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European journal of endocrinology , 159 (5), 547554

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Why Impaired Nutrient Status Delays Recovery When nutrient reserves decline: Collagen and connective tissue repair slows Micro-injuries accumulate faster than they can resolve Inflammatory regulation becomes less efficient Muscles fatigue more quickly and recover more slowly Nerve tissue becomes more vulnerable to irritation This helps explain why some patients experience: Recurrent strains or tendon injuries Persistent joint pain despite normal imaging Slower recovery from physical therapy or exercise Pain flares during stress, illness, or poor sleep In these cases, pain is not merely a signal to suppress it reflects compromised repair capacity

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