Low Vitamin D Levels Are Associated With Increased Risk of Musculoskeletal Injuries in Collegiate Athletes

Background: Vitamin (Vit.) D is an essential nutrient that is both synthesized by the body and supplemented via diet. Vit. D deficiency has been found to correlate with an increase in a variety of musculoskeletal injuries. Hypothesis: Lower levels of serum Vit. D would be associated with an increased number of musculoskeletal injuries in collegiate athletes. Study Design: Routinely collected data were reviewed for 284 student athletes at a Division I Big10 University. Level of Evidence: Level 4. Methods: Serum 25-hydroxyvitamin D (25[OH]D) levels were obtained on athletes via chart review and classified as normal (≥32 ng/ml), insufficient (20-31 ng/ml) and deficient (≤19 ng/ml). Vit. D was analyzed both as a continuous variable and based on the 3-level classification. The odds of injury were estimated with mixed effects logistic regression models. Results: Results showed that 47.2% of athletes were Vit. D insufficient, with 17.6% being deficient. The odds of sustaining an injury at any point during the collection period were 13% higher for each 5 ng/ml decrease in the athlete’s Vit. D level (odds ratio [OR], 1.13 (1.00-1.27); P = 0.05). There was no significant difference in injury time based upon Vit. D class. There was a significant negative correlation between Vit. D level and max jump height/max jump force (OR, –0.50 (–0.99, –0.02), P = 0.04; –0.20 (–0.37, –0.04), P = 0.01 respectively), which are clinically insignificant changes. Conclusion: Many collegiate athletes had insufficient or deficient Vit. D levels. Our results showed for each 5 ng/ml decrease in an athlete’s Vit. D level, there was a 13% increase in odds of injury. Finally, there was no significant association between Vit. D level and athletic performance or injury recovery length. Clinical Relevance: Vit. D deficiency and insufficiency is highly prevalent in collegiate athletes.