During each phase of the healing process, practitioners should apply different nutritional protocols to meet specific tissue needs. In this article, we cover three broad recommendations for acute pain and inflammation as well as those for tissue and collagen repair. Acute phase resolution is imperative for successfully initiating the phases of repair and regeneration.


First, let’s cover turmeric, which is safe, effective and backed by multiple studies. I called it the “golden, first-line therapy” in a related blog I wrote several years ago. Turmeric is a wonderful alternative to NSAIDs, given their various constraints, such as renal and liver comorbidities, cardiovascular and gastrointestinal risks, and potential cartilage loss from either NSAIDs or intra-articular corticosteroid injections.1 Turmeric is also an excellent tool for supporting chronic conditions, such as osteoarthritis.

There are 200-plus bioactive compounds present in the natural matrix of turmeric. The main constituents are curcuminoids, which were previously believed to be the principle active components of turmeric. More recent evidence shows that the non-curcuminoid components, like turmeric, turmerones, elemene, furanodiene, curdione and bisacurone, also demonstrate the ability to reduce pain and inflammation separate from curcumin.2-7 Turmeric in supplement form should contain the complete, natural matrix, not just the isolated curcuminoids.


If significant trauma—such as major bruising, sprains, strains or bone trauma—is involved in an injury, then I will add to the mix the proteolytic enzyme bromelain alongside quercetin and rutin.

  • Research has shown that bromelain compares well to standard medical therapies in patients with acute joint challenges.8
  • Quercetin normalizes inflammatory response—among other benefits—and enhances absorption of curcumin, which is one of the key reasons I like seeing them together in an acute injury treatment protocol.9
  • Likewise, rutin has benefits on multiple fronts, but from a musculoskeletal standpoint, rutin supports connective tissue health by inhibiting the enzymes hyaluronidase, collagenase, LOX and COX, which all are contributors to connective tissue degeneration.10

These key ingredients in tandem with a complete turmeric matrix work together to deliver better results. For ease of use, economy of scale and better compliance, I recommend using capsules that combine these ingredients and contain turmeric at 660 mg, bromelain at 240 mg, quercetin at 240 mg and rutin at 50 mg taken twice per day, without food.

When acute pain becomes the major player, I utilize a packet with a broader array of enzymes which are known inflammatory mediators, cutting short immune complexes by up to 80%.11 Along with the above-mentioned turmeric and quercetin, GABA (as GABAnol) can be used to relax hyper neurotransmitter activity in the brain and body.


Nutritional support for collagen repair is essential since day one to prevent permanent scar tissue, loss of elasticity and ensure complete healing. To enhance full recovery while providing support in the acute phase, a combination product should be used that includes Mobilee®, proline, vitamin C, zinc, MSM and manganese.

  • Mobilee® is a patented, high-molecular-weight hyaluronic acid that enhances the viscoelastic lubricating properties of synovial fluid (note: I have seen “old” injuries with limited or no range of motion respond beautifully).12,13
  • Proline composes 50% of collagen, whereas vitamin C combines with lysine and proline to form procollagen.
  • Zinc also supports collagen repair, and multiple studies show MSM prevents scar tissue formation, making this combination of nutrients essential for the successful care of your acute injury patients.14

These well-researched and proven nutrients will more quickly help your acute care patient achieve full resolution with renewed strength, flexibility and biomechanics. Health optimization can then become your focus, which makes caring for your patients much less stressful! Personally, I shoot for 70% of my patient visits to be about health optimization and about 30% of visits dedicated to acute or recovering patients. To reach that target, I have found the previously discussed nutrients critical for optimal recovery.


Helping physicians find patients who they can best help



Educated in both the Netherlands and the United States, Dr. Adrian den Boer is a board-certified and licensed Naturopathic and Chiropractic physician. In addition, Dr. den Boer is fully certified as a functional medicine doctor. Dr. den Boer has treated over 10,000 patients successfully by utilizing multiple resources to manage patient care. Most recently, he joined the Lifestyle Matrix Resource Center as the Clinical Expert serving the MSK Solutions Pain Recovery Program.


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