26% higher injury rate of college athletes for each 10 ng lower Vitamin D

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

Sports Health. 2026 Mar doi: 10.1177/19417381251407674

Alexandra M Frank 1, Mikel R Joachim 1 2, Jennifer L Sanfilippo 2 3, Cory J Call 1, Scott J Hetzel 4, Margaret A Brooks 1, Andrea M Spiker 1

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.

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• Overview Sports and vitamin D contains:

  Athletes are helped by vitamin D by:

1. Faster reaction time

2. Far fewer colds/flus during the winter

3. Less sore/tired after a workout

4. Fewer micro-cracks and broken bones

5. Bones which do break heal much more quickly

6. Increased VO2 and exercise endurance Feb 2011

7. Indoor athletes especially need vitamin D

8. Professional indoor athletes are starting to take vitamin D and/or use UV beds

9. Olympic athletes have used UV/vitamin D since the 1930's

10. The biggest gain from the use of vitamin D is by those who exercise less than 2 hours per day.

11. Reduced muscle fatigue with 10,000 IU vitamin D daily

12. Muscle strength improved when vitamin D added: 3 Meta-analysis

13. Reduced Concussions