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Bone Health in Young Athletes

Did you know?

Vitamin D contributes to strong bones in young athletes?

An estimated 50 million children in the US suffer from low Vitamin D Levels?

Low Vitamin D and a poor calcium intake can place athletes at risk for recurrent fractures and stress fractures?

Bone Health in Young Athletes

Calcium and Vitamin D are both important for strong bones. Many children, especially those who are dairy avoidant, have a diet that is lacking in needed calcium. The body needs calcium for critical body functions. When dietary intake is poor, the body will take or “steal” the calcium from the stores in the bone, thus further contributing to poor bone density over time. Vitamin D helps absorb calcium, so even if calcium intake is good, a child can still be at risk for developing poor bone strength.

It is important to recognize that children and adolescents are in their prime bone-building years, as peak bone mass is typically achieved by 25 years of age.  After that, bone loss gradually occurs naturally with age. Therefore, the “bank or reserves” that are achieved by that age will need to sustain the individual throughout life.

Vitamin D, our “sunshine vitamin,” is often easy to make during the summer months. However, because of the fear over adverse effects of sun exposure, sunscreen is applied to the skin blocking up to 95% of Vitamin D. Athletes who train inside all year round may be especially at risk for Vitamin D deficiency. During the winter, even in sunny climates, Vitamin D is more difficult to obtain from the sun because of its latitude. Unfortunately, Vitamin D is not readily present in a typical diet, so it is common for Vitamin D levels to significantly decrease in the winter season.  

What to do to Boost Calcium and Vitamin D Levels

  1. Encourage a balanced healthy diet with quality sources of calcium. Children typically need 4-6 servings of calcium rich foods every day.
    1. E.g., small piece of cheese, cup of yogurt, 6 oz. milk
  2. If a child is dairy avoidant, consider calcium fortified food and drinks
    1. E.g. orange juice, cereals, almond milk
  3. In the summer, allow short periods of time outside without sunscreen
    1. 15-30 min between 10 a.m.-3 p.m., at least 2 times per week. Dark skinned people require 3-5x longer exposure
    2. Expose most of the skin (e.g. shorts and t-shirt)
    3. Aim for just enough exposure for the skin to be pink
  4. When there is concern over the diet/sun exposure, consider giving a supplement. The amount to supplement depends on the age/size of the child
    1. Calcium: 500-1000mg per day. (For higher dose, divide to 500 mg twice per day for better absorption)
    2. Vitamin D: 400-1000 IUs per day. Vit D3 is most commonly recommended
  5. Screening for Vitamin D deficiency may be considered in the setting of recurrent fractures, stress fractures, or poor healing of bone injury.