Is there an Association between Serum 25-OHD Level & the Time Taken to Recover from a Stress Fracture in British Army Recruits?

Research Paper Title

British Army recruits with low serum vitamin D take longer to recover from stress fractures.


Recruits undergoing military training experience a particularly high incidence of stress fractures. The role of combined calcium and vitamin D (25-OHD) deficiency and subsequent supplementation has been well described in the literature, but the role of 25-OHD deficiency alone is less well understood, particularly its influence on recovery once a stress fracture has been incurred.


Retrospective data of recruits who had incurred stress fractures were collected (n=37). Independent-samples t-tests were conducted in Microsoft Excel to investigate the association between serum-25 OHD and the time taken to recover.


Significant differences (p<0.05) were found in the mean time taken to recover from stress fractures when participants were grouped according to serum 25-OHD level. Sufficient levels of serum 25-OHD (>50 nmol/L) at the time of injury resulted in shorter recovery times than all other groups.


The study demonstrated an association between serum 25-OHD level and the time taken to recover from a stress fracture. The sample population of this study was too small to contribute to the discussion about whether a minimum serum 25-OHD status should be met before entering British Army training, but a larger prospective study should be able to provide the data required for a cost benefit analysis to be conducted and a decision made.


Richards, T. & Wright, C. (2018) British Army recruits with low serum vitamin D take longer to recover from stress fractures. Journal of the Royal Army Medical Corps. pii: jramc-2018-000983. doi: 10.1136/jramc-2018-000983. [Epub ahead of print].


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