Dancers and stress fractures - Vitamin D

[ZooZoo]

I am sorry to hear of all the injured dancers who have been posting recently and wish you all a speedy recovery.  I recently got chatting to an injured dancer who had found out they had a vitamin D deficiency.  It is quite common and can lead to a higher incidence of stress fractures, I understand.  I have no medical training but recent googling has led me to conclude that a vitamin D supplement might be a good idea for a dancing child (or anyone really as lots of adults in the Uk have the deficiency too, it seems).  Does anyone know more about this than me?  It is not something that I had thought about before but my recent research has been very interesting.  It is hard to make enough vitamin D from sunlight in the UK, especially in Northern Uk or if you have darker toned skin.  

[Fiz]

I was diagnosed with Vitamin D deficiency in December. My GP and chiropractor say that is becoming increasingly common and they believe it will shortly become a routine test. I am still being treated for it. I haven't been well enough to go to class since the end of September.

[Picturesinthefirelight]

This was an issue when dd & ds were babies as breastfed babies were advised to take vit d drops (formula is fortified)

 

I never supplemented but apparently a lot is to do with our lifestyles. Babies & children (& dancers) arnt exposed to as much sunlight as instead of walking everywhere we go by far (& instead of playing outside or outdoor sports dancers are inside a studio for many hours I guess)

[ZooZoo]

Oh dear Fiz I am sorry to hear that.  The reason that I started this thread is/was that my own view, gleaned over just a few days, is that this is a real issue.  Hence I wanted to make as many people aware as possible so that they could research and form their own view - my view is that Vitamin D seems a good idea, especially for dancers due to the high impact on bones/stress.  Vitamin D can also assist with the healing process, it seems that some studies support this.  I stress again I am not in any way medically qualified, but it was a hidden issue for me until recently.

[Fiz]

Thank you. Someone I know who is medically qualified thinks that Vitamin D should be added to bread as it is such a growing problem.

[Mrs Brown]

I have read this too, not in relation to dancers but in relation to people in general especially children.

 

I am really concious about not overapplying suncream unless we need to (but I have 1 quite pale child and 1 extremely pale child so equally have to avoid burning risk).  I have recently put them on multivitamins because I do worry about them getting the recommended amount of things. It isn't just because of lack of exposure to sun it is also thought to be that the vegetables etc we buy are less rich in vitamins and minerals than they used to be and microwaving can apparently deplete it more.  So it is a combination of things I think. Definitely something we should all be aware of.

[John Mallinson]

There's been quite a lot of research on this topic - google 'vitamin d deficiency in dancers'. 18 months ago the Guardian reported a study involving BRB dancers which appeared to show a correlation between injuries and low D levels.

[Kat09]

In my quest to keep my daughter healthy and injury free, I have conducted personal research on products & supplements which might support her. I started her on an immublend (Vitamin D,Vitamin C and Zinc) and also an Aloe Vera drinking gel with added Chondroitin,glucosimine and methylsulphonylmethane (MSM),this has been formulated specifically to maintain healthy joints and flexibility as well as to boost immunity with essential vitamins,minerals and amino acids.

The products have really immpressed me & I have decided to join the company producing these.

As an independent business owner and am happy to extend a 10% discount to all balletcoforum members.

If you would like any information about the products or wish to try them please get in touch.

Kat

[Balletmumfor2]

My dd visited school nutritionist recently and as she is so pale skinned, was told she should try to supplement her Vitamin D. Nutritionist said many dancers have low levels due to the amount of time spent inside in studios. I know she is now adding vitamin D rich food to her diet but will have to check with her exactly what she now eats. I know it's very simple as she has to provide all her own food.

[LinMM]

I agree that many people in the Northern Hemisphere and probably especially dancers may have a deficiency of vitamin D

 

However this cannot be "guessed" at or just by having a PNA's extra pale looking skin etc.

You find out if you have a deficiency with a blood test and personally I wouldn't recommend additional vit D ONLY supplementation without having confirmed this via a doctor.

 

I am slightly osteopaenic ....discovered after having five fractures in eight years!!

I was also very slightly Vit D deficient but not much so have supplemented ever since but it's not a huge amount......not at medical levels etc as the doctor didn't think I needed massive supplementation of calcium or Vit D

 

On retesting a year later Vit D within normal levels but still a bit low in calcium.

 

Also since then in the summer I always have the first hour in the sun without protection......so as to let the skin absorb sunlight.

This is best done between 12 and 3pm ......I know contrary to all advice about skin and avoiding cancer etc ......but if your skin were to burn in half an hour then obviously you don't go to burning levels......as that won't help the skin to absorb anything!!

 

The problem is that sometimes when a deficiency shows it's not that there's a real shortage in the system there may be a problem with absorption (often connected to the Thyroid) so things are not always so simple. No matter how much Calcium or Vit D you take if there is an absorption problem your body won't be using it.

 

Professional dancers probably should get tests every 2-3 years to see how things are.

[Belljul]

My DS's school physio recommended a vit D supplement to help with his recurring shin pain. I am pleased this issue is being addressed. I sometimes refer to my son as a "battery ballet chicken" because he is rarely outside!!

[Oldermum]

Some of Elmhurst students are on bone density research trials with Wolverhampton University, I think this is also related to the research with BRB dancers. My dd has multi vitamins and I try to get her to think about spending time outside especially at weekend and when she's home. We were advise up to 1/2 hour outdoors between 10 am and 11 am depending on the weather without sunscreen and not over-covered up obviously consider the sun strength and your child's complexion. They are also studying the affect on the arms of dancers as their natural body focus is to build up the density in the bones of the hips and legs due to the impact of jumping etc.

[Michelle_Richer]

During last April I met Prof Matthew Wyon at a Seminar at the Royal Society of Medicine and had an interesting conversation with him on this very topic, later that day he presented his paper which can be viewed if you do a Google search on :

“http://dx.doi.org/10.1016/j.jsams.2013.03.007”but don’t click on it or place it in the URL field of explorer, as you will not have access to it.

 

However if you do a Google search it will allow the full document (a pdf file) to be downloaded.

 

This is the supporting evidence to The Guardian article in John Mallinson’s post.

Edited March 3, 2015 by Michelle_Richer

[LinMM]

In terms of absorbing vitamin D from the sun the best time is when the rays are at their strongest between 12-3 pm.

 

45 mins to an hour between these times should give enough .....daily in the summer if possible.

 

The big leg bones, the upper arm and ribs are apparently best to expose!!

 

A good quality multivitamin should be okay for younger dancers though obviously if they are having breakages or bone pains this must be investigated by a doctor.

[Melody]

Doctors are adding vitamin D screening to routine blood tests over here these days, and my doctor was saying that the combination of a more indoor lifestyle and the use of sunscreens out of doors - as already mentioned earlier in this thread - is leading to lower vitamin D levels. It's added to milk here, as well as to milk products like yogurt, but it still sometimes isn't enough. He did say that if people need more vitamin D, he recommends just taking a vitamin D supplement rather than a multivitamin that might contain things which aren't useful, so I've been taking a daily vitamin D pill for a couple of years now.

[Hambleton]

Good old fashioned cod liver oil? I believe it contains easily absorbable vit D?

[2dancersmum]

Whilst I too agree that many people and especially dancers spending so much time indoors may well have a vitamin D deficiency and I know that it is becoming more common in our society - I am with LinMM that you should not self diagnose or guess and use a vitamin D only supplement without consultation with a doctor/blood test.    Too much vitamin D (even if unlikely) can also cause problems - everything needs to be in balance within the body and as LinMM also says sometimes deficiencies can exist with absorption of vitamins and minerals rather than it being the quantity or with the excretion of excesses.   Everything has a knock on effect.  I had to go through a very long checklist with the doctor and the hospital when I had an abnormality in levels in a blood test (not vit D) so that they could rule out various supplements as being the cause. 

Edited March 5, 2015 by 2dancersmum

[LinMM]

To come back for a minute to the idea that you can tell by looking at people what they may be deficient in .....one can give a good possible "guess" however that is just the notion that motivates you to check against evidence etc.

 

If you looked at me you would never guess in a million years that I'm osteopaenic. I have large wide bones (large frame) and am taller than average height. So you would think I would be fine in the bone department!

 

However I am below average for my age group in bone density! (Osteopaenic is not as bad as osteoporotic but means you have to be monitored in case it moves in that direction......which it doesn't always thank goodness. Doing Ballet has helped with this but of course recreational level is very different to professional level dancing.

 

I managed to increase my vitamin D levels with a mixture of ordinary but very good multivitamin products eg Solgar Biocare Viridian Quest etc. It was the regularity of taking the multi rather than individual high doses which I think worked for me .....as for a year at least I was very focussed on this.

 

Interestingly I took....or rather was given cod liver oil and malt extract all through my childhood so must have served well at one point but hasn't prevented the decline of bone density in my 60's.

 

The balance of bone formation and bone destruction story going on in the body is a fascinating one which involves the thyroid and pituitary gland as well so is quite complex which is why I think it is important to check out any suspicians where bones are concerned with a doctor especially if involved in things like dance or running marathons and similar!

[LinMM]

Another useful supplement I have found ......and for anyone a bit sporty I should think ......is by Optima. It's there Glucosamine complex which has glucosamine chondroitin calcium Vit C ....(another important part of the whole process which helps with Vit D absorption) ....selenium and Aloe Vera.

[Dance*is*life]

What an interesting post - I think I will suggest to the parents of children with injuries, that they ask for a Vitamin D test next time they do a blood test.  We are in a hot country, but dancing children are in the studio a lot and may not be benefiting from the sun - I know my own son who doesn't dance, but is a computer freak, lacks it and takes pills.

[drdance]

As a teacher, I'm now inside a lot and having suffered with various fatigue-related issues I finally went to the GP and demanded blood tests. Eventually my Vitamin D was discovered as much lower than the 'usual' winter time range (which is already on the low end of 'normal'). I was immediately tested for parathyroid function because this is connected to low vitamin D, and for blood-calcium levels. Don't just assume low vit D can be fixed with supplementation. However, in my case, thankfully the PTH was negative and having had 2 and a half months of prescription dose vitamin D I am starting to feel a lift in my mood. The dose is something like 10 times the over-the-counter version. Fatigue is still an issue but I think there's been an effect of taking the vit D. It wasn't instant, at all.

[Fiz]

I have to go back for a blood test at the end of the month. My doctor warned me it would be slow and it might take more than an oral supplements to fix the problem.

[drdance]

Fiz- fingers crossed. I haven't been running in months due to various aches and pains, and what I thought was recurrent high hamstring tendinopathy (but it could be to do with the vit D deficiency).

[Fiz]

Thank you. I am fed up with it!