Bone health in athletes. Factors and future considerations

Bone Mineral Reference Values for Athletes 11 to 20 Years of Age

Objectives. Training for sport is associated with the development of bone minerals, and the need for reference data based on athletes is often indicated. The purpose of this study was to develop a reference for bone mineral density (BMD) and content (BMC) specific for youth athletes of both sexes participating in several sports. Methods DEXA (dual energy X-ray absorptiometry) was used for total body measurements of bone minerals in 1385 athletes 11 to 20 years, 1019 males and 366 females. The athletes were training in several sports at Hungarian academies. Reference values for total bone mineral density and bone mineral content, and also BMD excluding the head (total body less head, TBLH) were developed using the LMS chartmaker pro version 2.3. Results. The centile distributions for BMD and BMC of the athletes differed significantly from those of the age- and sex-specific references for the general population. The youth athletes had higher BMD and BMC than those of the reference for the general population. Conclusion. The potential utility of the DEXA reference for male and female youth athletes may assist in monitoring changes in the BMC and BMD associated with normal growth and maturation, and perhaps more importantly, may be useful in monitoring changes specific to different phases of sport-specific training protocols.

Issues unique to the female runner

Care and treatment of female runners will improve as further knowledge regarding the unique factors that affect them becomes available. For care and treatment to be their most effective, current and recent information needs to be disseminated among health care providers, coaches, teachers, school administrators, and parents. In young athletes, peer support and education are the most important factors in the success of detection and treatment. Individuals who have the female athlete triad are at significant risk for stress fractures and other injuries. Early detection and multidisciplinary treatment should begin after fractures are detected to reduce or prevent long-term adverse sequelae to bone. In addition, correction of menstrual dysfunction can help to prevent later fertility problems. Addressing the unique biomechanics and core strength of female runners also is essential to rehabilitate athletes past symptom resolution. A thorough understanding of the unique issues for female runners is essential for the prevention of injuries and plays an important role in the promotion of female participation in recreational and competitive running.