Nutrition Before and Foot and Ankle Surgery

What to Eat, What to Avoid, and What Actually Helps Healing

Recovery from surgery or injury isn’t just about the procedure — nutrition plays a major role in how well and how fast your body heals. The right fueling strategy can support wound healing, bone repair, muscle preservation, sleep, and return to activity.

Below are practical, evidence-informed guidelines I routinely discuss with patients.

• Surgery places your body in a high-demand healing state
• Calorie needs often increase, even if activity decreases
• Poor fueling can slow:
  • wound healing
  • bone healing
  • muscle recovery
  • immune function
• Supplements help, but they cannot replace adequate food intake
   

Key principle: Healing is an active process — your body needs raw materials to do the work.

• Needed for: 
  • wound healing
  • bone repair
  • muscle preservation
• Typical needs:
  • Soft-tissue injury: ~1.4–1.8 g/kg/day
  • Major surgery or reconstruction: up to 2.0–2.5 g/kg/day (temporarily)

More protein is helpful — but protein alone is not enough.
 

• Carbohydrates:
  • spare protein so it can be used for healing
  • replenish glycogen needed for rehab and physical therapy
• Severely restricting carbs can delay recovery and increase injury risk
   

Balanced plates heal better than extreme diets.

• Healthy fats support:
  • hormone balance
  • vitamin absorption (especially vitamin D)
• Include sources like olive oil, nuts, seeds, avocado, and fish
   

• Supports collagen formation and wound healing
• Found in citrus, berries, peppers, and leafy greens
  

• Functions more like a hormone than a vitamin 
• Supports:
  • bone healing
  • muscle function
  • immune health
• Blood levels matter — many active patients are low
• Often best absorbed in oil-based (gel cap) formulations
   

• Essential for bone healing
• Best taken separately from iron supplements
• Often paired with vitamin D for absorption

• Important for:
  • cellular repair
  • immune function
• Useful during recovery, but excessive dosing can cause GI upset
   

• Help regulate inflammation
• Best obtained from food early (fish)
• High-dose supplements are usually delayed ~2 weeks after surgery
  • early inflammation helps deliver nutrients to healing tissue
     

• Dehydration contributes to:
  • muscle cramping
  • fatigue
  • poor tissue elasticity
• Many patients are chronically under-hydrated
• Electrolytes can help:
  • muscle function
  • hydration retention
  • cramp prevention

Hydration supports tendons, muscles, and recovery — especially as we age.
 

• Magnesium glycinate is commonly used to support:
  • sleep quality
  • muscle relaxation
  • cramp reduction
• Better sleep = better recovery
   

• Protein supplementation (to meet daily needs)
• Creatine
  • supports muscle preservation
  • emerging evidence for brain health
• Magnesium (for sleep and cramping)
• Vitamin D (if deficient)
   

• “One-size-fits-all” supplement stacks 
• Adaptogens marketed in drinks or coffee
• Peptides and unregulated injectables
  • limited high-quality data
  • safety and sourcing matter
     

Supplements should support good nutrition — not replace it.

During injury or surgery recovery, this is not the time for:

• extreme calorie restriction
• intermittent fasting
• ketogenic or carnivore diets

These approaches can:

• reduce energy availability
• impair healing
• increase bone and soft-tissue injury risk
   

Consistency beats restriction during recovery.

It’s common to gain some weight when activity decreases — and that’s okay.

What matters more:

• preserving muscle 
• supporting healing
• returning safely to activity
   

Focusing too aggressively on weight loss during recovery often slows healing and leads to setbacks.

1. Eat consistently — don’t skip meals
2. Prioritize hydration (with electrolytes if needed) 
3. Focus on body composition and healing, not the scale
    

There is no single supplement or diet that “fixes” recovery.

Healing happens best when:

• calories are adequate
• protein is sufficient
• carbohydrates are not feared
• hydration and sleep are prioritized 

Nutrition is part of your treatment plan — not an afterthought.