Purpose
To evaluate the association between serum vitamin D level and the prevalence of lower
extremity muscle strains and core muscle injuries in elite level athletes at the National
Football League (NFL) combine.
Methods
During the 2015 NFL combine, all athletes with available serum vitamin D levels were
included for study. Baseline data were collected, including age, race, body mass index,
position, injury history specific to lower extremity muscle strain or core muscle
injury, and Functional Movement Screen scores. Serum 25-hydroxyvitamin D was collected
and defined as normal (≥32 ng/mL), insufficient (20-31 ng/mL), and deficient (<20 ng/mL).
Univariate regression analysis was used to examine the association of vitamin D level
and injury history. Subsequent multivariate regression analysis was used to examine
this relation with adjustment for collected baseline data variables.
Results
The study population included 214 athletes, including 78% African American athletes
and 51% skilled position players. Inadequate vitamin D was present in 59%, including
10% with deficient levels. Lower extremity muscle strain or core muscle injury was
present in 50% of athletes, which was associated with lower vitamin D levels (P = .03). Athletes with a positive injury history also showed significantly lower vitamin
D levels as compared with uninjured athletes (P = .03). African American/black race (P < .001) and injury history (P < .001) was associated with lower vitamin D. Vitamin D groups showed no differences
in age (P = .9), body mass index (P = .9), or Functional Movement Screen testing (P = .2). Univariate analysis of inadequate vitamin D levels showed a 1.86 higher odds
of lower extremity strain or core muscle injury (P = .03), and 3.61 higher odds of hamstring injury (P < .001). Multivariate analysis did not reach an independent association of low vitamin
D with injury history (P = .07).
Conclusions
Inadequate vitamin D levels are a widespread finding in athletes at the NFL combine.
Players with a history of lower extremity muscle strain and core muscle injury had
a higher prevalence of inadequate vitamin D.
Level of Evidence
Level IV, retrospective study-case series.
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Article info
Publication history
Published online: December 21, 2017
Accepted:
October 2,
2017
Received:
June 26,
2017
Footnotes
See commentary on page 1286
The authors report the following potential conflicts of interest or sources of funding: S.A.R. receives consultancy fees from Joint Restoration Foundation; and has stock/stock options in OrthoRTI and Rotation Medical. R.F.W. has stock/stock options in Ivy Sports Medicine and Orthonet. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
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Copyright
© 2017 by the Arthroscopy Association of North America
ScienceDirect
Access this article on ScienceDirectLinked Article
- Editorial Commentary: Is Vitamin D the New Wheaties? Preventing Muscle Fatigue Could Keep Athletes in the GameArthroscopyVol. 34Issue 4
- PreviewVitamin D deficiency is an oft overlooked and underevaluated condition that is widespread in patient-athletes, including the elite and professional. Although the symptomatology of this deficiency is well known in the general population (osteoporosis and increased risk of fracture), the symptom of muscle fatigue is not. It is only recently that the association between vitamin D deficiency and muscle fatigue in professional athletes has been placed in the spotlight. However, vitamin D deficiency should be of increasing concern for orthopaedists in regard to all athletes.
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