Is cycling breaking you?

 

Osteoporosis and the battle of ageing

Osteoporosis is recognised as the most common form of bone disease, with an estimated 200 million people affected worldwide. In Australia, 23% of women and 5% of men over the age of 50 are living with osteoporosis. The biggest risk factor contributing to its development – ageing!

Osteoporosis is a condition that causes bones to become weak, thin and fragile - such that even a bump or minor incident (minimal trauma) can cause a fracture. The process is a result of how our bones are developed and maintained over our lifespan. We are constantly enduring rates of deposition (addition of new bone) and reabsorption (bone loss) in our bones. Over 50 years of age, the rate of reabsorption exceeds that of deposition.

While this disease is a significant burden for women over 50, who are at higher risk. We need to be mindful of the risk to the men in our lives, and the lack of awareness and intervention for them. Males who only participate in sports such as cycling and swimming are a group at a significant higher risk.

In simple terms?

Men are more likely to develop it at an older age, they are less likely to participate in any preventative or screening assessments and they are more at risk of fractures if they participate in only non-weight bearing sports.

Facts about men and osteoporosis:

  • Men tend to have more osteoporosis-related complications (e.g. Fractures/breaks, loss of function, pain) compared to women.

  • In 2012, 60% of women whilst only 18% of men had undergone screening for osteoporosis.

  • The risk of an osteoporotic fracture in men aged over 50 years is 27% in men (1 in 4 men).

  • From 2002 to 2012 the number of hospitalisations due to minimal trauma hip fracture among men aged over 50 years increased by 36%.

  • After sustaining a hip fracture, men are less likely to receive and engage in osteoporosis related treatment (8%) compared to women (24%). Up to 1-5 years post fracture, 9 % of men receive appropriate medical treatment compared to that of 48% of women.

  • Men who smoke are more likely to lose bone mineral density than women.

So I cycle/swim – why am I affected more?

In recent studies, males that undertake cycling or swimming have an associated lower bone mineral density (BMD) level, due to the nature of the sports, resulting in an increased risk of fracture from potential falls.  

It was found that there was a higher prevalence of osteoporosis and osteopenia in master cyclists when compared to inactive individuals in the same age bracket— 89% compared to 61% respectively.

Bone adapts to the forces applied upon it which is low in the sports of cycling and swimming. It was shown that cyclists put themselves at higher risk for osteoporosis younger in life due to the low loading the bone undergoes, thus resulting in bone loss earlier in life. Professional swimming or even a high volume of swimming was shown not to promote any increase in BMD.

All current evidence supports cyclists and swimmers participating in moderate to high intensity weight bearing activity to complement their sport and positively affecting their BMD. This includes strength, plyometric or high impact training.

It is also important to recognise the other risk factors participating in these sports may include – high volume training, over training and decreased nutritional support, which create imbalances in energy levels, hormone levels and calcium intake.

Take Home Message:

  • We are all at risk of osteoporosis as we age.

  • It is important to stay strong with weight bearing exercise.

  • Encourage screening and prevention in those aged over 50 +, particularly with history of fractures or breaks.

  • Men – you are at risk too!

Sources:

Abrahin, O., Rodrigues, R. P., Marçal, A. C., Alves, E. A. C., Figueiredo, R. C., & de Sousa, E. C. (2016). Swimming and cycling do not cause positive effects on bone mineral density: a systematic review. Revista Brasileira de Reumatologia (English Edition), 56(4), 345-351.

Alswat, K. A. (2017). Gender disparities in osteoporosis. Journal of clinical medicine research, 9(5), 382.

Andersen, O. K., Clarsen, B., Garthe, I., Mørland, M., & Stensrud, T. (2018). Bone health in elite Norwegian endurance cyclists and runners: a cross-sectional study. BMJ open sport & exercise medicine, 4(1).

Australian Institute of Health and Welfare. (2014). Estimating the Prevalence of Osteoporosis in Australia. https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/estimating-the-prevalence-of-osteoporosis-in-austr/contents/table-of-contents

Smathers, A. M., Bemben, M. G., & Bemben, D. A. (2009). Bone density comparisons in male competitive road cyclists and untrained controls. Medicine and Science in Sports and Exercise, 41(2), 290-296.