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Muscle Soreness, Exercise Injuries and Vitamin D

When doctors don't know the cause of a patient's problem, they often give it a fancy name so you will believe they are giving you a useful diagnosis. A perfect example of this is "idiopathic inflammatory myopathy", which means you have chronic muscle soreness and your doctor doesn't know why. Researchers recently reviewed the effects of exercise on people with chronic muscle soreness and found that exercise is beneficial (Current Opinion in Rheumatology, 04/07/09):
• The muscles of many of subjects with this condition did not get a sufficient oxygen supply
• Exercise increases endurance-type fibers after a 12-week exercise program
• Creatine supplements plus an exercise program are more beneficial than exercise alone
• Intensive resistance training improves muscle strength and endurance
• Exercise reduces muscle soreness and possibly even muscle inflammation

I am now convinced that a leading cause of muscle soreness and slow-healing injuries is lack of vitamin D. All my life, I have suffered a series of baffling injures that usually occur in the winter and heal in the summer. For the entire winter of 2007-8, I was unable to exercise because of a non-healing hamstring injury and diffuse muscle soreness. Eventually I found that my vitamin D 3 level was 22 nmol/L (normal is greater than 75). I took the prescribed treatment of 50,000 IU of vitamin D twice a week and my muscles became so sore that I couldn't even walk. In the summer, the hamstring injury healed and the soreness disappeared. This winter I went to Florida and was able to train on my bicycle better than ever. In March I went back to wintery Maryland and the non-healing hamstring injury and soreness reappeared. This time I improved within 24 hours of taking 2000 IU of vitamin D twice a day. From my experience, I conclude that:
• my muscle soreness and non-healing injuries are caused by or worsened by low levels of vitamin D
• very high doses (50,000 IU) may increase muscle soreness
• lower doses of vitamin D (2000 to 4000/day) or daily sunlight exposure cured my muscle soreness and helped to heal my injuries

Dr. John Cannell of the Vitamin D Council quotes 14 studies that show that athletic performance improves in the summer months when sunshine is abundant, or with ultraviolet light exposure in winter.

If your muscles feel sore or you keep on being injured when you exercise, get a blood test called D3. If it is below 75 nmol/L, your problems may be caused by lack of vitamin D and be cured by getting some sunshine or taking at least 2000 IU each day of the very inexpensive vitamin D3.

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Reports from drmirkin.com - Common Exercise Injuries

Achilles tendinitis
Tennis elbow
Shoulder injuries

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Dear Dr. Mirkin: I get so nervous before races that I have diarrhea almost every time. Can you help me?

Hard running causes giant contractions of the colon in runners whether they are nervous or not. However, it is a problem only if your colon is full when you start the race. The solution is to be sure to empty your colon before you run. On the day before a race, eat lots of fiber-rich foods: salads, vegetables, and fresh or dried fruits. On the day of the race, get up and eat your pre-race meal and drink fluids several hours before your race. This causes the gastro-colic reflex that stimulates your colon to contract. About half an hour after the meal, spend a long time trying to empty your colon. You should then be able to run without any distress.

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Dear Dr. Mirkin: Why do many of Diana's recipes use bouillon? My doctor advises restricting salt.

Bouillon cubes and granules often contain a lot of salt, but if you are restricting salt, many low-salt or salt-free bouillon products are available. For other suggestions see Diana's notes on bouillon choices

Salt is a problem primarily for people with metabolic syndrome (Lancet, March 2009). You should be cautious about using salt if you have trigylcerides over 150, fasting blood sugar over 100, HBA1C over 5.7, two-hour-after-eating blood sugar greater than 110, HDL cholesterol below 40, store fat primarily in your belly, or have a thick neck or systolic blood pressure over 120 before you go to bed at night. Get a blood pressure cuff and take you blood pressures several evenings before you go to bed. If the systolic BP is greater than 120, you may need to restrict salt.

In my opinion, people who do not have the symptoms of metabolic syndrome or high blood pressure usually do not need to restrict salt. Athletes and heavy exercisers need extra salt. If they don't replace salt lost in sweat, they are likely to develop a salt-losing syndrome resulting in chronic fatigue and muscle cramps.

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Recipe of the Week:

Harira - a lovely lemony soup to welcome springtime

You'll find lots of recipes and helpful tips in The Good Food Book - it's FREE

June 22nd, 2013
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About the Author: Gabe Mirkin, MD

Sports medicine doctor, fitness guru and long-time radio host Gabe Mirkin, M.D., brings you news and tips for your healthful lifestyle. A practicing physician for more than 50 years and a radio talk show host for 25 years, Dr. Mirkin is a graduate of Harvard University and Baylor University College of Medicine. He is board-certified in four specialties: Sports Medicine, Allergy and Immunology, Pediatrics and Pediatric Immunology. The Dr. Mirkin Show, his call-in show on fitness and health, was syndicated in more than 120 cities. Read More
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