The world of professional cycling is facing a hidden danger: a silent threat to riders' bone health. 'It's historically embraced practices that have jeopardized riders' bones' - a shocking revelation that demands attention. But how can a sport that's all about physical prowess have such a dark side? Let's delve into this intriguing yet crucial topic.
Exercise is generally beneficial, but cycling has a hidden pitfall. The more you pedal, the more you might be putting your bones at risk, and you may not even realize it until it's too late. The issue is that low bone density often goes unnoticed, as it presents with little to no symptoms, and it's a challenge to reverse, especially as we age. Demanding endurance sports like cycling are now under the microscope for their potential negative impact on bone health.
Let's start with the basics: what exactly are our bones made of? Your skeleton is not just a mineral deposit. It's a complex structure of hardened tissue containing living cells that constantly break down and form new bone. The inner core is porous, known as cancellous or spongy bone, which houses your bone marrow, the factory for red and white blood cells.
Approximately 80% of your bones are a hard exterior called 'cortical' or compact bone, which provides structural support and allows muscles to leverage movement. Inside this hard shell are microscopic tubes filled with osteoblasts, cells that build new bone, and osteoclasts, which break down bone tissue.
The foundation for strong bones is laid early in life, with bone density typically peaking in a woman's early 20s and a man's late 20s. The strength of your bones at this stage is crucial, and a good diet and weight-bearing exercise play a significant role in building this foundation.
Your bones are a calcium reservoir, and during exercise, this calcium is needed for muscle contractions. Maintaining 'calcium homeostasis' is vital, ensuring your body can meet the demands of your muscles.
Estrogen seems to play a protective role in women's bone health. However, menopause brings a drop in estrogen levels, which can lead to a rapid decline in bone density. Hormone replacement therapy can slow this process, emphasizing the importance of women discussing bone health with their doctors as early as their mid-30s.
Now, here's where cycling enters the picture. Unlike weight-bearing exercises like running or jumping, which stimulate bone growth, cycling doesn't provide enough force to have the same effect. In fact, intense aerobic efforts in cycling can cause the body to break down bone tissue to meet mineral demands elsewhere.
Historically, professional cycling has promoted practices that put riders' bone health at risk. Riders are encouraged to maintain a lightweight physique by restricting calories and avoiding weight training or impact sports during the season. But there's a silver lining: Therese Hammerschmith, Head of Performance at Human Powered Health, assures us that the culture is gradually changing for the better.
Hammerschmith proudly shares how her team prioritizes athletes' health by utilizing the resources of the Human Powered Health labs to address all bone health risks. They conduct annual baseline assessments to evaluate riders' strength, bone mineral density, resting metabolic rate, and aerobic capacity. This data-driven approach allows them to customize training and nutrition plans for each athlete, ensuring optimal performance on and off the bike.
The cycling community is waking up to this issue, with most pro teams now including bone density tests like DEXA scans in their annual assessments. Hammerschmith believes that this increased awareness is a step in the right direction, ensuring riders don't suffer from osteopenia or, worse, osteoporosis.
She highlights the importance of off-bike activities, such as weight lifting, plyometrics, or even a simple run once a week, to counteract the bone density decline often seen during the lengthy cycling season. By providing actionable data insights, the Performance Lab can collaborate with medical staff, nutritionists, and sports coaches to create personalized training regimens that address each athlete's unique needs.
Some osteoporosis risk factors are within our control, while others are not. A poor diet in childhood can set the stage for lower bone density later in life, especially if other controllable factors like smoking, alcohol consumption, and an unhealthy adult diet are not addressed.
Chronic use of glucocorticosteroids and untreated celiac disease can increase osteoporosis risk by disrupting calcium and vitamin B12 absorption. Additionally, 'low energy availability', a term experts use for calorie restriction, can disrupt hormones that maintain bone balance.
Certain factors, like gender, ethnicity, heredity, and small stature, are more challenging to address. Women, especially those with smaller frames and less bone mass, are at a higher risk due to the potential for rapid bone density loss during menopause. Medical conditions like celiac disease, inflammatory bowel disease, kidney or liver disease, cancer, and rheumatoid arthritis also increase osteoporosis risk, regardless of gender.
So, what can we learn from all this? Hammerschmith emphasizes the importance of athletes paying close attention to their diet, ensuring they consume enough calories and all essential vitamins and minerals. A well-balanced diet is key to a well-functioning body.
She warns that low energy availability can lead to RED-S (relative energy deficiency syndrome), previously known as 'the female triad'. While women may notice the early signs through menstrual irregularities, men's symptoms are more subtle, including decreased performance, irritability, insomnia, depression, or low libido. RED-S is linked to low bone density in both men and women.
To maintain bone health, athletes should consider incorporating impact exercises like running, plyometrics, and weight training into their weekly routines. Some studies suggest that consuming calcium-rich food or supplements before exercise can reduce the body's need to draw calcium from bones during physical activity.
Human Powered Health's approach, which involves customizing diets and training to each rider's physiology, is a promising strategy to prevent bone health issues in professional cycling. By prioritizing athletes' health and tailoring their training, we can ensure that a cycling career doesn't come at the cost of bone strength.
As we conclude, let's reflect on the journey from a little-known issue to a topic of growing concern. The cycling community is taking steps in the right direction, but is it enough? What do you think? Are there other sports that might have similar hidden dangers? Share your thoughts and let's keep the conversation going!
