What is Kinesiology Taping?

Kinesiology tape is a thin, stretchy, elastic cotton strip with an acrylic adhesive. Therapeutic kinesiology tape can benefit a wide variety of musculoskeletal and sports injuries, plus inflammatory conditions. 

Kinesiology tape is almost identical to human skin in both thickness and elasticity, which allows kinesio tape to be worn without binding, constricting or restriction of your movement.

Kinesiology tape is used for treating athletic injuries and a variety of physical disorders. For the first decade after its introduction practitioners in Japan were the main users of the therapeutic kinesiology tape. By 1988 the tape had been adopted by Japanese Olympic and professional athletes before spreading across the world.

You would have noticed that more and more professional athletes use kinesiology taping improve their sporting performance, prevent injury and allow them to return to sport quicker.

What are the Benefits of Kinesiology Taping?
Kinesiology tape has a comprehensive array of therapeutic benefits. Because it can be left on for up to 5 days, these therapeutic benefits are available to the injured area 24 hours a day, significantly accelerating the healing process from trauma, injuries and inflammatory conditions.

1. Pain Relief
Kinesiology taping relieves pain through both physical and neurological mechanisms. The lifting action of the tape relieves pressure on pain receptors directly under the skin, allowing for quick relief from acute injuries. Chronic pain is affected through sensory stimulation of other types of nerve fibres This is especially effective for pain that persists after an injury has healed or for pain that is out of proportion to the severity of an injury.

2. Reduced Swelling, Inflammation and Bruising

Reduced pressure on the lymphatic drainage channels enhances the removal of fluids and other materials that collect in an injured area. This applies not only to sports injuries, but to other inflammatory conditions, including the extreme swelling of lymphodema.
 
3. Prevention or Relief from Spasms and Cramping

Enhanced circulation to working muscles helps deliver oxygen and nutrients at the cellular level as well as accelerate the removal of waste products. Both of these mechanisms can help prevent or relieve spasms and cramps in overused or injured muscles.
 
4. Speedier Recovery of Overused Muscles

Fatigued, overused muscles contain byproducts of exercise (such as lactic acid) that contribute to pain and stiffness and limit the ability to continue exercising. When kinesiology tape is used over these areas, enhanced removal of these byproducts allows for more rapid recovery. This could translate into improved performance in endurance events or more complete recovery between repetitive, high intensity events.
 
5. Structural Support for Weak or Injured Body Parts

The unique elastic properties of kinesiology tape allow it to provide support to an injured muscle or joint, discouraging harmful movements while still allowing a safe, healthy range of  motion.
 
6. Enhanced Strength and Muscle Tone in Weak or 
    Injured Muscles

Loss of strength or muscle tone can result from pain, injury or a variety of neurological or muscular disorders. In these situations, the weakness can interfere with the ability to do the exercises that are critical to recovery or improving daily functioning. Kinesiology tape not only provides support to these areas, but it can also improve neurological muscle activation, allowing therapeutic exercises to be carried out more effectively. One of the major uses in this category is with infants and young children with hypotonia, poor muscle tone that limits their ability to learn to sit up, crawl, etc.

7. Allows Athletes to Remain Active while Injured:

This is one of the most important benefits of kinesiology tape for competitive athletes. Injuries can be taped to relieve pain, minimize inflammation and provide support  for injured structures, without compromising a healthy range of motion. Except in the case of severe injuries, this can allow athletes to continue training and/or competing as their injuries heal.

How Does Kinesiology Tape Reduce Swelling? 

How does Kinesiology Taping reduce Swelling and Bruising?
The profound effects Kinesiology tape has on pain, inflammation and performance are related solely to its physical interaction with the skin and the neurosensory receptors in the skin. Kinesiology tape contains no medications or analgesic ingredients.

The unique properties of kinesiology tape combined with kinesiology taping techniques allow it to affect the body in ways that cannot be duplicated by any other form of sports tape. 


Following is a simplified explanation of the major mechanisms of action:  
When a muscle or joint is overused or injured, that area becomes inflamed or swollen. This swelling is composed of blood (internal bleeding from the injury) and other fluids. The excess fluid should be removed by the lymphatic vessels in the area, but if the inflammation is great enough, the lymphatic vessels get compressed and can’t do their job. This can lead to an ongoing cycle of inflammation and pain, which limits performance and slows the healing process.
 When kinesiology tape is applied to the skin over an inflamed area, the stretch in the tape gently lifts the skin, creating a space between the skin and the tissues below. This creates an area of negative pressure, allowing both blood vessels and lymphatic vessels to dilate (open), increasing the circulation of both fluids.

Improved blood flow enhances delivery of oxygen and nutrients to the injured tissues, accelerating the healing process. When lymphatic vessels dilate, the fluid that has collected in the injured area can drain away. This reduces swelling, which relieves pressure on the pain receptors providing immediate pain relief.
 Additional mechanisms that also come into play involve an intricate interplay between the body’s sensory system, neurological system and muscular system.

The ongoing, low level sensory stimulation from the tape on the skin activates pain gating mechanisms that assist in the relief of chronic pain.

They also allow restoration of normal muscle activation, restoring strength and mobility in muscles that may have been inhibited by pain or injury.

What Conditions Does Kinesiology Tape Help?

Joint Pain	Arthritis, bursitis, lupus, degenerative joints, poorly aligned joints, joint instability
Muscle Pain	Torn muscles, pulled/strained muscles, tight muscles, fibromyalgia, muscle spasms, muscle cramps, calf strain, pulled hamstring, groin strain, strained gluteals, abdominal strain
Soft Tissue Injuries	Tendinitis, tennis elbow (lateral epicondylitis), golfers elbow (medial epicondylitis), patellar tendinitis, Achilles tendonitis, whiplash, back strain, neck strain, rotator cuff injuries, iliotibial band syndrome (ITB)
Joint Injuries	Joint sprains, dislocated joints, sprained ankle, sprained knee, sprained wrist, sprained elbow, degenerated meniscus, torn cartilage, unstable joints, joint hypermobility
Overuse Injuries	Carpal tunnel syndrome, repetitive stress syndrome, shin splints, Iliotibial Band Syndrome, tension headaches
Swelling and Edema	Lymphodema, swollen joints, edema, lymphatic congestion, chronic joint or muscle inflammation
Postural Problems	Poor posture, round shoulders, scapular instability, muscle weakness, muscle imbalance, poor muscle tone, hypotonia
Recovery from Surgery	Athletic injury surgery, reconstructive surgery, joint replacement surgery, meniscus repair, ligament surgery, tendon surgery, lymph node removal
Bruising	Bruising following injuries or surgery, contusions
Foot Pain	Plantar fasciitis, fallen arches

Hallux Rigidus Symptoms(Stiff Big Toe)

The most common site of arthritis in the foot is at the base of the big toe. This joint is called the metatarsophalangeal, or MTP joint. 

It's important because it has to bend every time you take a step. If the joint starts to stiffen, walking can become painful and difficult. 

In the MTP joint, as in any joint, the ends of the bones are covered by a smooth articular cartilage. If wear-and-tear or injury damage the articular cartilage, the raw bone ends can rub together. A bone spur, or overgrowth, may develop on the top of the bone. This overgrowth can prevent the toe from bending as much as it needs to when you walk. The result is a stiff big toe, or hallux rigidus. 

Hallux rigidus usually develops in adults between the ages of 30 and 60 years. No one knows why it appears in some people and not others. It may result from an injury to the toe that damages the articular cartilage or from differences in foot anatomy that increase stress on the joint. 

Symptoms:

• Pain in the joint when you are active, especially as you push-off on the toes when you walk
• Swelling around the joint
• A bump, like a bunion or callus, that develops on the top of the foot
• Stiffness in the great toe and an inability to bend it up or down  

Diagnosis:
If you find it difficult to bend your toe up and down or find that you are walking on the outside of your foot because of pain in the toe, see your doctor right away. Hallux rigidus is easier to treat when the condition is caught early. If you wait until you see a bony bump on the top of your foot, the bone spurs will have already developed and the condition will be more difficult to treat. 

Your physician will examine your foot and look for evidence of bone spurs. He or she may move the toe around to see how much motion is possible without pain. X-rays will show the location and size of any bone spurs, as well as the degree of degeneration in the joint space and cartilage. 

Treatment:
  
Nonsurgical Treatment



Pain relievers and anti-inflammatory medications such as ibuprofen may help reduce the swelling and ease the pain. Applying ice packs or taking contrast baths (described below) may also help reduce inflammation and control symptoms for a short period of time. 

But they aren't enough to stop the condition from progressing. Wearing a shoe with a large toe box will reduce the pressure on the toe, and you will probably have to give up wearing high heels. Your doctor may recommend that you get a stiff-soled shoe with a rocker or roller bottom design and possibly even a steel shank or metal brace in the sole. This type of shoe supports the foot when you walk and reduces the amount of bend in the big toe. 
  
A contrast bath uses alternating cold and hot water to reduce inflammation. You'll need two buckets, one with water as cold as you can tolerate and the other with water as warm as you can tolerate. Immerse your foot in the cold water for 30 seconds, then immediately place it in the hot water for 30 seconds. Continue to alternate between cold and hot for five minutes, ending in the cold water. 

You can do contrast baths up to three times a day. However, be careful to avoid extreme temperatures in the water, especially if your feet aren't very sensitive to heat or cold. 

Surgical Treatment:

Cheilectomy (kI-lek'-toe-me) 
This surgery is usually recommended when damage is mild or moderate. It involves removing the bone spurs as well as a portion of the foot bone, so the toe has more room to bend. The incision is made on the top of the foot. The toe and the operative site may remain swollen for several months after the operation, and you will have to wear a wooden-soled sandal for at least two weeks after the surgery. But most patients do experience long-term relief.  

Arthrodesis (are-throw-dee'-sis)  
Fusing the bones together (arthrodesis) is often recommended when the damage to the cartilage is severe. The damaged cartilage is removed and pins, screws, or a plate are used to fix the joint in a permanent position. Gradually, the bones grow together. This type of surgery means that you will not be able to bend the toe at all. However, it is the most reliable way to reduce pain in these severe cases.

For the first six weeks after surgery, you will have to wear a cast and then use crutches for about another six weeks. You won't be able to wear high heels, and you may need to wear a shoe with a rocker-type sole.

Arthroplasty (are-throw-plas'-tee) 
Older patients who place few functional demands on the feet may be candidates for joint replacement surgery. The joint surfaces are removed and an artificial joint is implanted. This procedure may relieve pain and preserve joint motion. 
 

Practice Safety Yoga

Think back to your sex education class in elementary school and the push for “safe sex.” Well, that’s exactly what I’m advocating here, except we’re talking about yoga. I am adamant about not forcing a yoga pose in my classes. If you’re going to practice yoga, do it mindfully. 

I had a conversation with another yoga teacher recently about how he got injured in yoga years ago. 

At the time, he was really into an intense yoga practice and pushing beyond his limits. He was reaching his arm around his back, his teacher made a slight adjustment with her leg, and then pop. He knew his shoulder was broken.

I had my own experience with injury in a yoga class after attending an advanced master class with a prominent yoga teacher in one famous yoga studio. I tried to keep up with the pace of the class, but...the class was more advanced than I expected. The yoga teacher remarked on my extended side angle pose, saying I was “wasting time.” He twisted me a little further and I heard my back pop and felt a sharp pinch. I walked away from this painful and humiliating experience learning a few hard lessons. Forcing yourself into a yoga pose is never a good thing!!

Yoga is not meant to be practiced that way. It’s about focusing on the correct posture and breathing, and being in acceptance. 

I try to instill this in my yoga students more than obtaining a pose(only position). Challenging yourself is great, but forcing is an entirely different mentality. This is a tangible concept you can incorporate into your everyday life, not just in yoga.



 
Here are a few tips I’ve come up with for safely practicing yoga:

Find a yoga teacher who uplifts, encourages, and safely guides you into furthering your yoga practice. 

If your teacher spends more time showing off her yoga skills rather than helping, you may want to look around. 

Notice your yoga teacher’s own limitations and how he or she handles them. We all have limitations, but it’s just a matter of how to work through them. Work with a teacher who helps you grow, not go.

Fewer egos are more in yoga.

Focus on the breath. 

I can’t say it enough in my yoga class. If you’re not breathing, then you’re forcing it. It’s our job as yoga teachers to help you breathe. Learning how to breathe in life is going to be a much bigger asset than learning how to stand on your head. Breath is more in yoga.

Be in acceptance and honor your body. 

Work with the limitations you are given and take baby steps towards your goals. We may have injuries, weaknesses, and issues that we have to contend with in our yoga practice. 

Yoga is being in a place of acceptance exactly where we are at right now. It helps to stay positive and envision yourself where you want to be. Remind yourself that you’re exactly where you need to be at this moment. Acceptance is more in yoga.

Yoga is not a competition. 
When you see your yoga neighbor contorting and you feel that tinge of jealousy, hold back. Notice and appreciate how beautiful the pose is and set the intention that you would like to be there someday. Go within and try to live in the space of loving yourself and those around you. You will get there when it is time. You are exactly who you need to be in this moment. You don’t earn medals in yoga.

Be patient with yourself and your yoga practice. You’ll be surprised at how quickly you progress in your practice. Surprisingly, I find that I progress even quicker when I focus on my breath and allow things to happen rather than force. That’s just a life principle that works with the flow of life. Enjoy the journey in yoga.

Yes, injury can happen in yoga just like in anything else. Incorporating a few of these suggestions into your daily life may help you avoid this from happening to you. Things happen, life happens, but yoga continues. Don’t blame the practice; blame the ego. Yoga won’t injure you, but you practicing yoga the way it wasn’t intended just might.

How Safe From the Dangers of Yoga?

If you’ve been practicing yoga – or have been thinking about it, you might have been thinking about what a wonderful, gentle form of exercise it is. Maybe your doctor told you it was a good way to start getting into shape. Or your roommate talked about how much it improved her stress level.

But if you’re looking at yoga from only that perspective, there’s information you’re just not considering.  Are you safe from the dangers inherent in yoga?  

Check this list and see which ones you might need to watch out for.

1. Perfectionism
When you’re working on inner peace and relaxation in yoga, it can seem like a kind of quest for perfection. And as you seek perfection in the “yoga part” of your life, it can start to seep out into other areas of your life as well. 

Don’t get me wrong – improvement is always a good thing. But if you start getting obsessed with the idea of perfection to the point where it prevents you from enjoying the realities and imperfections of life, well, that’s a danger.

2. Yoga clothes
Just say no to Spandex and wardrobe malfunctions.  Now I know you’d never go there, but it can be such a distraction when the person on the mat next to you does.  Or if the combination of sweat and the use of natural deodorants combines to cause an issue with body odor. And so forth. Or maybe it’s your own sweat or wardrobe malfunction that has you embarrassed and afraid.

Incidentally, this is where healthy detachment can be helpful. Rather than getting caught up in which part popped out of a yoga top where and was visible by whom, or who smells bad today, etc., you can just mentally take a step back and acknowledge the current reality and acknowledge when your irritation about it passes.

3. Getting hurt
I know…yoga is supposed to be gentle and healing. Some docs even prescribe it as part of a physical therapy plan.

But if you’re practicing yoga on your own (not in a class setting) where there’s no one to make sure you’re doing your poses correctly, it’s absolutely possible that you’ll hurt yourself. 

Make sure to have your instructor check your poses as well to make sure you’re doing them correctly and not setting yourself up for a back injury.

4. Fear of failure
This unique fear can be the one that blocks your progress more solidly than any other fear, if you can believe it. If you’re afraid of doing something wrong, or of looking dumb or of being out of tune as you chanted the Om, etc., you’re likely to start playing safe when practicing yoga. 

You might decide not to stretch yourself. You might worry about learning something new and just stop trying. And sometimes this fear can affect you in other areas of your life.

Yoga is often associated with promoting strength and flexibility, therapeutic value, and overall personal development. 

This activity is indeed very beneficial. It can be done in a class with other practitioners or therapist. It is also easy enough to be performed by people of all ages. 

However, Yoga can do much more harm than good if not done properly. You can get muscle strain and even injuries in some parts of your body. 

Here is a list of guidelines to keep in mind to stay injury-free while practicing Yoga:

• Find a reputable Yoga teacher

It is ideal to practice Yoga under the supervision   ofa certified Yoga instructor who can see if you are doing the Yoga Poses correctly and help you when necessary. You also need to tell your instructor if you are pregnant or if you have had any injuries, surgery, or special needs. He or she will be able to modify the poses or suggest other exercises that will meet your needs. Ask your doctor if you can practice Yoga.

• Practicing Yoga is not a competition.
  If you are practicing Yoga with other people, there is no point in comparing your performance to theirs. Should you get left behind, just do your own thing at your own pace and do not force yourself to keep up with them. Besides, there is no hurry when it comes to Yoga. Carry out each pose gently while breathing slowly and evenly. Start with the basic poses and if your body is up for it, move on to difficult ones.


• Stay within your limits.
  Prevent injuries by knowing what you can and cannot do. Your Yoga instructor can assist you in determining the poses suitable for your ability level. If you feel something painful, stop doing the pose.


• Do some Warm-up exercises before a Yoga session.
  Relax your muscles and promote blood circulation prior to a Yoga session by doing some Warm-up exercises. Stretching is a good way to improve flexibility of the muscles.


• Wear loose clothing that will make you comfortable.
  Being comfortable with what you are wearing can make Yoga a lot more enjoyable to do. This activity requires a wide range of motion so avoid wearing clothes which can restrict your movement.

Safe Exercise

When people begin a new exercise program, they often push their bodies too far and put themselves at risk for injury. The common notion that exercise must be really hard or painful to be beneficial is simply wrong. Moderation is the key to safe exercise. Safe exercise programs start slowly and gradually build up in intensity, frequency, and duration. 

In addition, if you have an existing health problem, such as high blood pressure, diabetes, a history of heart disease, or are a smoker, you should contact your doctor before beginning any vigorous physical activity. 

Safe Exercise Guideline:

Use Proper Equipment:
Replace your athletic shoes as they wear out. Wear comfortable, loose-fitting clothes that let you move freely and are light enough to release body heat. When exercising in cold weather, dress in removable layers. 

Balanced fitness:
Develop a balanced fitness program that incorporates cardiovascular exercise, strength training, and flexibility. In addition to providing a total body workout, a balanced program will keep you from getting bored and lessen your chances of injury. 

Warm Up:
Warm up to prepare to exercise, even before stretching. Run in place for a few minutes, breathe slowly and deeply, or gently rehearse the motions of the exercise to follow. Warming up increases your heart and blood flow rates and loosens up other muscles, tendons, ligaments, and joints. 

Stretch:
Begin stretches slowly and carefully until reaching a point of muscle tension. Hold each stretch for 10 to 20 seconds, then slowly and carefully release it. Inhale before each stretch and exhale as you release. Do each stretch only once. Never stretch to the point of pain, always maintain control, and never bounce on a muscle that is fully stretched. 

Take Your Time:
During strength training, move through the full range of motion with each repetition. Breathe regularly to help lower your blood pressure and increase blood supply to the brain. 

Drink Water:
Drink enough water to prevent dehydration, heat exhaustion, and heat stroke. Drink 1 pint of water 15 minutes before you start exercising and another pint after you cool down. Have a drink of water every 20 minutes or so while you exercise. 

Cool Down:
Make cooling down the final phase of your exercise routine. It should take twice as long as your warm up. Slow your motions and lessen the intensity of your movements for at least 10 minutes before you stop completely. This phase of a safe exercise program should conclude when your skin is dry and you have cooled down. 

Rest:
Schedule regular days off from exercise and rest when tired. Fatigue and pain are good reasons to not exercise. 

Common Sports Injuries 

Overuse Injuries 
Exercise puts repetitive stress on many parts of the body such as muscles, tendons, bursae, cartilage, bones, and nerves. Repetitive stress can leads to microtraumas — minor injuries that would typically heal with enough rest. When you exercise too frequently, your body never has a chance to repair these microtraumas. As microtraumas build up over time, you become prone to overuse injuries, such as:

• Damage to elbow cartilage in athletes who throw
• Heel bursitis and stress fractures in runners
• Nerve entrapment in rowers
• Kneecap (patellar) tendinitis in volleyball players

Traumatic Injuries  
To build strength and endurance from exercise, you must slowly and gradually push your body beyond its limits. When you push too far too fast, the body is prone to traumatic injuries such as sprains and fractures. 

Many seasonal sports injuries happen when athletes rush their reconditioning and do too much too soon with bones, joints, tendons, ligaments, and muscles they ignored in the off-season. 
  
Risk Factors 
There are many risk factors that make injury during exercise more likely.

• The duration, intensity or frequency of an exercise is excessive or rapidly increasing.
• The terrain or weather conditions are extreme or irregular.
• You use incorrect equipment, such as athletic shoes that are not designed for your activity.
• You have been injured in the past.
• You smoke or have led a sedentary lifestyle.
• You have low aerobic or muscle endurance, low or imbalanced strength, or abnormal or imbalanced flexibility.
• You have underlying musculoskeletal conditions that predispose you to injury, such as bowed legs or high arches in your feet.

First Aid
Accidents can happen despite safe exercise precautions. If you pull a muscle (or worse) during exercise, apply a protective device such as a sling, splint, or brace. Then use the first aid standard for musculoskeletal injures: rest, ice, compression, and elevation (RICE). 

• Rest the injury.
• Ice it to lessen swelling, bleeding, and inflammation.
• Apply a compression bandage to limit swelling.
• Elevate the injury above heart level to reduce swelling.

You may use nonsteroidal anti-inflammatory medications such as ibuprofen for pain. See your doctor if you have severe pain, cannot move the injured body part, or if symptoms persist. 

Supplements Vitamin D....do not help bone health?!

Bad news for osteoporosis sufferers: Vitamin D supplements "do not help bone health"

The Independent warns,the claim comes after the publication of a major study into the effects of vitamin D supplements on bone density.

Bone density weakens as we get older with Post-menopausal women being at particular risk due to the effects that changes in hormone levels can have on bone density. This can increase the risk of fractures, such as hip fractures.

Vitamin D supplements – which are estimated to generate millions of pounds of profit for the dietary supplements industry – have been marketed as a way of preventing bone weakening. But the study in question throws doubt on this claim.

The study pooled the findings of 23 published studies. The results showed that vitamin D increased bone density by a small amount in just one site (femoral neck) of five sites tested. The effect was very small, and was reported to be unlikely to be clinically significant for preventing osteoporosis or fracture.

The conclusion that taking vitamin D does not appear to increase bone density on its own seems credible. Although the study didn’t directly test a link to bone fracture it did point to other research that showed that vitamin D might also be ineffective in this scenario.

The UK guidance on vitamin D supplementation is being reviewed and will take into account the best available evidence to inform its recommendations.

Where did the story come from?
The study was carried out by researchers from the University of Auckland, New Zealand, and was funded by the Health Research Council of New Zealand.
The study was published in the peer-reviewed medical journal The Lancet.

The media reporting was broadly accurate with some media outlets focusing on the science while other stories focused more on the cost implications of potentially wasteful use of vitamin D supplements in the NHS in England. 

The Daily Telegraph reports that “the NHS currently spends more than £80m per year on prescriptions for vitamin D-based medicines”. However, this figure also includes treatment costs for people with diagnosed vitamin D deficiency, so the £80m figure is inaccurate.

Who should take vitamin D supplements? The Department of Health recommends that the following groups should take vitamin D supplements:

• pregnant women
• breastfeeding women
• babies and children between the ages of six months and five years
• older adults aged 65 or over

People who have limited exposure to sunlight, such as the housebound, or those who wear a veil for religious reasons, may also require supplements.
 

For more detailed information on the recommended dosages for each group read the Behind the Headline’s special report on vitamin D.

What kind of research was this?

This was a meta-analysis of randomised controlled trials looking at whether vitamin D affects bone mineral density.
Vitamin D has several important functions including helping to regulate the amount of calcium in the body. This makes it biologically important in the formation and density of bones.

A meta-analysis of randomised controlled trials is a common method of trying systematically to identify all known research on a topic and to summarise it into a single conclusion. There have been a lot of research studies published on the effect of vitamin D on bone density, so this approach is an appropriate way of pooling the findings into an overall measure of effectiveness.  

Vitamin D supplements are sometimes given alongside calcium to prevent and treat osteoporosis, a condition where the bones become less dense (they lose bone mineral density), becoming more frail and likely to break. Fracture, especially hip fracture, can cause hospitalisation and is linked, particularly in the elderly, to an increased risk of dying from subsequent complications while in hospital. 

However, the study authors reported that a number of recent research studies have questioned the effectiveness of vitamin D supplements alone for increasing bone density, preventing bone breaks and preventing osteoporosis. So the researchers aimed to review all the literature on the subject to see whether vitamin D supplementation affects bone mineral density.

What were the basic results?
The literature search identified 23 studies that were relevant to the topic and were analysed in the meta-analysis. The studies included 4,082 participants, 92% of whom were women, with an average age of 59 years and the vitamin D interventions lasted an average of 23.5 months (just under two years). Nineteen studies had mainly white participants. 

Bone mineral density was measured at one of five sites:

• lumbar spine (the bottom section of the spine in the lower back)
• femoral neck (the top of the femur near the hip joint and commonly the place where a hip fracture occurs)
• total hip
• trochanter (another part of the femur near the top)
• forearm

An overall total body bone density was also calculated.
The baseline levels of vitamin D varied a lot between the studies – the average level ranged from 30 nanomole (nmol) per litre to more than 75nmol per litre.
In 12 studies calcium supplements were also given to participants in both arms of the trial, balancing out any effect due to calcium.
Out of the 23 studies:

• Six found a statistically significant benefit of vitamin D on bone density at one specific site – the femoral neck. Only one study showed benefit at more than one site.
• Two found a statistically significant detrimental effect of vitamin D on bone density.
• The rest, the majority, found no significant differences in bone density.

When they were pooled in a meta-analysis the results showed a small (0.8%) increase in bone density using vitamin D measured at the femoral neck only (weighted mean difference 0.8%, 95% CI 0.2–1.4). 

However, the characteristics of the underlying studies feeding into this result differed significantly (this is known as significant heterogeneity). For example, participants in the various studies were of different ages, ethnic groups or had different underlying conditions. This means that pooling the results may not be the most appropriate thing to do. No statistically significant effect at any other site was reported, including the total hip. 

The authors noted that there was positive publication bias for femoral neck and total hip. This means that studies finding that vitamin D was effective were more likely to be published, and those that found no effect were less likely to be published. As a result there wasn’t an accurate balance of findings in the published literature – it was biased towards positive results.

The researchers used a range of statistical models to take into account the possible influences (confounders) on bone density.

 These included:

• age
• study duration
• number of participants
• sex
• vitamin D concentration/dosage
• weight
• baseline bone mineral density

Even after taking these confounders into account no significant beneficial effects of vitamin D on bone density were seen, aside from the small increase in femoral neck (which, as mentioned, may have been a distorted result due to publication bias).

How did the researchers interpret the results?

The authors’ central conclusion was that “continuing widespread use of vitamin D for osteoporosis prevention in community-dwelling adults without specific risk factors for vitamin D deficiency seems to be inappropriate”.
They are quoted in The Independent as saying “our data suggest that the targeting of low-dose vitamin D supplements only to individuals who are likely to be deficient could free up substantial resources that could be better used elsewhere in healthcare”.

Conclusion

This meta-analysis of randomised controlled trials found that there was a statistically significant increase in bone mineral density at only one site (femoral neck) through giving vitamin D. 

This effect was very small, and was reported to be unlikely to be clinically significant at preventing osteoporosis or fracture. 

This, the media and study authors suggest, calls into question the reportedly widely held belief that vitamin D supplementation is beneficial for preventing and treating osteoporosis and preventing bone fracture.
So does this contradict the current UK government recommendation that over-65s take a daily supplement?

Well, it is important to point out that preventing hip fracture is not the only reason people are advised to take vitamin D supplementation. The supplements have a variety of other important roles in the body and may be beneficial for other reasons, for example treating vitamin D deficiency due to an underlying condition such as Crohn's disease.

Similarly, osteoporosis is known to have many influencing factors such as genetics, diet and the environment, which are not accounted for in this study. So vitamin D is just one of the potentially influential factors on osteoporosis risk.

The study authors acknowledge that their research was limited by restrictions common to the individual studies included. Some were unblinded, short-term or used low doses of vitamin D, and most participants had adequate calcium intakes. They also highlighted strengths, including the fact that the total number of participants was large, most individual studies were well powered and there were wide ranges of baseline vitamin D concentrations, vitamin D doses and dosing regimens covered. 
Overall, the study findings appear to be relatively reliable.

The implication of the research was that giving vitamin D supplements to healthy individuals was a wasteful and inefficient use of healthcare resources and that “targeting of low-dose vitamin D supplements only to individuals who are likely to be deficient could free up substantial resources that could be better used elsewhere in health care”. 

The UK guidance on vitamin D supplementation is under review and it would be highly surprising if this new evidence were not considered.
The bottom line is that this evidence suggests that vitamin D supplements alone may not be effective at increasing bone density in healthy people. Any changes to your medications should be discussed with your GP.

REF: Nhs.uk/news