Elsevier

Bone

Volume 38, Issue 2, February 2006, Pages 227-233
Bone

Bone mineral density among female sports participants

https://doi.org/10.1016/j.bone.2005.08.024Get rights and content

Abstract

Training for and participation in impact-loading sports are associated with alterations in bone strength which are specific to anatomical site and type of strain. The effect of exercise on bone mineral density (BMD) depends on the type of activity engaged in. Sports with high impact loading seem to have a positive effect in promoting bone mineralisation, whereas those with low impacts may have negative or no effects. The aims of the present study were to compare BMD and body composition measures among female participants in three distinctly different sports and investigate differences from sedentary control subjects.

Participants were club and university level Rugby Union football players (n = 30, age: 21.4 ± 1.9 years, height: 1.67 ± 0.05 m, mass: 73.3 ± 10.7 kg), netball players (n = 20, 20.7 ± 1.3 years, 1.68 ± 0.07 m, 64.3 ± 7.2 kg), distance runners (n = 11, 21.5 ± 2.6 years, 1.68 ± 0.04 m, 57.1 ± 6.1 kg), and sedentary controls (n = 25, 21.4 ± 1.1 years; 1.64 ± 0.07 m, 56.8 ± 6.8 kg). With the exception of three distance runners, all participants were eumenorrhoeic. Bone mineral density scans were performed for whole-body, left proximal femur, and lumbar spine (L1–4) using dual-energy X-ray absorptiometry. Fat mass, percent body fat, and fat-free soft tissue mass were assessed from whole-body scans. Regional and segmental analysis was also carried out on whole-body BMD data using standard procedures.

The runners had a lower fat mass and percent body fat compared to the other sports participants and the controls. All sports groups had higher BMD values than had the controls. Density of bone in the upper body was most pronounced in the rugby football players and least pronounced in the runners. Positive effects were evident at all sites for the rugby players. There were significant correlations between BMD and fat-free soft tissue mass, BMD and body mass, and BMD and training volume.

It is concluded that sports participation has positive effects on BMD. The effects are site-specific and depend on the loading characteristics of the sport.

Introduction

The benefits of load-bearing exercise on bone mineral accrual are dependent on the type of activity undertaken and are due to the sensitivity of osteogenic processes to the type, rate, direction, frequency, and magnitude of strain [1], [2], [3]. In an attempt to determine the types of sport that could lead to improved bone mineralisation, a number of cross-sectional studies have compared bone mineral density (BMD) measurements in participants of sports with different loading characteristics [4], [5], [6], [7], [8]. The results from these investigations have indicated that strength-based and contact-type sports are most beneficial in boosting bone mass.

In addition to the loading characteristics of a specific activity, an athlete's physical and anthropometric characteristics may play a role in explaining the large variation between sports in bone density measurements of participants. Body mass [9], height [10], fat mass [11], and muscle mass [12], [13] have all been directly or indirectly associated with BMD. An athlete's BMD may be determined in part by anthropometric characteristics which predispose towards participation in a particular event, as well as by the changes in body composition that result from training for that particular sport.

Running, netball, and Rugby Union football are three impact sports which differ greatly in their loading characteristics. Distance running is characterised by repetitive linear forces, concentrated on the lower limbs with ground reaction forces of two to four times body mass [14]. As well as incorporating locomotory landing impacts, netball also involves large amounts of turning and jumping, with torsional and compression forces being placed on the limbs. Similarly, playing rugby football involves large compressive forces on both the upper and lower limbs, due to the physical contact involved in the game. The physical characteristics of participants may also differ according to the specific requirements of these sports.

There has been no published research on the effects of participation in rugby football or netball on bone mineral density in females, despite the increasing popularity of these sports among females in the United Kingdom and elsewhere. Increased BMD values have been reported in male Rugby Union players [15], particularly in forwards who are frequently engaged in physical contact that involves use of the arms, legs, pelvis, and spine (e.g. in scrums, rucks, mauls, and tackles).

Dual energy X-ray absorptiometry (DEXA) is the criterion method of measuring BMD and diagnosing osteopenia and osteoporosis according to the World Health Organization classification. In addition to providing accurate BMD measurements at the sites which are most susceptible to osteoporotic fractures (i.e. hip, lumbar spine, and forearm), advances in DEXA technology allow whole-body measurements and subsequent calculation of segmental and regional bone density values. These measures may be instrumental in understanding and quantifying regional bone responses to the unique loading characteristics of a particular sporting activity. Consequently, a greater understanding of the mechanisms underlying the osteogenic role of physical activity may be reached, and more effective programs for the prevention of osteoporosis may be designed.

The aims of this study were thus, to determine local, regional and segmental DEXA measurements of BMD among female Rugby Union, netball, and distance running participants and sedentary controls and to compare body composition measures between the four groups.

Section snippets

Subjects

Female University and club level Rugby Union players (n = 30, age: 21.4 ± 1.9 years, height: 1.67 ± 0.05 m, mass: 73.3 ± 10.7 kg), netball players (n = 20, 20.7 ± 1.3 years, 1.68 ± 0.07 m, 64.3 ± 7.2 kg), and distance runners (n = 11, 21.5 ± 2.6 years, 1.68 ± 0.04 m, 57.1 ± 6.1 kg) volunteered to take part. Athletes were matched for age and height. Details of training frequency and volume and playing experience were obtained by questionnaire. Written informed consent was received from all

Results

Group means for anthropometric and training data are summarised in Table 2, and significant differences between groups are indicated. Total mass, fat-free soft tissue mass, fat mass, and percent body fat differed significantly between the groups (F3,82 = 14.9–21.54; P < 0.001). The runners had significantly lower fat mass and lower percent body fat than any of the other groups (P < 0.001), while the rugby players had a greater total mass, fat-free soft tissue mass, and fat mass than any of the

Discussion

Attainment of peak bone mass is essential in the prevention of osteoporosis, and modest increases in physical activity in college-age women may significantly reduce the risk of osteoporosis in later life [17]. The effects of exercise on BMD are specific both to the type of activity and to anatomical site at which strain is applied. Thus, sports that assist the attainment of peak bone density should be identified and promoted.

The current study has indicated that participation in Rugby Union

Conclusions

In summary, mean BMD values were highest in Rugby Union football players at all measured sites, regions, and segments, compared to netball players and runners, though all sports participants had higher values than sedentary controls. Rugby Union football, a sport associated with a variety of strain types, appears to be more beneficial in boosting bone density than distance running, a sport associated with repetitive loading. Impacts in rugby football occur at high accelerations, and so the

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