Osteoperosis in healthy male cyclists, doctors please discuss

Jan 18, 05 8:32

Post #1 of 23 (3453 views)

Okay, so maybe I'm talking out my ass here, but doesn't anybody find it strange the number of bone fractures in healthy male road cyclists? Salvodelli falls at 20k/hr going up hill and breaks his collarbone, Matt White falls over a tv cable as slow as a turtle and breaks his...you guessed it, collarbone. The list goes on and on and on.

Let me take a step back. My GF is a rep for an osteoperosis drug, so I am quite sensitive to the whole bone density thing and fragility fractures. The incidence of fractures in pro road cyclist seems to be rather high to me when compared to other sports, especially when compared to the tumbles that mtn bikers make and walk away from.

So here's our theory. The human body reaches maximum bone density around the age of thirty, and maximum bone density is tied in large part to weight bearing exercise, which road cycling is not. So, if these guys spend the bulk of their 20's on a bike, their bone density is going to drop through the basement at this key point in their lives. Also factor in the fact that they probably aren't getting enough calcium in their diets as elite athletes and you have a ticking time bomb of bones just waiting to break.

Osteoperosis is generally considered to be a womens health issue, so right now there isn't an urgency in the medical field to look at men for indicators.

I would like to see someone in this field do a study comparing male road cyclists to male mtn bike riders and their respective bone densities to determine if perhaps the snapping of collarbones could be avoided or at least greatly reduced.

Any thoughts from the doc's out there?

Ian MacLean
http://www.imfit.ca
Success comes when fear of failure goes

Re: Osteoperosis in healthy male cyclists, doctors please discuss [Ian MacLean] [ In reply to ]

Jan 18, 05 8:41

Post #2 of 23 (3448 views)

What I have read is that "bone jarring" sports help to strengthen bones(like running, mountain biking, etc...). Road cycling, doesn't give the body that "impact" to help build the strength in bones.

Also, studies are showing that weightlifting doesn't strengthen bones as much as previously thought.... its more of the "pounding and jarring" thats seems to help...

Re: Osteoperosis in healthy male cyclists, doctors please discuss [viking1] [ In reply to ]

Jan 18, 05 8:52

Post #3 of 23 (3437 views)

Very true, there is a common misconception that weight lifting(training) and weight bearing are the same thing, which they are not. Weight bearing refers to bearing ones own body weight in an impactful way, walking, running, jumping etc. Simply lifting weights does not provide the jarring necessary to cause bone structure to increase in density. There must be an impact to the skeletal system.

My question is how do we track this, and what do we prescribe to remedy it? Cross training comes to mind. Even if cyclists took up running for 2-3 months in the off season for cross training, my thought is that it would do wonders for an increase in bone density.

Ian MacLean
http://www.imfit.ca
Success comes when fear of failure goes

Re: Osteoperosis in healthy male cyclists, doctors please discuss [Ian MacLean] [ In reply to ]

Jan 18, 05 8:58

Post #4 of 23 (3430 views)

I can be a case study for your - 31 years old - SEVERE Osteopenia...some vertebra meet the class for Osteopososis. This primarilly is due to high cortisol levels. I could go on and on but dont have much time right now.

----------------------------------------------------------

What if the Hokey Pokey is what it is all about?

Re: Osteoperosis in healthy male cyclists, doctors please discuss [Ian MacLean] [ In reply to ]

Jan 18, 05 8:59

Post #5 of 23 (3429 views)

well, right off the cuff, I can imagine that the impact that MTB riders endure helps them maintain their bone mass much moreso than the smooth no impact of road riding. this is only my guess though.

but you have to consider that, dirt/ground is much softer than pavement...so, obviously MTB fall on a totally different surface and wear totally different gear. Plus, road riders are often going at a faster pace...combine this with a harder unforgiving surface and it's like dropping glass on concrete.

in general though, most americans are fat and out of shape. with that comes a sacrifice of bone density, among numerous other health conditions. this applies to men and women, however, the focus is usually only on women. but, the reality is that lack of bone density plagues this country in more than just elderly and women. I would wager to say that if you were to take an out of shape man and women ages 35-40 I"m sure the results would show much softer bones than someone of 50 years old who is fit and trains regularlly (with running, weight training, or other bone building activities).

also, (here comes a rant), since everyone is eating processed, highly refined, trans-fats foods, that are high in pesticides and chemicals, it's a wonder we're all not dead.

Re: Osteoperosis in healthy male cyclists, doctors please discuss [viking1] [ In reply to ]

Jan 18, 05 9:00

Post #6 of 23 (3427 views)

"Also, studies are showing that weightlifting doesn't strengthen bones as much as previously thought.... its more of the "pounding and jarring" thats seems to help... "

i read something about that as well. a dr friend of mine also said that weightlifting like musclebound meatheads do does more to promote good bone density than the type that i do for training. this year i'm incorporating more 'impact' type of weight training (lunges & step ups). i did find it odd that my endocrinologist (sp) told me to stop running completely, even though impact type of stuff is supposed to strengthen bones. we came to an agreement that i wouldn't run marathons (training for IM doesn't count, does it? ;) )

fingers cross for no stress-fractures this year!

Re: Osteoperosis in healthy male cyclists, doctors please discuss [viking1] [ In reply to ]

Jan 18, 05 9:01

Post #7 of 23 (3425 views)

Agreed! I am limping proof! After many years of swimming and then several years of just biking I think I sucked all the calcium out of my body. A few years ago when I deciced to try Triathalon I finally started running. In the last 10 years i have broken my hand twice, three broken toes (water polo), shattered a tooth and now am the proud owner of two Titanium screws and a some titanium wire in my right ankle, which I broke over a year ago. I am now 2 weeks into a 8 week strech in a cast. The Doc who did the surgery said that my bones were very soft and he could not perform the techinique he wanted, hence the wire harness. He said that I have very low bone denisty for a person my age (33).

I have never been a Milk drinker at all except some milk on my cereal in the mornings. I used to drink 4-5 cups of coffee a day along with a few diet cokes a day. Never took a vitamin sup, but I do have a healthy diet full of calcium rich foods and drink OJ with calcium. Ever since the surgery I have changed my attitude towards my diet. I am now down to 2 cups of coffee/ day, 2-3 Diet Cokes/ week drink 2 glasses of milk a day, plus my cereal. And now I take a one a day vit in the AM and a Calcium pill in the PM. Hopefully this along with more running after I get out of this God Awefull cast will start depositing calcium instead of stripping it. I am a firm believer that my calcium poor diet along with TONS of non weight bearing sports has been a major casuse of my recent injuries.

----------------------------------------------------------
I'm just a 10 cent rider on a $2,500.00 Bike

Re: Osteoperosis in healthy male cyclists, doctors please discuss [hasbeenswimmer] [ In reply to ]

Jan 18, 05 10:35

Post #8 of 23 (3380 views)

wow, that certainly sucks!

The good news is that you can turn this around. take calsium/magnesium, and there are lots of green leafy vegetables that are very high in calcium...so incorporate those into your diet as well. look it up on the internet and you will find all kinds of alternative food to milk that will get those bones right in shape.

I'm 30 and have a see through hand basically...there is a huge screw in my forearm and apparently my hand has never been the same. but with the weight training, supplements I'm taking, I'm hoping this changes soon...

Re: Osteoperosis in healthy male cyclists, doctors please discuss [Ian MacLean] [ In reply to ]

Jan 18, 05 10:54

Post #9 of 23 (3362 views)

Generally speaking, clavicle fractures are not fragility fractures, ie they don't tend to happen more in osteoporotic patients. Ok, the extremely porotic people can break anything, but if pro cyclists were that osteoporotic, they would probably break other things as well as their clavicles in the same falls, eg vertebral bodies.

Another point - weight bearing exercise does improve bone density, but almost exclusively in weight bearing bones, it doesn't make a big difference to clavicles.

I think from a nutritional point of view, though, you may have a point. It has, I seem to remember, been proven that cyclists are not paragons of bone density. I just don't know that that's what's breaking their clavicles; I think it's the pavement.

Deke

Re: Osteoperosis in healthy male cyclists, doctors please discuss [Ian MacLean] [ In reply to ]

Jan 18, 05 11:21

Post #10 of 23 (3346 views)

Does she sell Fosomax? It is one of my medications also..

I am not a doctor, I am a rep.

No way. You are correct when you cite that males reach peak BMDensity by the age of thirty. But I think that most fractures are the result of the sheer velocity and impact of a rider hitting the ground. ALthough bone is extremely hard, the impact of a 150 lb body hitting the ground is more than enough to create a force that is strong enough to fracture a bone.

Good theory.. but I would have to disagree.:-)

Re: Osteoperosis in healthy male cyclists, doctors please discuss [deke] [ In reply to ]

Jan 18, 05 11:41

Post #11 of 23 (3334 views)

Dr. Deke,

Have you met many world-class cylists in person? Something struck me as obvious when I shook Lance Armstrong's hand...I commented to my buddy that his skeleton seemed "birdlike". His wrists, measured from outer radius to inner ulna were about like my ulna alone. I remember saying, this guy doesn't have any extra bone weight to haul up the mountains. I wonder if this is true of many of the top level guys, or just LA. If it is common, it might explain some of the propensity for clavicular fractures...then again, I don't know for a fact that pro cyclists have a greater incidence of clavicular fractures than the rest of the cycling population, or the rest of the non-cycling population for that matter.

To comment on the bone-jarring exercise statements made by others, I always thought it was the bone-bending exercise that stimulated bone growth, not bone-jarring. True, false, both, neither?

Quid quid latine dictum sit altum videtur
(That which is said in Latin sounds profound)

Re: Osteoperosis in healthy male cyclists, doctors please discuss [Ian MacLean] [ In reply to ]

Jan 18, 05 12:50

Post #12 of 23 (3314 views)

I took a class last year in which we addressed this issue.

While cycling is somewhat weight bearing, and swimming isn't at all...one must remedy the situation with a possible crosstraining exercise, be it squats, some sort of running for cross training (or jogging, or the eliptical, etc.)

the gist i got is that you don't use it...you lose it.

i don't think that being a 'healthy' male adult at 5-8 to 5-10+ and <150lbs (ie tyler) is healthy either. when you get down to some of the body fat levels that lots of the climbers have, you start having physiological problems brought on by that.

i'd be interested to know just what the pro's who broke bones BF%'s were/are, and if they are having other problems with joint healing and stuff like that on a day to day basis.

also...drinking milk? calcium intake might also be another issue?

p.s. exercise physiology class today, we were talking about RER and the testing that i'm coming down to do...i'm super stoked for it now :D

"Anyone can work hard when they want to; Champions do it when they don't."

Re: Osteoperosis in healthy male cyclists, doctors please discuss [Ian MacLean] [ In reply to ]

Jan 18, 05 13:05

Post #13 of 23 (3294 views)

Ian MacLean,

I thought one of the surprising discoveries as a result of the more complete physicals pro cyclists were required to take was that there were a surprising number of them who were borderline or suffering from osteoperosis.

I thought there was already research studies published on this that discovered that in large part as a result of sweating so profusely while exercising at such high levels of exertion, not only did these cyclists sweat out the calcium in their blood, but they were leaching it out of their bones!

The recommendation of the research was that professional cyclists needed to take this elevated nutritional requirement into account for dietary purposes to prevent this calcium deficit in their diets.

Secondly, it was recommended that serious recreational cyclists might also be at risk for this same condition.

Was I the only one who read about this over the last few years as the medical evaluations for proffessional cyclists got ratchetted up?

You guys need to log off every once in a while and study up on the rest of the world outside of SlowTwitch. There really is a world out there!

Ben Cline

Better to aspire to Greatness and fail, than to not challenge one's self at all, and succeed.

Re: Osteoperosis in healthy male cyclists, doctors please discuss [Graz] [ In reply to ]

Jan 18, 05 14:31

Post #14 of 23 (3273 views)

She sells ACTONEL...guess i better not put you two in a room together!

As for your comments, I still disagree. mtn bikers hit the ground just as hard if not harder than many road falls, and there is far less instance of breakage IMO. Yes the dirt may be softer than pavement, but rock and trees aren't.

Also, you ignored my statements regarding speed. Salvodelli hit the ground going UPHILL at 20km/hr, Matt White hit the ground hardly moving.

I'm not saying I'm right and I'm not saying that you are wrong, but I think somebody needs to take a long hard look at this to see if anything can be done for upandcoming cyclists to stave off a reduction in bone density.

Besides, wouldn't that just create a bigger pie for all you drug reps?

Ian MacLean
http://www.imfit.ca
Success comes when fear of failure goes

Re: Osteoperosis in healthy male cyclists, doctors please discuss [Wants2rideFast] [ In reply to ]

Jan 18, 05 14:37

Post #15 of 23 (3266 views)

Ben,

I thought I read an article in one of the cycling mags relating to that, but I can't remember where I read it. My GF only looks at it for her target market(little old ladies) so wouldn't get some of that research sent her way. Do you have a link to that research, I'd love to take a harder look at it. Thanks for responding. Feel free to email be directly with info on where to find those studies.

Ian MacLean
http://www.imfit.ca
Success comes when fear of failure goes

Re: Osteoporosis in healthy male cyclists, doctors please discuss [krgregg] [ In reply to ]

Jan 18, 05 14:40

Post #16 of 23 (3264 views)

Hey K,

I'd love to hear what you talked about today...fire me an email when you get a chance with a synopsis. How goes the training this week? I've got a cold so I've been doing nothing but weights the last couple of days. Sucks, but should be back on the bike tomorrow.

Ian MacLean
http://www.imfit.ca
Success comes when fear of failure goes

Re: Osteoperosis in healthy male cyclists, doctors please discuss [Ian MacLean] [ In reply to ]

Jan 18, 05 14:47

Post #17 of 23 (3257 views)

I don't have the mag. any more or even know the name of the study. But I read in an article in men's health several years ago that a study done of bone density in a variety of men. The study stated that road cyclists had the same bone density of a sedentary person of the same age.

Take it for what its worth, I'm sure the study is out there somewhere to lookup.

Re: Osteoperosis in healthy male cyclists, doctors please discuss [Wants2rideFast] [ In reply to ]

Jan 18, 05 14:53

Post #18 of 23 (3251 views)

I have a memory of reading this too, but I could find no medline reference. My recollection is that it wasn't that they were osteoporotic, but that they were no different from the sedentary population - who don't tend to break clavicles that easily.

In terms of the necessary speed, one can break a clavicle from stading height but no forward motion pretty easily - witness snowboarders and rollerbladers who can do it at rest. You just hafta hit right.

Deke

Re: Osteoperosis in healthy male cyclists, doctors please discuss [Ian MacLean] [ In reply to ]

Jan 18, 05 19:43

Post #19 of 23 (3212 views)

Ian and deke,

I'll point you in the direction I'm quite sure I picked it up from. Velo News, Cycle Sport or ProCycling. I don't remember which publication. I think there was mention of this discovery in more than just one of these publications. I think it was a shorter article, a column or two in the front part of whichever publications I read it in. It was not just a paragraph to catch one's interest and then leave them hanging. I think it was early last season but it may have been the season before that. I'm pretty sure it was early this past year however, I do remember beginning to share my wife's calcium tablets after reading it. I don't remember taking the calcium supplement the season before last.

I did have a nasty tumble with two other cyclists this season and although, the one broke his collarbone, I managed not to break any bones. It could have been dumb luck or misfortune, too, however you choose. I did feel like I had crossed paths with a mafia enforcer, however, for about two weeks. Wrecked my favorite frame in the process.

I don't have the time to do any searching right now. I'm working on an article for a cycling publication as I type this and the deadline is looming.

Ben Cline

Better to aspire to Greatness and fail, than to not challenge one's self at all, and succeed.

Re: Osteoporosis in healthy male cyclists, doctors please discuss [Ian MacLean] [ In reply to ]

Jan 18, 05 21:30

Post #20 of 23 (3199 views)

Hey Ian,

We haven't covered anything in too much detail yet...it's still a first year exercise phys class...and i'm pretty sure at this point i could almost teach the class...oh well...(guess what i 'learned' today...sprinting doesn't use your anaerobic systems!!!! holy crap! i'm glad my education is being put to good use...;)

anyway, training is going very well...got in my run yesterday, felt great., skipped this morning's swim, but did weights in the afternoon, which hurt, but was good, and then managed to get my swim in before bed tonight.

i feel great. gaining weight again...:P, but that may have just been due to the big meals today.

i'm thinking of making some switches to my program layout as well, to include the weights, i'll send you an email tomorrow though with the details, bed time right now.

as for the osteoporosis, i'll try and find the studies tomorrow that are cited in this textbook from this course i took last year. they had some interesting data on BMD vs. spinal loading and why some athletes get osteoporosis at an increased rate.

"Anyone can work hard when they want to; Champions do it when they don't."

Re: Osteoperosis in healthy male cyclists, doctors please discuss [Ian MacLean] [ In reply to ]

Jan 19, 05 6:36

Post #21 of 23 (3175 views)

Great topic.

From what I understand, any type of stress to the bone that would cause it to naturally produce an additional layer of protection would help to strengthen the bone. So, jarring, bending,any type of pressure, but as you all pointed out, cyclists are so afraid of carrying additional weight that they forego any execise to make those bones stronger.

I have pointed out many times the benefits of weight training and often someone will write in that it "does not benefit cycling". Well, this is just another reason to do so. Functional weight training, especially when it loads the spine (anything standing up but more so squats, deadlifts, lunges), will benefit in many ways but definitely with osteoporosis. The lift also needs to be hard enough to stress that bone structure, so, certain types of yoga and expecially pilates, just won't do.

Someone mentioned an article in a cycling magazine regarding this issue - could it be the March 2004 Bicycling? I read an article and here is the response I sent to the editor: Great article, "Why You Need to Bone Up'', in the March issue. As a triathlete and strength and conditioning specialist I am constantly teaching the importance of strength training for endurance athletes. The one comment I would like to add is in your recommendations "9 Ways to a Strong Skeleton", you mention in #4, lifting weights to failure. I would never recommend that but go to a point just before it, where ALL reps are done with perfect form. This will help to prevent injury. Lifting to failure should only be done with proper spotters on hand and only with highly trained lifters. Also, perform closed-chain exercises to maximize the compression force (good force, not shear force which is common with machines) on the most vulnerable bones, the spine and pelvis. I wonder if more incidents of osteoporosis, poor core strength and muscle imbalance are due to athletes doing the bulk of their exercises on machines. If we stick with the old stuff, squats, lunges, push ups, we train our bodies to be strong throughout the whole chain, not just in isolated muscles. If someone has a back problem, they can do bodyweight exercises. If they feel they can't handle a bodyweight exercise due to too much stress on their back, then they need to strengthen that back a bit (most likely by doing that same squat, bodyweight only) until the back catches up to the rest of the body. Too often I hear "I can press so much more weight on a leg press". Well, until they build a bike with support for the back like that of a leg press I do not recommend having your legs be that strong while continually making the back weak. On a final note, the back exercises you recommend and the pilates movements you show on pg. 86 all strengthen the back from a neutral position (belly on floor) to a hyperextended position, which is not very functional. The back should be strengthened in the positions the strength is needed. For example, when picking somehting off the ground, the body is bent forward, most likely with a curved spine. Start in that position with no load, bodyweight only, and slowly curl up into hyperextension if they safely can. Also, as a closed chain exercise, this trains that whole chain to get strong to support the body. Concentrate on correct body positioning and imbalances should be resolved. Mark Verstegen is a big proponent of this type of strengthening as I am sure you have read in his new book. At his facility I do not remember seeing one strength machine other than the cable stack - all functional. He is a wealth of knowledge and a great teacher.

-----------------------------------------------
maylene jackson, cscs
http://www.kidsintraining.org

Re: Osteoperosis in healthy male cyclists, doctors please discuss [Ian MacLean] [ In reply to ]

Jan 19, 05 6:43

Post #22 of 23 (3167 views)

Sorry for the shorr reply as I was short on time.

I like your thinking..

There are so many factors to consider. It would be an interesting study, but very difficult to control. One thing to consider would be that bone matrix is susceptable to fracture depending on the angle of impact. Also, just thinking out loud here...the ends of the bones are always more dense than the center of the bones. One would need a substancialy large sample population with similar type fractures in order to really conclude anythig.

Another thing would simply to take a large sample of pro/semi-pro cyclists and compare the average bone density to that of normal joe shmo's.

I last year a perfectly healthy friend of mine fractured his ankle as he stepped on a small stone upon exiting the passenger side of my Ford Explorer. Just a freak accident. I think it was a combination of weight and the angle at which impact effected his ankle.

Another thought would be would the syudy be limited strictly to cyclists? What about elite olympic and collegic level swimmers? I would place these athletes in a similar class of fracture risk as their activy is literally non weight bearing.

Re: Osteoperosis in healthy male cyclists, doctors please discuss [Graz] [ In reply to ]

Jan 19, 05 6:51

Post #23 of 23 (3161 views)

Maylene:

Thanks for the update. I thought I read that somewhere, now I have to go root around and find an back issue of Velonews. Ughh. Maybe they can send me the article and their sources.

Graz: Good point. I guess I never really thought of swimmers as they tend not to fall and break things during training, but you are right, as a couple of posters have mentioned, swimming is completely non weight bearing. I'm very interested to see how this affects their bodies in the long run, both cyclists and swimmers.

The question now is, how do we get this on the radar screen of the medical establishment and get some research done here? I think a potentially dangerous long term health risk is being ignored in these athletes.

Ian MacLean
http://www.imfit.ca
Success comes when fear of failure goes

Our Partners

transition-DOT-area-AT-slowtwitch-DOT-com

Advertise with us

©1999-2024 Slowtwitch, Inc., and Slowtwitch.com
Reproduction of material from any Slowtwitch.com page
without written permission is strictly prohibited.