Female Athletes Bone Loss Prevention Must Start Earlier

While most of us don’t worry about our bone health until much later in life, an article in the October, 2017 issue of Clinics in Sports Medicine, “Osteopenia and Osteoporosis in Female Athletes,” suggests that for female athletes maximizing bone health needs to start in adolescence.

John M. MacKnight, M.D., CAQSM, FACSM, professor of internal medicine and orthopedic surgery in the University of Virginia Health System wrote that while more than half of American adults over 50 years of age have low bone mass at the femoral neck or lumbar spine and almost 10% of them meet the criteria for osteoporosis, female athletes are at particular risk because of a decreased rate of bone accretion in their adolescent and teen years.

He said, “Low bone mass poses a particular challenge for athletes because it not only predisposes to stress-related bone injuries but also sets the stage for increased risk of osteoporosis and insufficiency fractures with aging.”

Other key points he made were:

• While exercises helps stimulate bone health and density, too much of it can also negatively affect a female athlete’s bone health, especially in combination with delayed menarche and poor nutrition.
• Encouraging lifestyle choices that optimize maximal bone mass developments needs to start in adolescence.

MacKnight, who is also the team physician and medical director of University of Virginia Sports Medicine, discussed with OTW warning signs to look out for in female athletes.

He said, “Unfortunately, there are no clinical symptoms that correlate with osteopenia or osteoporosis until a fracture occurs. High risk individuals have low body weight relative to height (low Bone Mass Index), have eating disorders or disordered eating, and have few or no regular periods. Bone density deficiencies are determined by dual x-ray absorptiometry (DEXA) scanning.”

He recommends that orthopedic doctors “pay close attention to features suggesting female athlete triad, encourage regular weight-bearing exercise, encourage adequate caloric intake + calcium and vitamin D, and stress the importance of maximizing bone density and bone health early in life to minimize the impact of bone loss with aging.”