Phoenix Therapeutic Massage, Training & Bodywork

02/10/2023

03/04/2022

Amazing

Meet the paragliding dog who calls the French and Italian Alps home.

11/29/2021

Happy Holidays To Everyone.
Celebrate!
Be Safe.
Wash your hands.
Get vaccinated!

08/07/2018

Haven't posted in a while, good article on the benefit of resistance bands:
SUMMARY
Researchers at the University of Valencia were interested in determining the effectiveness of 2 different elastic resistance exercise programs in older, overweight women (60-85 years old). Subjects were randomly assigned to elastic band exercises, elastic tubing exercises, or a control group. The elastic resistance groups performed the same exercises with either TheraBand resistance bands or the TheraBand exercise station using elastic tubing with handles.

The subjects performed 6 overall body exercises at moderate-to-high perceived exertion of 7 to 9 on the OMNI TheraBand scale. After the 8 week program, both elastic resistance groups significantly improved their physical performance measures (strength, flexibility, balance) compared to the control group; there was no significant difference between the exercise groups. Both groups also significantly improved their total body composition, although greater increases in trunk fat-free mas and cardiorespiratory endurance was noted in the exercise with tubing group.

Although body weight did not change, both exercise groups reduced their fat mass by 7 to 10%. The authors concluded, “training with elastic resistance equipment at moderate to high RPE is an effective strategy for short-term improvements in body composition and functional performance in older overweight women.”

Fritz NB, et al. Positive Effects of a Short-Term Intense Elastic Resistance Training Program on Body Composition and Physical Functioning in Overweight Older Women. Biol Res Nurs. 2018 May;20(3):321-334.

03/07/2018

Keeping a Pain Free Environment at Work-
Scott Coldwell, ACSM Personal Trainer, LMT, Wellcoach.
If you’ve spent hours hunched over your computer, you’ve probably started to feel the effects of your day through bleary eyes, an aching back and sore wrists. In particular, the repetitive use of the mouse can easily lead to wrist pain and eventually carpal tunnel syndrome if left untreated. Listed here are some ideas to help you create a more ergonomic workstation.
Here are some things to watch for:
(a) static or awkward posture, (b) repetitive motion, (c) poor access and excessive reach, (d) computer displays that are difficult to read and understand, and (e) furniture controls that are confusing to operate or require too much force.
Step 1: �Set up your computer so that you are an arm's length from the screen. The monitor should be at or below eye level to help prevent eye fatigue.
Step 2: �Use an adjustable table for proper monitor and keyboard height.
Step 3: �Use a document holder on your desk or attach a document holder to the computer screen to minimize neck and eye strain.
Step 4: �Purchase a headset if you are on the phone frequently. This enables you to write or use your computer while on the phone without putting stress on your neck.
Step 5: �Avoid twisting & side bending. Get an adjustable chair so you can swivel and move across the floor easily. Remember your head & shoulders should always be facing the same direction as your hips.
Step 6: �Correct posture & Workstation Design; It’s all about 90o degree angles.
Correct work station height depends upon the user of a work station and upon the chair and other factors that interact with the user and table. The ideal is for the user to be able to sit at the work station with the keyboard in place and be able to easily maintain a 90-100 degree elbow angle and straight wrists while keying. The height of an adjustable keyboard support should adjust between 23" and 28" to accommodate most-but not all-users. 26" is a recommended compromise.
Leg room: Knee spaces should allow a worker to feel un-crowded and to allow some changes of position even with the keyboard support lowered to the correct level for use. The knee space should be at least 30" wide by 19"deep by 27" high to comply with the requirements of the Americans with Disabilities Act. For those using a footrest, clearance must be calculated with the legs in place on the footrest. Likewise, depth of the "clearance envelope" for both legs and toes should be evaluated while the workstation user is in a normal working position at the work station.
Footrest:
Situations will arise in which a user is perfectly adjusted for keyboard use and with the monitor at a correct angle, but his/her feet do not rest flat on the floor. A footrest may be used to correct this problem.
Step 7:
Get up and stretch or walk around for 5-10 minutes at least every 2 hours. Your body will thank you.
Step 8: �Clear your immediate work area of any supplies or objects so that you can move about freely without touching or bumping into things.
Step 9: �Adjust lighting so there is minimal glare in your work area. Turn off overhead lights and use task lights in your immediate work area. Close blinds or curtains to minimize glare. Attach a glare screen to your computer to reduce eye strain.

Remember if you are comfortable when you are working you will be more productive, happier, have less pain & more energy to do the things you enjoy after work.

02/26/2018

IF YOU HAVE OSTEOARTHRITIS, YOU NEED MASSAGE,
May 2, 2017 Heath
Osteoarthritis is a painful joint disorder involving inflammation and the loss of healthy cartilage in one or more joints. By far, the most common type of arthritis is osteoarthritis, which is also known as degenerative joint disease.
According to the Centers for Disease Control and Prevention (CDC), more than 27 million American adults have received an osteoarthritis diagnosis—this number is rising, particularly as our society ages and becomes more sedentary.
Medication and surgery treatments for arthritis have limited benefits and many undesirable side effects.
The beautiful thing is, natural remedies such as massage and functional movement can halt—and, some people say—even reverse the painful and debilitating symptoms of arthritis.
Benefits of Massage Therapy
Encouragement and pain relief are part of the plan as members of a client’s healing team.
In 2012, PLOS ONE published “Massage therapy for osteoarthritis of the knee: a randomized dose-finding trial,” which recommended one 60-minute massage session per week.
“Given the convenience and cost savings of a once-weekly protocol, with a well trained massage therapist, the 60-minute once weekly massage was determined to be optimal.
As massage therapists, we are always looking for the best ways to support our clients and relieve painful conditions based on both science and our experience.
There aren't any insights

08/14/2017

Exercise helps keep your brain in shape

Daily walks, mental challengers, nutrition can help stave off Alzheimer's, Parkinson's diseases.
Gannett News Service
A fast spin on the dance floor or taking daily walks might help keep the brain in top shape as people age -- and might reduce the risk of developing age-related diseases such as Alzheimer's or Parkinson's, experts now say.

Both Alzheimer's and Parkinson's are degenerative, incurable diseases of the brain. Both are more common in older people; together they afflict more than 5 million people in the United States. Alzheimer's causes memory problems, and Parkinson's leads to tremors and shakiness, but the diseases often overlap: Some people with Parkinson's also have memory loss.

Growing evidence now suggests that lifestyle factors such as diet, exercise and challenging activities, might help ward off or delay the onset of neurodegenerative diseases, possibly by building connections between brain cells or even spurring the production of new brain cells. People who power up the brain in this way may have a better shot at reaching old age with a brain that still performs at top speed, says Elizabeth Edgerly, a brain expert at the Alzheimer's Association.

To keep the brain healthy:
• Stay fit. Physical activity boosts the blood supply to the brain, and that keeps brain cells well nourished.

Edgerly recommends taking a walk, swimming, yoga or anything that's physically active three to five days a week. Spend about 30 minutes a day on such activities if you can, but a study suggested that even a 15-minute daily walk could reduce the risk of Alzheimer's.

"My guess is that we're going to discover that we should be exercising most days of the week," said Michael Zigmond, a Parkinson's researcher at the University of Pittsburgh.

He and other experts say workouts that involve a mental challenge might be better for the brain than those that are routine. So learning a series of complex dance moves might be better than zoning out while riding a stationary bike; a 2005 study found that older men and women who learned to tango got measurable improvements in balance and memory, skills that might help compensate for early signs of a brain disease.

• Challenge your mind. The mental decline that goes along with old age can be traced to altered connections between brain cells, Edgerly says. But stimulating leisure activities can help keep those connections strong. Activities such as playing chess or card games such as poker, going to the theater, reading a book or learning how to play a musical instrument might help keep older brain cells agile and less vulnerable to damage, she says.

• Eat a healthful diet, one loaded with colorful fruits and vegetables. Neurodegenerative diseases such as Alzheimer's and Parkinson's are tied to damage done by free radicals, highly reactive molecules that are byproducts of metabolism, says James Joseph, a researcher at Tufts University. Fruits and vegetables contain antioxidants, powerful substances that combat free radical damage and might help protect the brain, he says.

His studies of diets rich in such foods show that older rats get a boost in the ability to remember and stay balanced. He says humans might get the same benefit and recommends adding blueberries, strawberries, spinach and other colorful fruits and vegetables to a whole-grain diet that includes low-fat dairy foods and very little junk or fast food fare.

07/11/2017

Tackling Migraines Head-On
Katie M. Golden, May 23, 2017
Nobody likes to be in pain, and for people who suffer from migraines, pain can be debilitating, disrupting both their personal and professional lives. Whether migraine hits once in a while or on a regular basis, finding relief—preferably relief that can be counted on—is a top priority.

Massage therapy has shown some success in helping people who suffer from migraine better manage the pain. To help your clients who get migraines, you’ll need to understand the condition and what massage therapy has to offer in terms of pain relief.

Breakdown of a Migraine Attack
Migraine is a neurological disease, not a vascular issue as previously thought. Peter Goadsby, M.D., who is a neurologist and headache specialist at the University of California San Francisco, describes the disease as “an inherited tendency to have headaches with sensory disturbance. It’s an instability in the way the brain deals with incoming sensory information, and that instability can become influenced by physiological changes like sleep, exercise and hunger.”1

Migraine is a complex condition that can be activated by a variety of factors, but also mitigated by a range of interventions.

First, let’s explore how migraines develop. Each migraine cycles through four phases.2 The accompanying symptoms in each phase can vary dramatically among people who suffer from migraines.

Phase 1—Prodrome. Up to 72 hours before the pain hits, there can be warning signs that a migraine is imminent. These signs can include severe exhaustion or hyperactivity, difficulty
concentrating, food cravings, sleepiness and neck pain.

Phase 2—Aura. The most commonly reported aura is visual, although it only occurs in onethird of the migraine population. A person’s vision can be interrupted by sparkly spots, zigzag lines or tunnel vision, lasting between 20 to 60 minutes. An aura can present in other ways, too, such as vertigo, tinnitus (ringing in the ears) and even temporary paralysis on one side of the body.

Phase 3—Headache. The pain during this phase is often described as throbbing, piercing or pulsating. The client may also be sensitive to light, sound and smell. Physical activity usually makes the symptoms worse. This phase can be debilitating for hours or days. Most seek refuge in a quiet, dark room.

Phase 4—Postdrome. Once the pain has subsided, the body requires a recovery period. A person might feel exhausted, sluggish, confused and even depressed.

The Science of Massage and Migraine
Dawn Buse, Ph.D., Associate Professor of Neurology at Albert Einstein College of Medicine and the Director of Behavioral Medicine at the Montefiore Headache Center in New York, says that although firm scientific data is lacking, patients still find value in massage therapy.

“Data on the efficacy of massage for migraine are somewhat limited. This does not mean that massage is not helpful for migraine, but rather that there have been few studies, and they have had smaller samples and less rigorous designs, so we do not have the scientific evidence necessary to make a conclusive statement about its efficacy. This is due in large part to the fact that there is less funding available to support research on massage and other non-pharmacologic treatments than there is to support the testing of new medications,” she explains. “However, many patients find massage therapy helpful, in which case I encourage them to make it a regular part of their treatment plan along with other healthy lifestyle habits, relaxation and self-care activities.”3

Though limited, there have been a few studies that point to a positive connection between massage and migraine relief:

A randomized, controlled trial of massage therapy as a treatment for migraine.4 Participants either received no massage or two 30-minute traditional massages for five weeks. Before and after each session, each participant’s heart rate, anxiety level and salivary cortisol were measured. The massage group reported a decrease in the frequency of migraine attacks compared to the control group. Heart rates, anxiety level and salivary cortisol levels also decreased by the end of each massage session.
Myofascial trigger point-focused head and neck massage for recurrent tension-type headache: a randomized, placebo-controlled clinical trial.5 Participants with tension-type headache, a related headache disorder, received either no massage, ultrasound or 12 myofascial trigger-point massage sessions within a sixweek period. This type of massage focuses on releasing abnormal skeletal muscles, often a contributing factor in triggering tension-type headaches and migraine. The massage group reported the highest positive change in headache frequency as well as perceived headache pain. The massage group also experienced greater improvement in their pressure-pain threshold than the placebo and control groups.
Effects of Thai traditional massage on pressure pain threshold and headache intensity in patients with chronic tension-type and migraine headaches.6 Participants with chronic tension-type and migraine headaches either received ultrasound or nine sessions of Thai traditional massage in a three-week period. This type of massage uses compression, stretching, pulling and rocking motions as opposed to rubbing of muscles. The pain pressure threshold increased for those in the massage group, while it decreased in the placebo group. However, both groups reported a significant reduction in the intensity of their migraine attacks.
How Massage Can Help Migraine
Jamie Valendy and Anna Eidt suffer from chronic migraine. Both women have 15 or more migraine
days a month. Only 8 percent of the migraine population in the United States have migraines this frequently or this severe—roughly 4 million people.7

Valendy schedules a massage every 4–6 weeks to help her manage her migraine attacks. Her therapist is trained in deep tissue, trigger point and Swedish massage. Valendy says that she knows it’s time to schedule a massage session when her “shoulders become so tight that they start lifting
upward and [she has] a difficult time getting them to relax back into a normal posture.”8

Eidt, who schedules a massage every two weeks, believes finding the right massage therapist is essential. “It takes a very special, knowledgeable and responsive practitioner for massage therapy to be an effective form of migraine prevention,”9 she says. She prefers gentle myofascial trigger point massage, noting that anything too rough or hard is often too much to bear and can trigger a migraine attack.

Shiatsu for Migraine
“Shiatsu has a profound effect on the nervous system, and I think that is why it is so effective for migraine,” says Leisa Bellmore, a Shiatsu therapist from Toronto.10 Shiatsu technique focuses on pressure points along muscle lines, nerve pathways and blood vessels, along with gentle stretching.

When a client is having an active migraine during a session, Bellmore focuses first on pressure points on the head and neck, then moves to the neck and shoulders. Pressure should start lightly and increase based on the client’s tolerability. Stretching the neck is also a key technique in addressing pain stemming from this area during an attack. Bellmore suggests performing the “forward flexion” technique on migraine clients, as outlined below:

Foward Flexion of the Neck

Support client’s head with left hand.
Slip right hand under client’s head, placing hand on left shoulder so that the head rests in crook of arm.
Place left hand on right shoulder.
Gently stretch head forward by straightening right arm while supporting the side of the head with the left arm, rising up slightly while you do so.
Hold for 10 seconds, then lower the head.
Support the head with the left hand while removing arm.
Let Cooler Heads Prevail—Using Cold Stones
Kelly Lott11 is a massage therapist and educator with 20-plus years of experience. Although Lott does not suffer from migraines, she has made it her mission to assist clients who need help managing migraine pain. “Migraine patients yearn for cold, not heat,” says Lott.

Lott has observed that active massage therapy can increase blood flow and cause inflammation in some migraine clients. She has developed a set of marble stones designed to be used on the forehead, temples, sinus area and back of the scalp. The stones are refrigerated at 36 degrees Fahrenheit until used.

The placement of the stones includes the area where the trigeminal nerves (found in the face and temples) and the occipital nerves (found at the base of the skull) are located. These two sets of nerves are known to cause migraine attacks if they become inflamed. The soothing coolness of the stones can help to calm these nerves. She recommends that cold stone therapy can be used once a week for prevention of migraine attacks or during an active attack.

Lott recommends the following four myofascial trigger points to relieve pressure in the face. This can be performed in conjunction with cold stone therapy or on its own.12

Place thumb pads under the orbital ridge (under the eyebrow bone) close to the bridge of the nose. Press up and inward to the bones, to a comfort level. This exercise tends to provide the fastest relief, say Lott.
Using your index fingers, press into the orbital ridge bone (eyebrow bone), one place at a time, from inside to outside. Hold for 20 seconds.
Using your index fingers, press into the sinus area (just beside the nostril) to a comfort level. Hold for 20 seconds.
Massage the sinus area in a circular motion to break up the mucus and pressure.
Related: Read more in "Cold Stone Therapy for Migraine Headaches"

Self-care at Home for Migraine Clients
Bellmore also emphasizes the importance of teaching self-care techniques to massage clients with migraine.13 Those experiencing chronic migraine can often feel they have no control over their own body. Self-care can help clients increase body awareness, thereby regaining feelings of control, explains Bellmore. Valendy agrees with this approach. Her husband gives her regular massage at home to prolong the effects of massage between appointments.

Related: Self-care Tips for Massage Clients

Here are some additional suggestions massage therapists can incorporate into their practice as well as teach their clients for self-care:

Lace thumb pads under the orbital ridge (under eyebrow bone) close to the bridge of the nose. Press up and inward to the bones, to a comfort level. Lott believes this is a natural place for people with migraine to carry tension. Focusing on this area first can jump-start the healing process.
Using hand reflexology, use two fingers to pinch the fleshy area between the thumb and pointer finger, feeling your way around for any sore areas.
Using foot reflexology, place a tennis ball under the foot while in a seated position. Roll the ball around, focusing on tender areas, and apply pressure. Repeat on the other foot.14
An area not instinctively thought of when treating migraine is to focus on the masseter muscle (chewing muscle). Many patients grind their teeth. Locating trigger points around the jaw can also relieve pressure.15 Some therapists pinch this muscle using the index finger inside the mouth and the thumb on the surface of the face.
Research has demonstrated that self-management interventions increase feelings of control and mastery. Giving your clients these tools can improve their overall health and perception of pain.

Establishing Boundaries
When working with a person who suffers from migraine, there are several key factors to address before beginning a session:

Some migraine patients experience allodynia, a condition in which one or several areas is extremely sensitive to touch. The pain is so intense that clients may say their hair hurts, a sensation caused by allodynia. Ask the client about any sore areas that should be avoided (especially the scalp).

Sensitivity to smell, or hypersomnia, is a common symptom for people with migraine. If using essential oils is part of your practice, make sure to ask the client before using any fragrance products.

Be on the same page regarding the firmness of massage. Some migraine clients want you to more aggresively work out those knots, while others just need a soothing touch.

Encourage your client to hydrate. Bellmore insists that her clients stay well-hydrated, as dehydration is a common trigger for a migraine attack.

Ask anyone who suffers from migraine and you’ll know that pain relief is one of their primary objectives—and massage therapy is starting to be recognized as a way for migraine sufferers to better manage pain and practice better self-care. Massage therapists who understand migraine can help people who experience it find relief faster and, perhaps, stay pain-free longer.

05/26/2017

The Role of Vitamin D in Athletic Performance

By Kelly P. Massey, Ph.D. EP-C, CMES, AASDN-NS and Anne R. Loughren, M.S.
Introduction

Supplementation, hydration techniques, and training methods are practices used by athletes to enhance their athletic performance. Vitamin D supplementation may have benefits as well to enhancing athletic performance. Is vitamin D a vitamin or a hormone? Vitamin D is a fat-soluble vitamin produced in the skin.7 Calcitriol is the predominant source of circulating vitamin D in humans.8 When ultraviolet B (UVB) radiation hits the skin surface the process of converting vitamin D into its active form calcitriol begins.3,6,7 Calcitriol, a secosteroid hormone, is transported in the blood by binding to a vitamin D protein with the purpose to signal gene transcription.7 Vitamin D's role is to maintain serum calcium and phosphorus levels by increasing absorption efficiency of calcium and phosphorus in the intestines and reabsorption of calcium in the kidneys.6 Vitamin D may be beneficial in injury prevention as adequate levels have been found to be important to musculoskeletal health.2,3,5-7,9

Vitamin D is measured by the 25(OH)D concentration.5-7,9 This concentration is formed from the hydroxylation of vitamin D2 and D3 in the liver.9 From the liver, 25(OH)D undergoes further hydroxylation in the kidneys forming the active form of vitamin D (1,25(OH)2D).9 Vitamin D classifications are controversial; however the general consensus lists sufficient levels >30 ng/ml and deficient levels between 10 to 20 ng/ml, with severe deficiency > 10 ng/ml.5-7 Vitamin D deficiency is considered an epidemic for all ages worldwide and athletes are not immune from this deficiency.5,6,8,10 Athletes who train or compete during cold or winter months, indoors, and early or late times of day are usually more susceptible to vitamin D deficiency.2,10

Previous research has suggested that vitamin D supplementation can possibly improve athletic performance; however, many athletes are inadequate in vitamin D.5,6,8,10 The meta-analysis by Farrokhyar et al.2 examined more than 2,000 athletes and found that 56% of the athletes had vitamin D levels classified as inadequate. Dubnov-Raz et al.1 found that 66% of their participants, who were competitive adolescent swimmers, had insufficient levels; 14% of which were deficient. A study by Willis et al.10 examining young Finnish runners, gymnasts, and nonathletes ages 9 to 15 years, found insufficient levels of vitamin D in nearly 68% of the participants. Examining how inadequate levels of vitamin D affect skeletal muscle can be important to understanding how to possibly prevent athletic injuries.

Vitamin D: Skeletal Muscle

Vitamin D functions through a vitamin D receptor (VDR) which is selective for 1,25 dihydroxyvitamin D (1,25(OH)2D).5 VDR was discovered in cultured rat myoblast cells in 1985, which showed muscle as a direct target organ for 1,25(OH)2D.5 The mechanisms reviewed by previous studies classify the effects of vitamin D as genomic (direct) and non-genomic (indirect) effects of 1,25(OH)2D on skeletal muscle.9 Hamilton points to a previous study showing VDR null mice having fiber size of the quadriceps and other muscles 20% smaller than that of the VDR-replete mice.5 This finding helped lead to 1,25(OH)2D and VDR having a direct role in the metabolic processes and the transcriptional regulation of skeletal muscle.5

Calcium acts as a regulator of skeletal muscle function.6 The maintenance of the physiologically acceptable range of intracellular and extracellular calcium concentrations is achieved by the function of 1,25(OH)2D and the parathyroid hormone (PTH).10 If vitamin D levels are inadequate, the intestinal absorption of calcium is reduced creating a decreased level of serum calcium concentrations. This decreased level of serum calcium concentrations stimulates the secretion of PTH, pulling calcium and phosphorus from bone in order to restore serum calcium levels to normal.10 This process, known as bone remodeling, may result in cortisol bone loss, an increase in fragility, and a greater risk of fractures.7 In a study conducted using military recruits, the risk of bone fracture was found to be significantly associated with reduced serum 25(OH)D and increased PTH among military recruits.7 Furthermore, a decrease in bone fractures was found with a supplementation of 800 IU/day vitamin D plus calcium.7

Vitamin D levels and injuries

Vitamin D deficiency can lead to an increased risk of injuries such as stress fractures.7 Stress fracture risk was significantly increased among young Finnish military recruits when their 25(OH)D levels fell below 30 ng.mL.7 Stress fracture incidence among female naval recruits was significantly reduced with the subjects that followed eight weeks of 800 IU of vitamin D plus 2000 mg of calcium supplementation compared to the placebo group.7,8 American professional football players with and without muscle injuries showed a significant difference in serum 25(OH)D levels.2 Whether inadequate vitamin D levels or supplementation with vitamin D affects injuries, is still a question. Health and athletic performance may be improved with vitamin D supplementation.8

The possibility of vitamin D affecting athletic performance has been around since the early part of the 20th century.3-6,7 Earlier studies believed athletes benefited from ultraviolet radiation exposure.7,8 To this day, many still believe that athletic performance can be enhanced with vitamin D even though there is limited research supporting vitamin D supplementation benefiting athletic performance.7,8 With that said, athletes with the lowest baseline vitamin D levels may benefit the most from vitamin D supplementation.7

A significant improvement in athletic performance is thought to occur in athletes that increase their vitamin D levels from 15 to 30 ng/mL, with little to no improvement occurring from 30 to 50 ng/mL.7 Todd et a1.9 mentions that athletes with high 25(OH)D concentrations may not benefit from vitamin D supplementation, while those with low 25(OH)D concentrations may have hindered their performance. Powers et al.8 found a significant positive correlation from two previous studies between serum 25(OH)D levels and muscle force, muscle power, hand grip strength, and jumping height and velocity of the subjects. Furthermore, a study conducted in the UK found a significant increase in 10 m sprint times and vertical jump (p < .05) in the subjects participating in vitamin D3 supplementation of 5,000 IU/day compared to the placebo group.3

Conclusion

Vitamin D does play an important role in the human body. Research has shown 25(OH)D to have a significant impact on injuries, specifically due to bone loss or weakness. Many studies have found a benefit in athletic performance with vitamin D supplementation; however, these findings are not conclusive. It does appear for athletes benefiting from vitamin D that the condition of the athlete, baseline concentrations of vitamin D, and the time of day/year of training/competition is meaningful. All athletes are at risk of injury; however, vitamin D and its relationship with the musculoskeletal system appear to have merit. Athletes, coaches, and trainers need to be aware of their athlete's vitamin D levels. Even though levels of vitamin D per day an athlete should have is debatable, having athletes maintain sufficient levels of vitamin D (>30 ng/ml) should be of importance.