>Health and Nutrition>Stress Reaction, Recovery
I am a collegiate XC runner who has been suffering from shin splints on and off for the past 8 months and recently found that I have a stress reaction. It all started one day when I did my first speed workout on a track in 2 months, and I was in a new spike that day as well. I had developed pain along the inside of my shin muscle and pushed through it till the end of the season, where it had gotten progressively worse. After the season, I took a week and a half off before slowly building into summer XC training, where I barely felt any pain and trained for two more months until the pain came back. I crossed trained for a while, did ankle strengthening, and still lifted weights and tried to return again during the XC season. Pain came back again, but not so intense and I basically declared a red shirt and stopped training. After two more months of strength (weights, ankle, hip mobility) and biking, I came back again with a different strike, landing more on my toes, but had to stop after a month due to pain coming back. I went to the doctor and I don't have a stress fracture, but rather a stress reaction. I'm in a boot for a month, but will still be biking, lifting, and mobility strengthening. What am I doing wrong that's preventing this from going away? Lifting weights does not really hurt (0.5-1, out of 10 pain scale). Biking does not hurt (0.5 out of 10 pain scale), and while my hip and ankle things do leave me sore, I believe they make me stronger overall. I will admit I could take better care of my lifestyle. My sleep could be better, as I probably average 6.5 hours over the last several months. My diet is acceptable, but could be better. I've been working with my trainer and trusting the process, but I just wanted to see if I could get other opinions as well? I have been distance training since 2015, and my highest weekly mileage count was 62 during my freshman collegiate XC season. I have not been injured before this, and was improving a lot. Any help, experience, or opinions on my situation would be deeply appreciated, I really want to get back to form.
Quick question. Where do you live and how much sun do you get?
H-WAVE - Helping Athletes Heal and Recover Faster
I live in the Midwest. I get plenty of sun throughout the seasons besides the winter.
Well, if you live in the Midwest, your winter is 8 months. No, seriously.....you simply do not have enough months with UV index above 3 to have adequate Vit D levels year round. Think about clothes you have when out in the sun and sunscreen. Time of day outside. I feel you simply cannot have optimum Vit D levels in much of the country unless you supplement or go to a tanning bed. You simply cannot get enough from your diet to keep blood levels at a optimum and protective level. There is a correlation to low D levels and incidence of stress fractures. https://www.newswise.com/articles/low-levels-of-vitamin-d-may-increase-risk-of-stress-fractures-in-active-individuals
Have you been tested? I worked in bone healing and fracture healing world for 14 years and treated a lot of stress fractures and in almost all cases Vit D levels were sub optimal or kess than 40. With optimal, I mean a U.S. level above 40 ng/mL. I believe 50 ng/mL can provide additional benefit. Get tested and if below 40 supplement with Vit D3 (stay away from prescription once weekly Vit D2). Also supplement with magnesium and Vitamin K2 (Americans commonly deficient in these 2 nutrients as well) as they work synergistically. When taking higher doses of D3 like 5000 - 10,000 iu + daily, you will get a surge of calcium release and absorption. This is good and bad. If you don't take the Vit K2 (MK-7 form) there is some risk of the extra calcium going where you don't want it to go. K2 transports calcium right to the bones where it is needed.
I will also add it is very important to get sleep and be nutritional sound with adequate protein intake. Even if you think you eat great, you are still likely low in D, magnesium and K2.. On a side note, if you consume dairy and green veggies, I am not a fan of calcium supplementation. Short term it would be fine taken with above nutrients.
Just to muddy the waters:
Vitamin D supplements aren't living up to their hype
Nothing so needs reforming as other people's habits.- Mark Twain
Just to muddy the waters:
Vitamin D supplements aren't living up to their hype
Yeah, one could get into a Vitamin D debate. The issue with the research is they look at people taking an additional 400 iu or 600 iu or even an additional 1000 iu per day and then do a study. Well, anyone who does some research on the topic will realize these are actually very small doses that don't do much at all to increase blood levels. Even 5000 iu per day is what I consider a moderate dose. I actually consider it a maintenance dose.
The RDA of 400-600 iu per day was set up to get someone to 20 ng/mL which most would consider Vit D deficient. So, in the trials if someone with a Vitamin D level of 18 goes on 400 iu per day as raises their level to 21. Well, the conclusion is that supplementing with Vitamin D provides no benefit. I think you can see where I am going with this. We need research on supplementing with Vitamin D or better yet getting sun exposure to get levels from A to B.
For example, someone starting at 18 ng/mL who supplemented with enough Vitamin D to get their levels to 40 ng/mL. Now, what are the health benefits? Bone health, immunity, mental health, cancer, CVD etc. Are there additional benefits at a level of 60?? Publish this mainstream. This is a better way to analyze the health benefits of supplementing with Vitamin D or simply increasing D levels. I am also an advocate of getting more sun. The media, articles, dermatologist, cosmetic industry etc. is telling us that the sun is poison. You will age, get cancer etc. A dermatologist told my friend to put 30 spf on in the morning because you are exposed to sun walking to your car, into work, while driving etc. WTF. This is crazy. AND have people researched what is actually in sunscreens? Anyway, this is my take and have strong feelings on the subject being an avid researcher on the topic. BUT, this might be a conversation for another thread
FYI. The Vitamin D Council website and Dr. John Cannell has a lot of the research supporting higher blood levels of Vitamin D. He recommends levels of 50-80 ng/mL.
Yeah, just saying the waters are pretty muddy. There's inadequate, inconclusive, conflicting, and poor quality research out there. Is there something that gives Dr. Cannell and the Council an edge on research quality, or do they just latch onto information that supports their point of view?
Best to not jump to conclusions on this, or most dietary supplements.
......Is there something that gives Dr. Cannell and the Council an edge on research quality, or do they just latch onto information that supports their point of view?.....
The Vitamin D Council was formed in 2003 (not for profit) by Medical Director John J Cannell, MD. He believed that there were likely bad consequences in getting so little sun exposure (vitamin D deficiency) and thus associated risk factors to many diseases. He then founded the Vitamin D Council to educate the public on the importance of sun exposure and adequate vitamin D levels. Because there is so much conflicting data and comments around the importance of Vit D, they are here to help both the public and health professionals sort through everything. The Vitamin D Council serves as a center for evidence-based vitamin D research and a reliable source for the general public. There are other too like. www.grassrootshealth.com
To get back on topic and this is more about stress fractures. Our bodies are made to self heal and not self destruct. Generally, when our body gets sore or breaks down, we recover and come back stronger. We adapt... we get stronger and more resilient. It is what we do we. It happens when we run and when we train. We get fitter, faster etc. Those with stress fractures don't adapt. They break down faster than they recover. I probably treated a few hundred stress fractures in my 14 years in bone healing industry. It wasn't until the last 5 years where I would ask docs if they tested the patient's D level. Some did and the last couple years most docs were doing Vit D level testing on these patients. Many docs I worked with found that many people who have foot pain, bone pain etc. will ultimately heal. However, sometimes things persist for many months. Like the poster. A few of the docs I worked with would send these patients for bone scans and almost always there was a stress fracture or stress reaction involved. Vitamin D levels were tested and almost always Vitamin D levels were sub optimal and many cases very low. No surprise by me. How can they not be living the in upper Midwest without higher UV sun exposure for many months of year. Is there a correlation to low Vitamin D levels and stress fractures. YES. I rarely saw a stress fracture where a
patient had a Vitamin D level above 30.
The Vitamin D Council or myself is not so much about pushing supplements or Vitamin D, it is more about educating on the potential negative side effects of sub optimal blood levels. If your levels are low, ideally get some sun. This is best clearly. Well it ain't happening in Green Bay from October to April. If your levels are low and you can't get sun, well you need to supplement. In my opinion, if you are nutritionally sound including optimal Vit D blood levels......you generally won't be getting a stress fracture (in most cases) because of our innate natural adaptation processes. The question is, how many of us sleep well, have no stress and have optimal nutrition? I think we all need to do our own research and be in tune with our bodies and our health.
This is great stuff guys I really appreciate it! Please keep it up! In reading these, I realize Vitamin D is important, but I think improving my overall nutrition and getting all my vitamins mostly through healthy food could be a breakthrough. My sleep has not been consistent in a long time either.