A foot and ankle injury that needs to heal, a surgery that one need recover from, are strongly dependent on the body’s ability to heal. Dr. Ed Davis utilizes state of the art surgical techniques to ensure fast healing but ultimately, the patient’s health will determine how fast and how well such healing occurs.
An injury to the body or a surgical event triggers a series of events in the body. The body mobilizes hormones and rallies its’ resources to start the healing process. The creation of new tissue requires protein, carbohydrates, fats, vitamins, minerals, enzymes, antioxidants and more.
The initial phase of healing is catabolic in nature, that is, involves tissue breakdown. The body must clear diseased or damaged tissue out of the way before it can replace it with normal tissue. There is an acceleration in metabolism that occurs. Redness and swelling are components of acute inflammation in which blood containing white blood cells called macrophages which remove damaged tissue and bacteria. Overly aggressive attempts to suppress acute inflammation can, at times, actually slow the healing process. Inflammation that is prolonged can turn to chronic inflammation, a process that the human body is ill suited to deal with.
- Protein provides that building blocks of tissue repair. It is important to ingest adequate amounts of high quality protein after an injury or surgical treatment, ideally 2 to 3 servings a day.
- Fatty acids are a component of cell membranes so cellular repair requires adequate fat intake. Omega 3 fats are considered high quality fats and are found in nuts, fish and grass fed beef. Many are accustomed to the softness and flavor of corn fed beef but such beef has a higher percentage of omega 6 to omega 3 fats and are much less healthy.
- Vitamin C is an important antioxidant and is involved in the production of collagen, the building block of connective tissue. Collagen production is critical in wound and injury repair. It is also involved in the formation of new blood vessels, known as angiogenesis. The creation and ingrowth of new blood vessels is critical as it is the source of tissue nutrition.
- Vitamin A and carotenoids are antioxidants which help modulate the inflammation process and assist with the ability to fight infection. Eggs, fish, green leafy vegetables, orange/red vegetables are sources of Vitamin A. Carotenoids appear to have a significant effect on wound healing early in the process: http://www.ncbi.nlm.nih.gov/pubmed/7097365
- Zinc is a mineral that influences hormone productions, immune system function and assists with collagen and protein production. Required levels are from 15 mg to 50 mg per day.
- Vitamin D acts as a vitamin and hormone precursor and is critical in wound healing and immune function. It is created in the body from cholesterol in an area not always appreciated as an organ – the skin. Vitamin D is also critical in bone formation as it signals the body to absorb calcium and direct the calcium toward healing bone. Ingesting calcium supplements without adequate vitamin D is futile due to the function of vitamin D in absorption and use in bone deposition. Vitamin D deficiency is very common for a couple of reasons. First, the amounts required have not been revised by the medical community and FDA for many years. Second, avoidance of sun exposure due to concerns about skin cancer have interfered with the natural ability of the body to make its own vitamin D. Injury or surgical wounds may increase the need for vitamin D, learn more.
Potentially deleterious effects of sun on the skin may be offset by adequate ingestion of carotenoids, learn more.
Vitamin B6, manganese and Vitamin E have also been linked to the healing process, especially tendon injuries.
Injury to cells both in the acute and chronic sense causes liberation of free radicals. Free radicals are highly reactive atoms that are implicated in tissue damage, the aging process and tissue degeneration. Antioxidants are are substances, often nutrients, which are reducing agents, that is, agents which deactivate free radicals. Antioxidants tend to be tissue specific or targeted toward specific areas of the body. The large number of different target tissues is why the body requires a variety of antioxidants. Antioxidants may improve healing by reducing or eliminating damage causing free radicals in injured tissue.
How does one determine which antioxidants are important?
There is not a perfect method to determine that so it is advisable to utilize supplementation with a variety of antioxidants. Sometimes one can examine target tissue to determine what the primary antioxidant exists in that tissue. For examples, assay of human heart tissue demonstrate that gamma tocopherol, one of the eight forms of vitamin E is predominant. Interestingly, there have been a number of poorly designed studies claiming that vitamin E is not beneficial. The studies were not performed with gamma tocopherol but with dl-alpha tocopherol, a synthetic form of Vitamin E that has even less activity than the natural counterpart d-alpha tocopherol. Excess alpha tocopherol may displace gamma tocopherol in tissues but excess dl-alpha tocopherol displaces but d-alpha tocopherol and gamma tocopherol. Learn more:
Dr. Davis is a Foot & Ankle specialist and Podiatrist, serving the 78258 San Antonia area. Call us to book your appointment today.