{"id":7660,"date":"2018-02-27T02:54:13","date_gmt":"2018-02-27T01:54:13","guid":{"rendered":"https:\/\/blogs.bmj.com\/bjsm\/?p=7660"},"modified":"2018-02-27T18:36:47","modified_gmt":"2018-02-27T17:36:47","slug":"cyclists-make-no-bones","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bjsm\/2018\/02\/27\/cyclists-make-no-bones\/","title":{"rendered":"Cyclists: Make No Bones About\u00a0It"},"content":{"rendered":"

By Dr Nicky Keay<\/strong><\/em><\/p>\n

Competitive cyclists<\/a>\u00a0are potentially at risk of suboptimal bone health. Although\u00a0cycling<\/a>is excellent for cardiovascular fitness, this type of non skeletal loading exercise does not mechanically stimulate osteogenesis (bone formation). This situation of low mechanical osteogenic stimulus to build bone can be compounded by restrictive eating patterns and associated hormone dysfunction of\u00a0relative energy deficiency in sports<\/a>\u00a0(RED-S).<\/p>\n

In a recent\u00a0pilot study 7\/10 competitive cyclists<\/a>\u00a0(Cat 2 and above) had low age-matched bone mineral density (BMD) in the lumbar spine. This is comparable to another study where 15\/28 male cyclists training over eight hours a week were found to have low BMD for their age and were therefore at risk of\u00a0low trauma fracture<\/a>. However, cyclists with a\u00a0lower training volume<\/a>\u00a0(Cat 4) did not fair so badly in terms of BMD, due to higher body mass index (BMI) and fat mass.\u00a0Although greater body mass mechanically loads the skeleton, the downside is that you need to generate more\u00a0power to get up a hill<\/a>.<\/p>\n

Why is cycling unique compared to other sports where an important adaptation to training is to improve, not impair, bone health? What are the practical solutions to prevent this potential negative effect of cycle training?<\/p>\n

Site Specific Effects on Bone Mineral Density<\/strong><\/p>\n

\"\"<\/p>\n

The illustration shows how different sports exert site specific effects on the bone mineral density of the skeleton. In general terms, hip femoral neck BMD is more dependent on mechanical loading osteogenic stimuli, whereas lumbar spine BMD is more dependent on nutritional and Endocrine status.<\/p>\n

What are the most effective mechanical osteogenic stimuli? Evidence from animal models demonstrates that\u00a0bone responds to exercise<\/a>\u00a0that is dynamic, non-repetitive and unpredictable. Load and repetitions are not such important factors. This is shown in a study of track and field athletes, where sprinters were found to have higher BMD at load bearing sites of the skeleton than long distance runners due to a\u00a0local loading effect<\/a>\u00a0rather than a systemic effect associated with repetitive loading nature of longer distance running. The other important consideration is that sprinters and rugby players tend to weigh more with higher lean mass than distance runners, providing higher skeletal loading forces. These differences in anthropometric and body composition metrics are also associated with different nutritional and Endocrine status.<\/p>\n

In contrast to sports involving running, rowing creates a mechanical osteogenic stimulus that is directed through the lumbar spine, resulting in an associated increase in BMD at this site. This\u00a0can prevent bone loss at the lumbar that would be anticipated with rowers<\/a> experiencing RED-S.<\/p>\n

Swimming and cycling are similar in that both these types of exercise do not provide mechanical skeletal loading osteogenic stimulus. However the consequences on BMD, particularly at the lumbar spine, can be compounded in cycling by the performance advantage of low body mass and therefore potential of restrictive nutrition and consequent effect on Endocrine status: factors which impact bone health.<\/p>\n

In the recent\u00a0pilot study<\/a>\u00a0of competitive cyclists, although 7\/10 had below average for age lumbar spine BMD, those with stronger bones had a previous history of other sports that improve BMD at this site: namely rugby and rowing, together with the cyclist doing concurrent and consistent weight training throughout the season. These findings were consistent with a\u00a0study<\/a>\u00a0where male riders who had undertaken pre-season weight training had better BMD than riders who had not. Cumulative skeletal loading over a lifetime determines BMD. However, the skeletal system is dynamic and as with any training adaptation, any beneficial effects of skeletal loading exercise are reversible if not maintained throughout the lifespan.<\/p>\n

Typically, the objective of off-bike strength and conditioning (S&C) is aimed at producing higher watts on the bike. Some strengthening exercises may, as by product, produce an osteogenic stimulus indirectly by muscle pulling on bone. Should\u00a0off-bike work include specific mechanical axial skeletal loading exercises that are continued throughout the season? Skeletal loading exercises for cyclists would have to be effective and practical, not requiring access to gym and possible to fit into training schedule throughout the season. This will be investigated in a\u00a0forthcoming study of competitive male cyclists<\/a>.<\/p>\n

In meantime there will be more discussion on \u201cHealth, Hormones and Human Performance<\/a>\u201d at the BASEM conference 22 March. All welcome, including athletes and coaches, alongside healthcare professional working with athletes.<\/p>\n

Competing interests<\/strong>
\n<\/i><\/div>\n
\n

None declared<\/i><\/p>\n<\/div>\n

References<\/strong><\/em><\/p>\n

Male Cyclists: bones, body composition, nutrition, performance<\/a><\/p>\n

Cycling and bone health: a systematic review<\/a>\u00a0BMC Medicine 2012<\/p>\n

Male Athletes: the Bare Bones of Cyclists<\/a><\/p>\n

Comparisons of Bone Mineral Density Between Recreational and Trained Male Road Cyclists<\/a>\u00a0Clinical Journal of Sport Medicine 2016<\/p>\n

Longitudinal Assessment of Bone Mineral Density and Body Composition in Competitive Cyclists<\/a>\u00a0Journal of Strength and Conditioning Research 2017<\/p>\n

Kings and Queens of the Mountains<\/a>\u00a0Science4Perforamnce<\/p>\n

Inhibition of osteopenia by low magnitude, high-frequency mechanical stimuli<\/a>\u00a0Drug Discovery Today 2001<\/p>\n

Bone density and neuromuscular function in older competitive athletes depend on running distance<\/a>\u00a0Osteoporosis International 2012<\/p>\n

Menstrual state and exercise as determinants of spinal trabecular bone density in female athletes<\/a>\u00a0BMJ 1990<\/p>\n

Male Athletes: the Bare Bones of Cyclists<\/a><\/p>\n

Resistance Training Is Associated With Higher Lumbar Spine and Hip Bone Mineral Density in Competitive Male Cyclists\u00a0<\/a>Journal of Strength and Conditioning Research 2018<\/p>\n

A meta-analysis of brief high-impact exercises for enhancing bone health in premenopausal women\u00a0<\/a>\u00a0Osteoporosis International 2012<\/p>\n

Jumping Improves Hip and Lumbar Spine Bone Mass in Prepubescent Children: A Randomized Controlled Trial<\/a>\u00a0JBMR 2001<\/p>\n

Longitudinal Changes in Bone Mineral Density in Male Master Cyclists and Nonathletes\u00a0<\/a>The Journal of Strength & Conditioning Research 2011<\/p>\n

\"\"<\/p>\n","protected":false},"excerpt":{"rendered":"

By Dr Nicky Keay Competitive cyclists\u00a0are potentially at risk of suboptimal bone health. Although\u00a0cyclingis excellent for cardiovascular fitness, this type of non skeletal loading exercise does not mechanically stimulate osteogenesis (bone formation). This situation of low mechanical osteogenic stimulus to build bone can be compounded by restrictive eating patterns and associated hormone dysfunction of\u00a0relative energy […]<\/p>\n

Read More…<\/a><\/p>\n","protected":false},"author":1,"featured_media":7661,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[8303,1127,16068],"class_list":["post-7660","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-uncategorized","tag-athlete","tag-cycling","tag-featured"],"yoast_head":"\nCyclists: Make No Bones About\u00a0It - BJSM blog - social media's leading SEM voice<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/bjsm\/2018\/02\/27\/cyclists-make-no-bones\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Cyclists: Make No Bones About\u00a0It - BJSM blog - social media's leading SEM voice\" \/>\n<meta property=\"og:description\" content=\"By Dr Nicky Keay Competitive cyclists\u00a0are potentially at risk of suboptimal bone health. 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