Low Bone Mineral Density in Male Athletes Is Associated With Bone Stress Injuries at Anatomic Sites With Greater Trabecular Composition

2017 ◽  
Vol 46 (1) ◽  
pp. 30-36 ◽  
Author(s):  
Adam S. Tenforde ◽  
Allyson L. Parziale ◽  
Kristin L. Popp ◽  
Kathryn E. Ackerman
Keyword(s):  
Bone Health ◽  
Female Athletes ◽  
Sports Participation ◽  
Mineral Density ◽  
Anatomic Site ◽  
Male Athletes ◽  
Bone Stress ◽  
Increased Risk ◽  
Sport Type ◽  
History Of

Background: While sports participation is often associated with health benefits, a subset of athletes may develop impaired bone health. Bone stress injuries (BSIs) are a common overuse injury in athletes; site of injury has been shown to relate to underlying bone health in female athletes. Hypothesis/Purpose: This case series characterizes the association of type of sports participation and anatomic site of BSIs with low bone mineral density (BMD), defined as BMD Z-score <–1.0. Similar to female athletes, it was hypothesized that male athletes who participate in running and sustain BSIs in sites of higher trabecular bone content would be more likely to have low BMD. Study Design: Cohort study; Level of evidence, 3. Methods: Chart review identified 28 male athletes aged 14 to 36 years with history of ≥1 lower-extremity BSI who were referred for evaluation of overall bone health, including assessment of lumbar spine, hip, and/or total body less head BMD per dual-energy x-ray absorptiometry. BMD Z-scores were determined via age, sex, and ethnicity normative values. Prior BSIs were classified by anatomic site of injury into trabecular-rich locations (pelvis, femoral neck, and calcaneus) and cortical-rich locations (tibia, fibula, femur, metatarsal and tarsal navicular). Sport type and laboratory values were also assessed in relationship to BMD. The association of low BMD to anatomic site of BSI and sport were evaluated with P value <.05 as threshold of significance. Results: Of 28 athletes, 12 (43%) met criteria for low BMD. Athletes with a history of trabecular-rich BSIs had a 4.6-fold increased risk for low BMD as compared with those with only cortical-rich BSIs (9 of 11 vs 3 of 17, P = .002). Within sport type, runners had a 6.1-fold increased risk for low BMD versus nonrunners (11 of 18 vs 1 of 10, P = .016). Laboratory values, including 25-hydroxy vitamin D, were not associated with BMD or BSI location. Conclusion: Low BMD was identified in 43% of male athletes in this series. Athletes participating in sports of running and with a history of trabecular-rich BSI were at increased risk for low BMD.

Haemophilic Arthropathy Is a Risk Factor for Reduced Bone Mineral Density and Vitamin D Deficiency

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 4685-4685
Author(s):  
M. Cem Ar ◽  
Serdar Sahin ◽  
Sevil Sadri ◽  
Isil Erdogan ◽  
Ayse Salihoglu ◽  
...  
Keyword(s):  
Vitamin D ◽  
Bone Health ◽  
Patient Characteristics ◽  
Haemophilia A ◽  
Mineral Density ◽  
On Demand ◽  
Haemophilic Arthropathy ◽  
Number Of Patients ◽  
Increased Risk ◽  
History Of

Abstract Introduction: Recent studies indicate an increased risk for developing low bone mineral density (BMD) in patients with haemophilia. This has been suggested to result from less physical activity, and impaired vitamin D metabolism due to viral liver disease. Here we present the preliminary results of an ongoing study aiming to identify the risk factors for impaired bone health in adult haemophilia patients. Material and Method: Twenty-nine severe and 7 moderate haemophilia A and B patients were included in the study. Patient characteristics were given in Table-1. All patients had haemophilic arthropathy in ≥1 joints and were on prophylactic factor replacement therapy except 2 on demand patients. None of the patients had decompensated chronic liver disease. Eleven patients had a history of joint intervention (RAS or joint replacement). None of the patients had received on vitamin D supplementation. DEXA scans to screen BMD, blood chemical analysis including liver and kidney function tests, vit. D (25 hydroxy vitamin D) calcium, parathormone, alkaline phosphatase were obtained from all patients at study entry. Results: Osteoporosis and/or osteopenia according to WHO criteria were detected by DEXA scans in 2/3 of the patients. Twenty-six patients (72%) had vit. D levels below 20ng/mL, with half of them having levels less than 10ng/mL. Median lumbar and femur T scores were in the osteopenia range, being -1.2 and -2.2, respectively. Osteoporosis/penia rates and vit. D levels did not significantly differ between patients with severe and moderate haemophilia. However, patients with severe haemophilia had lower lumbar T scores (p=0.048) and seemed to acquire low BMD 2 times more likely than moderate haemophiliacs. Patients with a history of joint intervention had significantly lower vit. D levels (p=0.005) and 1.4 times more risk for low BMD. Conclusion: Preliminary results of our study are in line with the recent literature indicating an increased frequency for osteopenia and osteoporosis in patients with haemophilia. Despite their young age our cohort of patients had lower BMD and vitamin D levels than the age-matched healthy population. This is an interesting finding in a country like Turkey where the average yearly total number of hours of bright sunshine is over 3000. Data at hand suggest increased risk for reduced BMD especially in severe haemophiliacs with impaired joint mobility. The most probable underlying cause for reduced BMD seems to be haemophilic arthropathy related inactivity. Furthermore, impaired bone health seems to be partially associated with less sunlight exposure, which is probably a result of increased home confinement of patients with haemophilia due to joint disease. The study is still recruiting. We hope to clarify other questions regarding factors influencing bone health in haemophiliacs when the study is completed and additional data on radiological and physical examination as well as on quality of life are obtained. Table. Patient Characteristics (n=36) Age, years (median [range]) 35 [20 - 55] Type of haemophilia ( A/B), n 32/4 Genotype (severe/moderate), n 29/7 Factor activity level, % (median [range]) 0.4 [0.1 - 4.2] Type of treatment (prophylaxis/on demand) 34/2 Annual bleeding rate (median [range]) 4 [1 - 12] Joint replacement, number of patients (%) 7 (19) Radioactive synoviectomy, number of patients (%) 7 (19) Any joint intervention, number of patients (%) 11 (30.5) Lumbar T scores (median [range]) -1.2 [-5.2 - 1] Femur T scores (median [range]) -2.2 [-3.9 - 0.6] Vit. D, ng/mL (median [range]) 10.5 [1.3 - 45] Calcium, mg/dL (median [range]) 9.6 [8.9 - 10.2] Alkaline phosphatase, U/L (median [range]) 91.5 [53 - 177] Parathormon, pg/mL (median [range]) 39 [20 - 179] Haemoglobin, g/dL (median [range]) 14.75 [8.9 - 16] Osteopenia, number of patients (%) 12 (33) Osteoporosis, number of patients (%) 12 (33) HBV/HCV/HIV, n 1/11/0 Disclosures No relevant conflicts of interest to declare.

scholarly journals Examination of Athlete Triad Symptoms Among Endurance-Trained Male Athletes: A Field Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Erin M. Moore ◽  
Clemens Drenowatz ◽  
David F. Stodden ◽  
Kelly Pritchett ◽  
Thaddus C. Brodrick ◽  
...  
Keyword(s):  
Local Community ◽  
Female Athletes ◽  
Energy Availability ◽  
Reference Ranges ◽  
Negative Effects ◽  
Mineral Density ◽  
Cross Sectional ◽  
Male Athletes ◽  
Increased Risk ◽  
Cross Sectional Design

Background: Studies examining the physiological consequences associated with deficits in energy availability (EA) for male athletes are sparse.Purpose: To examine male athlete triad components; low energy availability (LEA) with or without an eating disorder risk (ED), reproductive hormone [testosterone (T)], and bone mineral density (BMD) in endurance-trained male athletes during different training periods.Methods: A cross-sectional design with 14 participants (age: 26.4 ± 4.2 years; weight: 70.6 ± 6.4 kg; height: 179.5 ± 4.3 cm; BMI: 21.9 ± 1.8 kg/m2) were recruited from the local community. Two separate training weeks [low (LV) and high (HV) training volumes] were used to collect the following: 7-day dietary and exercise logs, and blood concentration of T. Anthropometric measurements was taken prior to data collection. A one-time BMD measure (after the training weeks) and VO2max-HR regressions were utilized to calculate EEE.Results: Overall, EA presented as 27.6 ± 10.7 kcal/kgFFM·d-1 with 35% (n = 5) of participants demonstrating increased risk for ED. Examining male triad components, 64.3% presented with LEA (≤ 30 kcal/kgFFM·d-1) while participants presented with T (1780.6 ± 1672.6 ng/dl) and BMD (1.31 ±.09 g/cm2) within normal reference ranges. No differences were found across the 2 training weeks for EI, with slight differences for EA and EEE. Twenty-five participants (89.3%) under-ingested CHO across both weeks, with no differences between weeks.Conclusion: Majority of endurance-trained male athletes presented with one compromised component of the triad (LEA with or without ED risk); however, long-term negative effects on T and BMD were not demonstrated. Over 60% of the participants presented with an EA ≤ 30 kcal/kgFFM·d-1, along with almost 90% not meeting CHO needs. These results suggest male endurance-trained athletes may be at risk to negative health outcomes similar to mechanistic behaviors related to EA with or without ED in female athletes.

scholarly journals Sex Differences in Time to Return-to-Play Progression After Sport-Related Concussion

2016 ◽  
Vol 9 (1) ◽  
pp. 41-44 ◽  
Author(s):  
Sarah Stone ◽  
Bobby Lee ◽  
J. Craig Garrison ◽  
Damond Blueitt ◽  
Kalyssa Creed
Keyword(s):  
Sex Differences ◽  
Sport Participation ◽  
Clinical Decision Making ◽  
Female Athletes ◽  
Collegiate Athletes ◽  
Sports Participation ◽  
American Football ◽  
Return To Play ◽  
Male Athletes ◽  
History Of

Background: Recently, female sports participation has increased, and there is a tendency for women to experience more symptoms and variable presentation after sport-related concussion (SRC). The purpose of this study was to determine whether sex differences exist in time to begin a return-to-play (RTP) progression after an initial SRC. Hypothesis: After initial SRC, female athletes (11-20 years old) would take longer to begin an RTP progression compared with age-matched male athletes. Study Design: Retrospective cohort study. Level of Evidence: Level 3. Methods: A total of 579 participants (365 males [mean age, 15.0 ± 1.7 years], 214 females [mean age, 15.2 ± 1.5 years]), including middle school, high school, and collegiate athletes who participated in various sports and experienced an initial SRC were included and underwent retrospective chart review. The following information was collected: sex, age at injury, sport, history of prior concussion, date of injury, and date of initiation of RTP progression. Participants with a history of more than 1 concussion or injury sustained from non–sport-related activity were excluded. Results: Despite American football having the greatest percentage (49.2%) of sport participation, female athletes took significantly longer to start an RTP progression after an initial SRC (29.1 ± 26.3 days) compared with age-matched male athletes (22.7 ± 18.3 days; P = 0.002). Conclusion: On average, female athletes took approximately 6 days longer to begin an RTP progression compared with age-matched male athletes. This suggests that sex differences exist between athletes, aged 11 to 20 years, with regard to initiation of an RTP progression after SRC. Clinical Relevance: Female athletes may take longer to recover after an SRC, and therefore, may take longer to return to sport. Sex should be considered as part of the clinical decision-making process when determining plan of care for this population.

Female Hyperandrogenism in Elite Sports and the Athletic Triad

2021 ◽  
Author(s):  
Angelica Lindén Hirschberg
Keyword(s):  
Female Athletes ◽  
Polycystic Ovary ◽  
Disorders Of Sex Development ◽  
Normal Female ◽  
Menstrual Disorders ◽  
Mineral Density ◽  
Energy Deficiency ◽  
Sex Development ◽  
Endocrine Disturbances ◽  
Increased Risk

AbstractEssential hyperandrogenism seems to be overrepresented in female elite athletes. This applies to mild forms such as polycystic ovary syndrome, as well as rare differences/disorders of sex development (DSD). The reason is likely a selection bias since there is increasing evidence that androgens are beneficial for athletic performance by potent anabolic effects on muscle mass and bone mass, and stimulation of erythropoiesis. XY DSD may cause a greatly increased production of testosterone in the male range, that is, 10 to 20 times higher than the normal female range. The established regulations concerning the eligibility of female athletes with severe hyperandrogenism to compete in the female classification remain controversial. The most common cause of menstrual disorders in female athletes, however, is probably an acquired functional hypothalamic disturbance due to energy deficiency in relation to energy expenditure, which could lead to low bone mineral density and increased risk of injury. This condition is particularly common in endurance and esthetic sports, where a lean body composition is considered an advantage for physical performance. It is important to carefully evaluate endocrine disturbances and menstrual disorders in athletes since the management should be specific according to the underlying cause.

Low Bone Mineral Density in Elite Female Athletes With a History of Secondary Amenorrhea in Their Teens

2018 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Sayaka Nose-Ogura ◽  
Osamu Yoshino ◽  
Michiko Dohi ◽  
Mika Kigawa ◽  
Miyuki Harada ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Bone Mineral ◽  
Female Athletes ◽  
Mineral Density ◽  
Secondary Amenorrhea ◽  
Low Bone Mineral Density ◽  
History Of

The Outcomes of Two Knee Scoring Questionnaires in a Normal Population

1998 ◽  
Vol 26 (1) ◽  
pp. 46-51 ◽  
Author(s):  
Anna M. Demirdjian ◽  
Scott G. Petrie ◽  
Carlos A. Guanche ◽  
Kevin A. Thomas
Keyword(s):  
Statistical Analysis ◽  
Confidence Interval ◽  
Female Athletes ◽  
Normal Population ◽  
Normal Subjects ◽  
Stair Climbing ◽  
Male Athletes ◽  
History Of ◽  
Male Subjects

The Noyes and Lysholm knee scoring questionnaires, commonly used for follow-up assessment after knee surgery, were developed based on knees with preexisting pathologic changes and have not been standardized to normal knees. We administered both questionnaires to normal subjects. Any subject reporting a history of injury or surgery to either knee, or preexisting knee pathologic changes, was excluded. From a total of 492 knees evaluated, 418 knees (253 male, 165 female) qualified for statistical analysis. The average age of the group was 17.6 years (range, 13 to 25). For male subjects, the total Noyes and Lysholm scores averaged 99.10 (range, 68 to 100) and 99.10 (range, 77 to 100), respectively. For female subjects, the average Noyes and Lysholm scores were 97.82 (range, 72 to 100) and 97.16 (range, 75 to 100), respectively. The 95% confidence interval computed for each of these groups did not contain the maximal value of 100. The female athletes reported significantly lower total scores than the male athletes on both questionnaires. For the Lysholm questionnaire, the male athletes scored significantly lower than the maximum in all categories except support and stair climbing, and the female athletes scored significantly lower than the maximum in all categories except limp and thigh atrophy. The range of scores found in this highly selected, “normal” population exemplifies the need for more accurate instruments in the evaluation of knee surgical outcomes.

scholarly journals Energy Deficiency, Menstrual Disturbances, and Low Bone Mass: What Do Exercising Australian Women Know About the Female Athlete Triad?

2012 ◽  
Vol 22 (2) ◽  
pp. 131-138 ◽  
Author(s):  
Stephanie M. Miller ◽  
Sonja Kukuljan ◽  
Anne I. Turner ◽  
Paige van der Pligt ◽  
Gaele Ducher
Keyword(s):  
Stress Fracture ◽  
Bone Health ◽  
Female Athlete ◽  
Female Athletes ◽  
Adult Women ◽  
Female Athlete Triad ◽  
Sports History ◽  
Menstrual Dysfunction ◽  
Energy Deficiency ◽  
History Of

Purpose:Prevention of the female athlete triad is essential to protect female athletes’ health. The aim of this study was to investigate the knowledge, attitudes, and behaviors of regularly exercising adult women in Australia toward eating patterns, menstrual cycles, and bone health.Methods:A total of 191 female exercisers, age 18–40 yr, engaging in ≥2 hr/wk of strenuous activity, completed a survey. After 11 surveys were excluded (due to incomplete answers), the 180 participants were categorized into lean-build sports (n = 82; running/athletics, triathlon, swimming, cycling, dancing, rowing), non-lean-build sports (n = 94; basketball, netball, soccer, hockey, volleyball, tennis, trampoline, squash, Australian football), or gym/fitness activities (n = 4).Results:Mean (± SD) training volume was 9.0 ± 5.5 hr/wk, with participants competing from local up to international level. Only 10% of respondents could name the 3 components of the female athlete triad. Regardless of reported history of stress fracture, 45% of the respondents did not think that amenorrhea (absence of menses for ≥3 months) could affect bone health, and 22% of those involved in lean-build sports would do nothing if experiencing amenorrhea (vs. 3.2% in non-lean-build sports, p = .005). Lean-build sports, history of amenorrhea, and history of stress fracture were all significantly associated with not taking action in the presence of amenorrhea (all p < .005).Conclusions:Few active Australian women are aware of the detrimental effects of menstrual dysfunction on bone health. Education programs are needed to prevent the female athlete triad and ensure that appropriate actions are taken by athletes when experiencing amenorrhea.

scholarly journals A competition period evaluation in the long jump events in terms of seasonal Variables: Creating prediction models

2021 ◽  
Vol 18 (2) ◽  
pp. 331-341
Author(s):  
Berfin Serdil Ors ◽  
Işık Bayraktar
Keyword(s):  
Prediction Models ◽  
Female Athletes ◽  
Polynomial Regression ◽  
Pearson Correlation ◽  
Correlation Coefficients ◽  
Male Athletes ◽  
Actual Performance ◽  
Long Jump ◽  
History Of ◽  
Competition Period

Aim: The purpose of training planning in performance sports is to achieve the desired performance in the target competition. Maintaining the desired performance in the major competition is the main subject of periodization. But at this point, the prediction of the season best, which will serve as a showcase for preparations, is a question as old as the history of training science for coaches. The aim of the study is to examine the variables in the competition period of female and male athletes participated in the top 100 places in the 2018 world lists in the long jump event, to compare by gender, and to create prediction models for the season best and season average performances (SPA) according to the average of first two performances (AF2P). Methods: Ages, total number of days in a season, the number of days between the competitions, total competitions, the number of competitions in which the season's best (SB) performance was achieved, the ratio of the SB to the total number of competitions, the percentages of the first, end, and average scores were analysed. Statistical comparison of female and male athletes was carried out using Independent Samples t-Test. To express the relationships between parameters Pearson correlation coefficients (r) were used. Besides, polynomial regression analysis was used. Finally, the quadratic equations were used to predict SB performance and SPA according to the AF2P. Findings: SB competition, season initial, AF2P, SB, SPA and season-end variables were found to be statistically different between genders. Season initial and SB showed significant relationships for both genders (women; r=0.68; p<0.001; men; r=0.51; p<0.001). AF2P explained 54% of the SB performance for women and 48% for men. Conclusion: The prediction model found in the current study to predict SB performance was applied to the male and female athletes from 2019 season. Models predicted the actual performance with an average of 1.15%. Depending on the close estimation of the actual SB performance of the models; It is thought that the prediction models will enable the trainers to predict the performance of their athletes in target competitions at the beginning of the season.   Özet Amaç: Performans sporlarında antrenman planlamasının amacı hedef yarışmada istenilen performansı yakalamaktır. İstenen performansın da majör yarışmada gerçekleştirilmesi periyodizasyonun ana konusudur. Fakat bu noktada hazırlıkların vitrini niteliğinde olacak sezonun en iyi derecesinin gerçekleşeceği öngörüsü antrenörler için antrenman bilim tarihi kadar eski bir sorudur. Çalışmanın amacı, uzun atlama branşında 2018 dünya listelerinde ilk yüz sırada yer alan kadın ve erkek sporcuların yarışma periyodundaki değişkenleri incelemek, cinsiyetlere göre karşılaştırmak, ilk iki performans ortalamasına göre sezonun en iyi ve ortalama performansları için tahmin modelleri oluşturmaktır. Metot: Çalışmada sporcuların yarışma verileri [yaş, bir sezondaki toplam gün sayısı (SGS), bir sezondaki toplam yarışma sayısı (TYS), sporcunun sezondaki en iyi derecesi (SB), SB performansının gerçekleştiği yarışma (SBY), sporcunun sezonun ilk iki yarışmasındaki performansının ortalaması (İ2PO), sezon en iyi derecesine göre; sezon ortalama (SORT), başlangıç (SBAŞ) ve bitiriş (SBİT) derecelerinin yüzde oranları] incelenmiştir. Parametreler arasındaki ilişkiler için pearson korelasyon (r) istatistiği, ilişkilerin belirleme katsayılarının (r2) bulunmasında polinom regresyonu, cinsiyete göre İ2PO’dan SB ve sezon ortalama performanslarının tahmin modellerinde karesel regresyon modeli kullanılmıştır. Bulgular: SBY, başlangıç, İ2PO, SB, SORT ve SBİT değişkenleri cinsiyetler arasında istatistiksel olarak farklı bulunmuştur. SBAŞ değerleriyle SB performansı arasında iki cinsiyet için anlamlı ilişkiler bulunmuştur (kadınlar; r=0,68; p<0,001; erkekler, r=0,51; p<0,001). İ2PO; kadınlarda SB performansının %54’ünü, erkeklerde; %48’ini açıklayabilmektedir. Sonuç: Çalışmada bulunan İ2PO’na göre SB tahmin modeli, 2019 yılında dünya listelerinde yer alan erkek ve kadın sporculara uygulandığında, modelin SB performansını ortalama %1,15 farkla tahmin ettiği görülmüştür. Modellerin gerçek SB performansını yakın tahmin edebilmesine bağlı olarak; tahmin modellerinin antrenörlerin sezon başında sporcularının hedef yarışmalardaki performanslarını öngörebilmelerine olanak sağlayacağı düşünülmektedir.

scholarly journals Sexual Dimorphisms in Anterior Cruciate Ligament Injury: A Current Concepts Review

2021 ◽  
Vol 9 (12) ◽  
pp. 232596712110253
Author(s):  
Tayt M. Ellison ◽  
Ilexa Flagstaff ◽  
Anthony E. Johnson
Keyword(s):  
Female Athletes ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Extrinsic Factors ◽  
Male Athletes ◽  
Acl Injuries ◽  
Sexual Dimorphisms ◽  
Increased Risk ◽  
Anterior Cruciate ◽  
Postsurgical Outcomes

Background: Although most anterior cruciate ligament (ACL) injuries occur in male athletes, female athletes are consistently observed to be at a higher risk for sports-specific ACL injury. Purpose: To provide a thorough review of what is known about the sexual dimorphisms in ACL injury to guide treatment and prevention strategies and future research. Study Design: Narrative review. Methods: We conducted a comprehensive literature search for ACL-related studies published between January 1982 and September 2017 to identify pertinent studies regarding ACL injury epidemiology, prevention strategies, treatment outcomes, and dimorphisms. By performing a broad ACL injury search, we initially identified 11,453 articles. After applying additional qualifiers, we retained articles if they were published in English after 1980 and focused on sex-specific differences in any of 8 different topics: sex-specific reporting, difference in sports, selective training, hormonal effects, genetics, neuromuscular and kinematic control, anatomic differences, and outcomes. Results: A total of 122 articles met the inclusion criteria. In sum, the literature review indicated that female athletes are at significantly higher risk for ACL injuries than are their male counterparts, but the exact reasons for this were not clear. Initial studies focused on intrinsic differences between the sexes, whereas recent studies have shifted to focus on extrinsic factors to explain the increased risk. It is likely both intrinsic and extrinsic factors contribute to this increased risk, but further study is needed. In addition to female patients having an increased risk for ACL injuries, they are less likely than are male patients to undergo reconstructive surgery, and they experience worse postsurgical outcomes. Despite this, reconstructive surgery remains the gold standard when knee stability, return to sports, and high functional outcome scores are the goal, but further research is needed to determine why there is disparity in surgical rates and what surgical techniques optimize postsurgical outcomes for female patients. Conclusion: Male athletes often predominated the research concerning ACL injury and treatment, and although sex-specific reporting is progressing, it has historically been deficient. ACL injuries, prevention techniques, and ACL reconstruction require further research to maximize the health potential of at-risk female athletes.

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