• Reduces muscle loss - proteins help prevent quadriceps from losing muscle mass post-surgery
• Enhances muscle growth - proteins stimulate muscle growth which promotes faster recovery
• Strengthens ligaments and bones - Vitamin D supports ligament integrity and bone health, reducing the risk of graft failure
• Reduces inflammation - Vitamin D helps to lower inflammation to improve recovery outcomes 
• Supports energy levels - a well balanced diet of carbohydrates, proteins, fats, vitamins, and minerals ensures overall well being and health during recovery

After surgery, muscle breakdown increases, particularly in the quadriceps, due to prolonged inactivity and the invasive nature of the procedure. Protein plays a crucial role in muscle repair, recovery, and function. ACL rehabilitation depends on resistance training, including weightlifting, which creates tiny tears in the muscle fibers. The body utilizes protein to repair these tears, leading to muscle growth and increased strength. Without adequate protein intake, muscle development is limited, regardless of training intensity. For optimal recovery, consuming protein within 30–60 minutes after a workout is beneficial. However, overall daily protein intake and evenly distributing protein consumption throughout the day are just as, if not more, important. This is because muscles can only utilize a limited amount of protein at a time.

Amino acids, the building blocks of protein, are essential for bodily functions. Of the 20 amino acids the body requires, it can produce 11 on its own. The remaining nine, known as essential amino acids, must come from the diet. Foods that contain all nine essential amino acids are considered complete proteins. The best sources of complete proteins include animal-based foods such as poultry, lean meats, fish, dairy, and eggs. Plant-based proteins are often incomplete, meaning they lack one or more essential amino acids. To obtain all nine, it’s important to consume a variety of plant-based protein sources. Some high-protein plant foods include beans, soy products, quinoa, nuts, and seeds.

The general recommendation for protein intake is 0.36 grams per pound of body weight. However, for muscle growth and recovery, a higher intake of 0.6–0.8 grams per pound of body weight is recommended. For example, a person weighing 150 lbs should aim for 90–120 grams of protein per day.

• Animal based protein: chicken, turkey, lean meats, fish, eggs, dairy
• Plant-based protein: beans (chickpeas, black beans, lentils) nuts, seeds, soy (tofu, tempeh) quinoa
• Supplementation: whey protein (animal-based), pea protein (plant-based), soy protein (plant-based)

Leucine is one of the nine essential amino acids that the body cannot produce on its own and must be obtained through the diet. Its most important role is activating muscle protein synthesis by triggering the mammalian target of rapamycin (mTOR) which is a key pathway responsible for muscle growth and repair. Think of mTOR as a "muscle-building switch" that signals the body to create new proteins, helping muscles grow and recover after strength and resistance training. Since leucine reduces muscle breakdown and enhances muscle growth, it is especially important for those recovering from ACL reconstruction (ACLR) and anyone looking to build strength.

To effectively stimulate muscle protein synthesis, 2.5–3 grams of leucine (or about 30 grams of protein) per meal is recommended. The most efficient way to reach this target is through high-quality animal based proteins, as they contain leucine in the most bioavailable and complete form. Some high-leucine foods containing approximately 2.5 grams of leucine include:

• 3.4 oz turkey breast or steak
• 1.5 chicken thighs
• 0.8 fillet of cod
• 1 cup of egg whites
• 3.4 oz non-fat Greek yogurt

Rather than focusing strictly on the exact amount of leucine in each meal, aim to include leucine-rich foods, especially in meals following workouts, to support muscle recovery and growth.

• Best sources: poultry, fish, beef, eggs, non-fat Greek yogurt
• Supplementation: L-Leucine supplements 

Vitamin D is an essential nutrient that the body obtains from sunlight, food, and supplements. It plays a critical role in bone health by helping the body absorb calcium, which strengthens bones and supports muscle contraction. When vitamin D levels are low, calcium absorption decreases, potentially leading to weaker bones and impaired muscle function. Additionally, research suggests that vitamin D helps reduce muscle fiber loss, particularly in the quadriceps, after surgery. This means maintaining adequate vitamin D levels could help preserve muscle mass during ACL reconstruction recovery.

There are two main forms of vitamin D:

• D3 (cholecalciferol) -  found in sunlight and animal-based foods
• D2 (ergocalciferol) - less common, but found in some plant sources

The body naturally produces vitamin D3 when the skin is exposed to ultraviolet (UV) rays from the sun. However, dietary sources and supplements are important, especially for those with limited sun exposure. The recommended daily intake for vitamin D is 600 IU (15 mcg).

For reference:

• 3 oz salmon contains 10–18 mcg (depending on the type)
• 3 oz portobello mushrooms provide 8 mcg

 

• Best sources: sunlight, fatty fish (salmon, tuna), mushrooms, fortified dairy, egg yolks
• Supplementation: found in both the D3 and D2 form

One of the biggest challenges in recovering from ACL reconstruction (ACLR) is managing inflammation. Surgery itself triggers inflammation due to tissue trauma, while strength and resistance training further contribute by causing tiny tears in muscle fibers as they rebuild and strengthen. Excessive inflammation can slow recovery by increasing joint stiffness, limiting range of motion, and damaging cartilage. Omega-3 fatty acids help control inflammation, improve joint mobility, and enhance overall recovery. They also reduce the risk of blood clots after surgery. Omega-3 and omega-6 are both polyunsaturated fats, but while omega-3s have anti-inflammatory properties, excessive omega-6 intake can promote inflammation.

Omega-3s, often called "good fats," may lower the risk of chronic conditions like arthritis, which is more common after an ACLR. They are found in fatty fish (such as salmon, mackerel, and sardines), flaxseeds, chia seeds, and walnuts. In contrast, omega-6s—commonly found in vegetable oils like corn, sunflower, and soybean oil—can contribute to inflammation when consumed in excess.

• Best sources
  • Fatty fish: salmon, mackerel, sardines
  • Nuts and seeds: walnuts, flaxseeds, chia seeds, hemp seeds
• Supplementation: fish oil