst you burn fewer calories from exercise, your resting metabolic rate increases during healing, especially in the first weeks post-injury. Restricting carbohydrates (and overall calories) too severely can impair healing by reducing available ATP (cellular energy currency) for tissue synthesis and by suppressing immune function. This is particularly problematic if you're also trying to comply with a demanding rehabilitation programme prescribed by your physiotherapist at our Surbiton clinic.

Carbohydrate periodisation—varying intake based on activity—is a useful concept during rehabilitation. On days with intensive physiotherapy sessions or rehabilitation exercises, increase carbohydrate intake to 4-6g per kilogram of body weight to fuel performance and support glycogen replenishment. On lighter days with minimal exercise, 2-3g/kg may suffice. This approach maintains energy availability when needed whilst avoiding unnecessary calorie surplus on rest days.

Carbohydrate quality significantly impacts inflammation and recovery. Complex carbohydrates from whole grains, vegetables, fruits and legumes provide steady energy release and come packaged with fibre, vitamins and minerals that support healing. Refined carbohydrates and added sugars (white bread, pastries, sugary drinks) cause sharp blood glucose spikes followed by crashes, promote inflammation and provide little nutritional value beyond calories. During recovery, prioritise nutrient-dense carbohydrate sources that support, rather than hinder, healing.

Glycogen (stored carbohydrate in muscles and liver) is particularly important if your rehabilitation includes strength training or high-repetition exercise—common in physiotherapy programmes. Adequate glycogen ensures you can complete your prescribed exercises with good form and appropriate intensity, maximising the training stimulus without compensatory movement patterns that risk further injury. Chronically low glycogen impairs performance, mood and motivation—none of which support successful rehabilitation.

For patients across Kingston upon Thames balancing weight management concerns with injury recovery, remember that appropriate carbohydrate intake supports rehabilitation. A modest calorie deficit is acceptable if fat loss is genuinely necessary, but severe restriction sabotages healing. Work with your physiotherapist or a nutrition professional to find the right balance for your specific circumstances.

Fats: Inflammation Modulation and Cellular Health

Dietary fats influence inflammation, hormone production and cellular membrane integrity—all relevant to injury recovery and physiotherapy outcomes. The type of fat you consume matters more than total fat intake, with omega-3 and omega-6 fatty acids requiring particular attention.

Omega-3 fatty acids (found in oily fish, flaxseeds, walnuts and algae) have well-documented anti-inflammatory properties. They produce signalling molecules called resolvins and protectins that help resolve inflammation and promote tissue healing. Studies show omega-3 supplementation can reduce muscle soreness, enhance recovery from exercise and support tendon healing. For patients recovering from injuries or chronic inflammatory conditions, increasing omega-3 intake—through two portions of oily fish weekly or supplementation (1-2g EPA+DHA daily)—is a simple, evidence-based intervention.

Omega-6 fatty acids (found in vegetable oils, nuts, seeds and processed foods) are essential but can be pro-inflammatory when consumed in excess relative to omega-3s. The modern Western diet provides omega-6:omega-3 ratios of 15:1 or higher, whilst our evolutionary diet likely provided closer to 2:1. During injury recovery, consciously reducing excessive omega-6 intake (particularly from processed foods and vegetable oils high in linoleic acid) whilst increasing omega-3s may create a more favourable inflammatory environment for healing.

Monounsaturated fats (found in olive oil, avocados and nuts) are neutral regarding inflammation and provide valuable energy and fat-soluble vitamin absorption. They should form the backbone of your dietary fat intake. Saturated fats from quality sources (meat, dairy, coconut) in moderate amounts are compatible with recovery, though excessive intake may promote inflammation in some individuals. Trans fats (in some processed foods) should be minimised or avoided entirely, as they're consistently linked to inflammation and poor health outcomes.

Fat intake also influences hormone production, including testosterone and growth hormone, which support muscle recovery and adaptation. Extremely low-fat diets (<15% of calories) can suppress these anabolic hormones, potentially impairing recovery. Aim for 20-35% of total calories from fat, emphasising omega-3 and monounsaturated sources, to support optimal hormone function and tissue repair.

Micronutrients: The Supporting Cast of Recovery

Whilst macronutrients (protein, carbohydrates, fat) provide structure and energy, micronutrients (vitamins and minerals) enable the enzymatic reactions that drive tissue repair. Deficiencies in key micronutrients can significantly delay recovery, even with optimal macronutrient intake and expert physiotherapy.

Vitamin C is essential for collagen synthesis. Without adequate vitamin C, collagen structure is weak and disorganised—a condition historically known as scurvy. Whilst frank scurvy is rare, subclinical vitamin C insufficiency may slow tendon, ligament and skin healing. Smokers, people under high stress and those with limited fruit and vegetable intake are at risk. Aim for 100-200mg daily from foods (citrus fruits, berries, peppers, broccoli) or supplementation if needed. Megadoses (>1000mg) aren't beneficial for most people and may cause digestive upset.

Vitamin D influences bone health, muscle function and immune regulation. Deficiency is extremely common in the UK, particularly during winter months when sunlight (necessary for vitamin D production) is scarce. Studies link low vitamin D to increased injury risk, impaired muscle function and slower recovery. Most people benefit from supplementation (1000-2000 IU daily) from October through March. Athletes, people with darker skin, and those who spend little time outdoors may benefit from year-round supplementation. Testing vitamin D levels is simple and can guide appropriate dosing. At Lambert Sports Clinic, we can advise on vitamin D optimisation as part of your comprehensive recovery plan, which may also include sports massage and other adjunct therapies.

Calcium is obviously critical for bone healing but also plays roles in muscle contraction and cellular signalling. Most people obtain adequate calcium from dairy products, fortified plant milks, leafy greens and tinned fish with bones. If you're recovering from a bone stress injury or fracture, ensuring 1000-1300mg daily is particularly important.

Iron is necessary for oxygen transport and energy production. Iron deficiency is common, especially in menstruating women and vegetarians. Symptoms include fatigue, poor exercise tolerance and impaired immune function—all counterproductive during rehabilitation. If you suspect iron deficiency, testing is essential before supplementing, as excessive iron can be harmful. Dietary iron comes in haem (animal sources, well absorbed) and non-haem (plant sources, less well absorbed) forms. Combining non-haem iron with vitamin C enhances absorption.

Zinc supports immune function, protein synthesis and wound healing. Deficiency delays recovery and increases infection risk. Good sources include meat, shellfish, legumes, nuts and seeds. Aim for 8-11mg daily from food sources. Excessive supplementation can interfere with copper absorption, so food sources are preferable to high-dose supplements unless medically indicated.

Magnesium is involved in over 300 enzymatic reactions, including muscle relaxation, energy production and bone health. Deficiency can manifest as muscle cramps, poor sleep and fatigue. Green vegetables, nuts, seeds and whole grains provide magnesium. Many people benefit from moderate supplementation (200-400mg daily), particularly if muscle tension or cramping is problematic during rehabilitation.

Hydration and Electrolytes: The Overlooked Essentials

Hydration status profoundly affects physiotherapy outcomes, yet it's often overlooked. Even mild dehydration (2% body weight loss) impairs exercise performance, cognitive function and thermoregulation. During rehabilitation, optimal hydration supports tissue perfusion (blood flow to healing tissues), nutrient delivery and waste removal—all critical for recovery.

General hydration guidelines suggest 2-3 litres of fluid daily, though individual needs vary with body size, activity level, climate and sweat rate. A practical gauge is urine colour: pale straw indicates good hydration, whilst dark yellow suggests you need more fluids. Don't wait until you're thirsty, as thirst is a late indicator of dehydration. Sip water consistently throughout the day, including before, during and after physiotherapy appointments.

Electrolytes—particularly sodium, potassium, magnesium and calcium—are crucial for muscle function, nerve signalling and fluid balance. Whilst most people obtain adequate electrolytes from food, those sweating heavily during rehabilitation (or in warm weather) may benefit from electrolyte-containing drinks. This needn't be expensive sports drinks; a pinch of salt and a squeeze of lemon in water, or coconut water, provides electrolytes without added sugars.

Timing hydration around physiotherapy sessions matters. Arrive well-hydrated (drink 400-600ml in the 2-3 hours before your appointment) to ensure optimal performance during rehabilitation exercises. Afterwards, replace fluid losses—approximately 150% of weight lost during the session if you've been sweating. For most physiotherapy sessions at our Surbiton clinic, this simply means drinking a couple of glasses of water after your appointment alongside your post-treatment protein-containing meal or snack.

Alcohol deserves specific mention. Whilst moderate alcohol consumption may not significantly impair recovery for most people, heavy or frequent drinking does. Alcohol disrupts sleep quality (essential for recovery), impairs protein synthesis, promotes inflammation and compromises coordination—increasing re-injury risk. If you're serious about maximising recovery, minimising alcohol during intensive rehabilitation phases is wise.

Sample Nutritional Plans for Different Injury Scenarios

Understanding principles is valuable, but practical application is essential. Here are evidence-based nutritional frameworks for common injury and rehabilitation scenarios we encounter at Lambert Sports Clinic in Surbiton, Kingston upon Thames and across South-West London.

Acute Muscle Strain (First 2 Weeks)

Goals: Support inflammation resolution, provide protein for muscle repair, maintain energy availability.

• Protein: 2.0-2.2g/kg daily, distributed across 4-5 meals
• Carbohydrates: 3-4g/kg (moderate, as activity is reduced)
• Fats: Emphasise omega-3 (aim for 2-3g EPA+DHA daily from fish or supplements)
• Micronutrients: Ensure adequate vitamin C (200mg), vitamin D (2000 IU), zinc (15mg)
• Sample day: Breakfast—scrambled eggs with spinach and salmon; Snack—Greek yoghurt with berries; Lunch—chicken salad with olive oil dressing; Snack—almonds and an orange; Dinner—grilled fish with quinoa and roasted vegetables; Evening—protein shake if needed to meet protein target

Tendon Injury Rehabilitation (6-12 Weeks)

Goals: Support collagen synthesis, provide sustained energy for progressive loading exercises, maintain muscle mass.

• Protein: 1.8-2.0g/kg daily, including collagen peptides (10-15g) post-physiotherapy
• Carbohydrates: 4-5g/kg on physiotherapy days, 3g/kg on rest days
• Fats: 25-30% of calories, emphasising anti-inflammatory sources
• Micronutrients: Vitamin C (500mg with collagen), vitamin D (2000 IU), copper-rich foods (shellfish, nuts)
• Sample day: Breakfast—porridge with protein powder, banana and walnuts; Snack—boiled eggs; Lunch—turkey and avocado wrap with mixed salad; Post-physio—collagen peptide drink with orange juice (vitamin C); Dinner—lean beef stir-fry with brown rice and vegetables; Evening—cottage cheese with pineapple

Post-Surgical Rehabilitation (0-6 Weeks)

Goals: Support wound healing, prevent muscle loss from immobilisation, manage inflammation.

• Protein: 2.0-2.5g/kg daily (higher due to surgical stress and potential immobilisation)
• Carbohydrates: 3-4g/kg (activity very low initially)
• Fats: Emphasise omega-3 and monounsaturated fats
• Micronutrients: Vitamin A (important for wound healing), vitamin C (500mg), zinc (20mg), vitamin D (2000 IU)
• Sample day: Breakfast—omelette with vegetables and cheese; Snack—protein smoothie with spinach, berries and flaxseeds; Lunch—salmon fillet with sweet potato and steamed broccoli; Snack—hummus with carrot sticks; Dinner—chicken breast with couscous and roasted peppers; Evening—Greek yoghurt with honey and walnuts

These plans are starting frameworks. Your specific needs depend on body size, injury severity, concurrent training, lifestyle factors and personal preferences. At Lambert Sports Clinic, we can work with you to develop personalised nutrition strategies that integrate seamlessly with your physiotherapy treatment plan. We can also advise on when additional support from a registered nutritionist or dietitian would be beneficial. Understanding how to optimise nutrition can also complement other treatments like our AI gait analysis for runners.

Supplements: When Are They Necessary?

The supplement industry aggressively markets products promising accelerated recovery, but evidence supporting most supplements is weak or absent. A whole-food diet meeting your energy and nutrient needs is the foundation; supplements, where beneficial, address specific deficiencies or provide convenience.

Protein powder is a food, not a supplement. It's convenient for meeting high protein targets when whole-food sources are impractical. Whey protein is well-absorbed and leucine-rich; plant-based options (pea, rice, soy blends) work well for vegetarians and vegans. Use protein powder as needed to reach your daily target, but prioritise whole foods when possible.

Omega-3 supplements provide concentrated EPA and DHA if you don't eat oily fish. Look for products providing 1-2g EPA+DHA daily, from fish oil, krill oil or algae (vegan option). Higher doses may have blood-thinning effects, so discuss with your GP if you take anticoagulants.

Vitamin D supplementation is advisable for most UK residents during winter. Take 1000-2000 IU daily, or more if blood tests reveal deficiency. Vitamin D is fat-soluble, so take it with a meal containing fat for better absorption.

Collagen peptides show promise for tendon and ligament injuries. Take 10-15g daily alongside vitamin C (which enhances collagen synthesis) approximately 60 minutes before your physiotherapy session. Evidence is emerging, with some studies showing modest benefits for tendon healing and joint health.

Creatine monohydrate supports muscle mass maintenance during rehabilitation, particularly if you're unable to train normally. Take 3-5g daily; it's one of the most researched and safe supplements available. It may reduce muscle loss during immobilisation and support strength gains during rehabilitation.

Most other supplements lack strong evidence for injury recovery. Glucosamine and chondroitin show inconsistent results for joint health. BCAAs (branched-chain amino acids) are unnecessary if you consume adequate total protein. Antioxidant megadoses may actually impair training adaptations. At Lambert Sports Clinic, we prefer evidence-based recommendations over trendy but unproven supplements. For complex cases, we can refer you to registered nutritionists who specialise in sports and rehabilitation nutrition.

The Physiotherapist-Nutritionist Collaboration Model

At Lambert Sports Clinic, we recognise that optimal patient outcomes require multidisciplinary collaboration. Whilst physiotherapists can provide general nutritional guidance, complex cases benefit from dedicated nutrition expertise. Here's how the collaboration works.

Your physiotherapist conducts initial assessment and diagnosis, creates a rehabilitation plan and provides fundamental nutrition advice—ensuring adequate protein, hydration and energy to support recovery. For most patients, this guidance is sufficient alongside your physiotherapy treatment, whether for common sports injuries or other conditions.

If you present with complex nutritional needs—significant weight management concerns, eating disorders, specific dietary restrictions, diagnosed nutritional deficiencies or elite athletic demands—your physiotherapist may recommend specialist nutrition support. We work with registered nutritionists and dietitians who understand sports medicine and rehabilitation, ensuring seamless coordination between your nutrition plan and rehabilitation programme.

This integrated approach means your nutritionist understands your injury, rehabilitation stage and functional goals, whilst your physiotherapist understands your nutritional status and any dietary modifications. For example, if you're recovering from an Achilles tendon injury whilst managing body composition, your physiotherapist programmes appropriate loading exercises whilst your nutritionist creates a modest calorie deficit that still provides 2.0g/kg protein to preserve tendon healing. Regular communication between practitioners ensures your nutrition and rehabilitation strategies synergise rather than conflict.

For patients in Surbiton and across Kingston upon Thames, this collaborative model means you receive holistic, evidence-based care without navigating conflicting advice from different practitioners. It's healthcare as it should be—integrated, patient-centred and outcome-focused. To learn more about other aspects of recovery, explore our article on when to seek physiotherapy.