I'm going to influence every part of of my healing that I can.
MY TAKE ON IT
After my ORIF surgery, my doctor advised that I take calcium and vitamins D and C—which I did. But, me being me, I wondered if I could do more.
Health, at least in recent years, has been at or near the top of my priorities. Without it, I can’t do anything for myself, or for anyone else. Without it, I can’t enjoy much of my life. This injury, this surgery, and this prolonged recovery only made me surer of that fact. I sure wasn’t enjoying life as much as usual sitting in front of the TV with my leg propped up on a pillow.
So much of healing requires patience. You can't make a fracture knit together through sheer determination, and you can't exercise your way out of the early stages of recovery. Taking something that might help can feel like one small part of the process you can actually control. I was all about that.
I did a lot of research, bought a lot of vitamins and supplements, and take them still. By all accounts, I’ve healed well. Are the supplements the reason? They’re not magic, for sure.
But I feel they played a part.
Feed Your Bones
Bone may look like an inert, rock-hard structure, but it’s living tissue that is constantly being broken down and rebuilt. After a fracture, that rebuilding process goes into high gear.
And bone may be only part of what needs repairing. An ankle fracture can also damage ligaments, tendons, muscles and other soft tissues. If you've had surgery, there are incisions to heal as well. Your body needs nutrients to repair all these structures.
Some nutrients have obvious starring roles in bone health; others support the process indirectly. And some supplements marketed for bone healing have much less evidence behind them than the advertising might suggest.
The Big Players
Calcium gets top billing for a reason. It’s the major mineral in bone, and your body needs an adequate supply while new bone is being formed. Dairy products, fortified plant milks, leafy greens and sardines are food sources; calcium carbonate and calcium citrate are common supplement forms.
Too much supplemental calcium can cause problems, including kidney stones, and calcium can interfere with the absorption of iron and zinc. Calcium is also better absorbed in smaller amounts rather than one enormous dose.
Vitamin D and calcium belong in the same conversation because vitamin D helps your body absorb and regulate calcium and plays an important role in bone remodeling. Sunlight, fatty fish and fortified foods provide vitamin D, and supplements usually contain vitamin D2 or D3.
Vitamin D is another nutrient you don't want to take indiscriminately. Excessive amounts can cause calcium levels in the blood to become too high and potentially lead to nausea, fatigue and kidney problems. If deficiency is a concern, bloodwork can help determine whether supplementation is actually needed and how much.
Protein is essential for repairing bone, damaged muscles and connective tissues. It also supports wound healing and may help limit muscle loss during prolonged inactivity.
Good sources include meat, fish, dairy products, eggs, beans and other foods. A protein supplement can be useful if you're not getting enough through your diet.
Collagen forms much of the framework of bone and is also a major component of tendons, ligaments and skin. Your body produces collagen using amino acids from dietary protein, along with nutrients such as vitamin C. Collagen plays an essential role in repairing these tissues and healing surgical wounds.
Collagen is found in gelatin and bone broth and is available in collagen-peptide supplements. Although some early research suggests that collagen supplements may support tendon health and recovery, there's not yet convincing evidence that they speed healing after an ankle fracture or associated soft-tissue injury.
Vitamin C is part of this picture because your body needs it to produce collagen, making it important for repairing injured soft tissues and healing surgical incisions. Citrus fruits may be the obvious source, but berries, peppers and broccoli are also rich in vitamin C.
Very large doses can cause stomach problems and, in susceptible people, may contribute to kidney stones.
The Supporting Cast
Several other nutrients play supporting roles in maintaining bone and helping the body repair itself.
Magnesium is involved in bone metabolism and helps the body activate vitamin D. Good food sources include nuts, seeds, whole grains and leafy green vegetables. Magnesium supplements come in several forms, including citrate and glycinate.
Too much supplemental magnesium can have an unmistakable downside: diarrhea and stomach upset. People with kidney problems also need to be particularly cautious about taking extra magnesium.
Vitamin K2 is involved with proteins that help incorporate calcium into bone. You'll find it naturally in foods such as natto, cheese and egg yolks, and it is widely sold as a supplement, often alongside vitamin D.
There is an important caveat: vitamin K can interact with certain anticoagulant medications, particularly warfarin.
Zinc participates in cell repair, collagen formation, immune function and wound healing—all useful processes when your body is recovering from injury or surgery. Meat, shellfish, legumes and nuts provide zinc, and supplemental forms include zinc gluconate and zinc picolinate.
High doses can cause nausea and interfere with copper absorption.
The Wild Cards
Bring in omega-3s, creatine and other supplements, and things become more interesting—and less clear-cut.
Omega-3 fatty acids, found in fatty fish, flaxseed and chia seeds as well as fish-oil supplements, have anti-inflammatory properties and may have benefits for bone health. But inflammation is also part of the body's normal healing response, and omega-3 supplements can affect bleeding risk. High-dose fish oil deserves particular attention if you're taking anticoagulants or preparing for surgery.
Creatine is much better known as a sports supplement than a bone supplement. It can support muscle mass and strength, which may become particularly relevant after weeks of inactivity and muscle loss. Stronger muscles also help support the recovering limb as rehabilitation progresses.
There is research interest in whether creatine might have additional benefits for bone, but the case for taking it specifically to make a fracture heal faster isn't established. Creatine monohydrate is the most commonly used supplemental form. It can cause water retention or digestive upset, and people with kidney disease should discuss its use with a physician.
Cissus quadrangularis has a long history of traditional use for bone healing, and some small human studies suggest it may help fracture healing. However, the research is still limited and generally low quality, and we don't yet have strong evidence showing that Cissus reliably speeds fracture healing.
Cissus appears to be reasonably well tolerated in the limited human studies available, but its long-term safety and potential drug interactions aren't well established. Because supplements also vary considerably in formulation and strength, check with your doctor or pharmacist before adding it—particularly while recovering from surgery or taking prescription medications.
More Than You Bargained For
Supplements can overlap. A multivitamin may contain vitamin D and zinc. Your calcium supplement may contain more vitamin D. A "bone health" formula may contain calcium, magnesium, D and K. Add separate bottles of each, and you may be taking considerably more than you realize.
Read the labels and add up the totals.
Don’t Crowd Food off the Plate
A varied diet can supply protein, calcium, vitamin C, magnesium, zinc and many of the other nutrients your body needs while healing. Food also provides calories—and recovery requires energy, so it’s not an ideal time for an aggressively restrictive diet.
But that doesn’t mean that ice cream, tortilla chips and French fries should hold a prominent place on the menu.
I usually burn a lot of calories in my everyday, active life, normally clocking over 10,000 steps before noon. But when I was non-weightbearing, my activity took a nosedive. My appetite didn’t follow suit. I was bored. I felt sad. The macaroni and cheese understood me.
I wasn't about to give up comfort food entirely, but I knew I needed to pay attention to what else was on my plate.
Think protein at meals, fruits and vegetables, calcium-rich foods and enough overall nutrition to support healing. Supplements can fill genuine gaps, but they don't replace the grocery store.
Healthy Eating for Ankle Fracture Recovery covers this in more detail.
ASK YOUR SURGEON
Before adding supplements during fracture or surgical recovery, consider asking:
Do I need any particular supplements based on my diet, age or bloodwork?
How much calcium and vitamin D should I be getting each day?
Should I get my vitamin D level checked?
Could any of my supplements interact with my prescription medications?
Are there supplements I should avoid while taking blood thinners?
Which supplements should I stop before surgery, and how far in advance?
When is it safe to restart them afterward?
And bring the actual list.
MY TAKE ON IT
I'm not very good at sitting around waiting for my body to heal. That probably understates it. I have a life to live! Horses to ride! Adventures to chase!
I imagine you’d like to get back to your life, too.
My philosophy is to do what I reasonably can to stack the deck in my favor. You might say I'm throwing things against the wall—but I'm not throwing blindly.
If there's something promising with reasonable evidence behind it and little downside for me, I'm willing to consider it—even if nobody can guarantee that it will make a measurable difference.
Some things have good evidence behind them, some have intriguing but preliminary evidence, and some may amount to little more than expensive urine. Supplements can interact with medications and surgery, and too much of a good thing can become a bad thing.
So read. Ask questions. Look at the evidence. Talk to your doctor. Know what you're taking and why you're taking it.
Then make your own informed decisions.