Correlation Between Vitamin D Deficiency and Increased Risk of Stress Fractures in Athletes
1Dr Muhammad Asim Munir Qureshi, 2Qamar Abbas, 3Muhammad Adeel Razzaque, 4Dr Asad khan Ghilzai, 5Isma Abbas, 6Faiza Maqsood
Submission: 14 January 2026 | Acceptance: 31 January 2026 | Publication: 22 February 2026
1Senior registrar lahore general hospital , Lahore
2PIMS Islamabad
3Assistant professor, Bakhtawer Amine Hospital Multan, Orthopedic Department
4Assistant professor, Bolan Medical complex hospital Quetta
5PIMS Islamabad
6UHS Lahore
ABSTRACT:
Background: Stress fractures cause substantial loss of training and competition time in athletes. Vitamin D is the essential factor in calcium metabolism and bone metabolism. Low levels of vitamin D have been suggested as a mechanism for decreased bone mineral density and an increased risk of stress fracture.
Objective: The objective of this study was to investigate the association between vitamin D deficiency and increased risk of stress fractures in athletes.
Methods: The present cross-sectional, analytical study was carried out at Pakistan Institute of Medical Sciences (PIMS), Islamabad, from May 2024 to April 2025. One hundred and 10 athletes with the range of 18-35 years were recruited through purposive sampling. Clinical assessment, measurement of serum 25-hydroxyvitamin D level, and radiographic confirmation of stress fractures were conducted. Statistical analysis was carried out using SPSS version 26. Correlations between vitamin D level and the occurrence of stress fractures were evaluated using Pearsonʼs correlation and chi-square tests.
Results: Among 110 athletes, 62 (56.4%) were vitamin D deficient (<20 ng/mL). Of these, 38 athletes (61.3%) had stress fractures confirmed on radiograph. Note however that only 9 (18.8%) of the 48 athletes who were not vitamin D deficient had stress fracture. There was a significant, negative correlation between serum vitamin D status and the occurrence of SF (r=-0.42, p < 0.001).
Conclusions: The study clearly revealed a well-established correlation between vitamin D deficiency and the development of stress fractures in athletes. These data emphasize the need for adequate monitoring and treatment of vitamin D levels to prevent stress fractures and to maintain bone health in athletic subjects.Keywords: Vitamin D deficiency, stress fractures, athletes, bone health, sports medicine, risk factors