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How Ehlers-Danlos Syndrome and Hypermobility Patients Can Optimize Muscle Growth and Recovery


Hypermobile patients are often advised to strengthen their muscles

One of the main recommendations for people with Ehlers-Danlos Syndrome and Hypermobility Spectrum Disorder is to strengthen the muscles around their hypermobile joints. Strengthening muscles is thought to help increase joint stability and decrease symptoms like muscle spasms and muscle pain. Anyone with Ehlers-Danlos Syndrome or hypermobility spectrum disorder will tell you that this is easier said than done!


Many people with joint hypermobility experience problems like fatigue, post-exertional malaise, and intense delayed onset muscle soreness as they work towards building muscle. All of these problems can make muscle-building exercises seem tortuous. But, the good news is that we can play an active role in helping our bodies recover and

rebuild from exercise, which makes reaching our goals easier.

Graphic that reads "nutrients for muscle, tendon, and ligament healing and recovery

Good nutrition is key for optimizing muscle recovery

In this article, let’s take a closer look at what nutrients our bodies need to recover from exercise.


In order for our muscles to get stronger, we need to create microtears in the muscle fibers through muscle-building exercises. Microtears formed during exercise do not magically disappear - our bodies use the nutrients we get from our food to heal them. When these microtears heal, our muscles grow and get stronger (exactly what we want to support our hypermobile joints!).


Not only does resistance exercise strengthen our muscles, over time it helps our tendons and ligaments become stronger too.


Here are important nutrients for recovery after exercise.


Nutrients for muscle, tendon, and ligament healing and recovery

  • Energy (aka calories)

  • Protein

  • Vitamin C

  • Zinc

  • Manganese

  • Copper


Graphic that reads "to get stronger, muscles need adequate energy and protein"

Nutrients needed for optimal muscle growth and recovery


Energy (calories)

Our bodies need enough energy to keep essential life processes going (hello heartbeat!) and enable us to go about our daily lives (walking, sitting, talking, exercising, etc.). If there is not enough energy to go around, our bodies will prioritize spending limited energy on the most important functions. This means that less energy will be available for a variety of processes, including recovering from exercise.


Optimizing muscle recovery after exercise requires enough energy derived from the calories in the food we eat to facilitate healing. A registered dietitian nutritionist (RD or RDN) can help you determine how many calories your body needs to take care of everything it needs to, including recovering after exercise.


  • Recommended calorie intake: highly individual and varies based on body size, activity level, infection/sickness/recent surgery, etc.

  • Food sources: High-calorie (but still nutritious!) foods include whole milk, whole yogurt, peanut butter, almond butter, olive oil, and coconut flakes

Protein

Protein is needed for muscle growth and repairing damaged cells and tissues in the body. Exercise, especially resistance training, creates small tears in our muscles. These microtears stimulate muscle growth through the healing process. For the body to heal and for the muscle to grow, we need the right amount of amino acids from the protein in the food we eat.


As a registered dietitian who works with patients with chronic illnesses like Ehlers-Danlos syndrome, I’ve noticed that the majority of my patients do not meet their body’s needs for protein due to fatigue, chronic nausea, or multiple dietary restrictions.


If you’re someone who struggles with really uncomfortable muscle soreness after exercise, it’s possible that you might not be eating enough protein to recover properly from exercise.


  • Recommended intake: highly individual and varies based on body size, type of exercise performed, presence of injury or infection, etc. Consult a Registered Dietitian to get assistance with estimating your protein needs.

  • Food sources: high protein foods include all meats, dairy, eggs, beans, peas, lentils, soy foods (soy milk, tofu, and tempeh), and protein supplements


Graphic that reads "our connective tissues need vitamins and minerals for collagen turnover"

Nutrients for optimal tendon and ligament healing and recovery

Just like muscles, tendons and ligaments become slightly damaged during exercise. When this happens, a process called collagen turnover helps replace damaged or degraded collagen bundles with new collagen. Over time, exercise stimulates tendons to become stronger and more resilient.


In addition to eating enough protein, getting the right amount of the following nutrients is crucial for tendon and ligament recovery after exercise.


Vitamin C

Vitamin C is required for collagen synthesis. Collagen synthesis is required for tendons and ligaments to heal. While it takes tendons and ligaments much longer to become stronger, we still need the right nutrition to help out the process.

  • Recommended intake for healthy adults: 75-90mg vitamin C daily

  • Food sources: most fruits and vegetables including strawberries, kiwi, potatoes, raw bell peppers, raw tomatoes, and raw broccoli

Zinc

As mentioned above, our tendons and ligaments also need to recover after exercise. Zinc is a mineral that acts as a cofactor for collagenase. Collagenase is an enzyme that facilitates collagen remodeling during the healing process.


Like protein, zinc is another nutrient that many of my patients seem to struggle to get enough of. Zinc is crucial for hundreds of processes in the body, including preserving the health of our connective tissues so it should not be overlooked!

  • Recommended intake for healthy adults: 8-11mg. People who are healing from surgery or an infection may benefit from more.

  • Food sources: oysters, meats, dairy, pumpkin seeds

  • Note: avoid long-term supplementation of zinc because it can lead to a copper deficiency.

Manganese

Manganese activates enzymes that our cells use to make proline. Collagen proteins contain proline, an amino acid that helps give collagen fibers their unique triple helix shape. Getting the right amount of manganese helps this process run smoothly.


Of course, if you have a type of EDS that affects the shape of collagen molecules, getting enough manganese or any other nutrient will not fix the issue caused by certain genes. However, getting the right amount of nutrients that your body needs for creating collagen is still important because certain nutrient deficiencies have the potential to negatively impact collagen quality.

  • Recommended intake for healthy adults: 1.8 milligrams for women and 2.3 milligrams for men.

  • Food sources: brown rice, pecans, dark chocolate, hemp seeds

Copper

Copper also plays a role in collagen production. It activates an enzyme called lysyl oxidase which is required for collagen maturation, one of the final steps of collagen production. Lysyl oxidase helps with the cross-linking process, which connects collagen fibers with other supportive fibers. This process helps form the scaffold that supports tissues.

  • Recommended intake for healthy adults: 900 micrograms

  • Food sources: dark chocolate, cashews, oysters, sunflower seeds


Nutrition matters for people with Ehlers-Danlos Syndrome

While we can’t change our genes, we can support our bodies with good nutrition. Pair good nutrition with muscle and connective tissue strengthening exercises, and we are on our way to feeling better!


Getting the right amount of energy, protein, vitamin C, zinc, manganese, and copper can help your body recover from exercise so you can gain strength and resilience over time.


Graphic that reads "Will eating enough of the right nutrients fix faulty collagen?"

Are you getting the right nutrition?

I help people with EDS and hypermobility learn how to meet their nutritional needs and manage their nutrition-related symptoms so they can feel better, more often. Click here to learn more.



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