Assessment of bone strength at differentially-loaded skeletal regions in adolescent middle-distance runners


      Bone adaptations to loading extend beyond mineral accrual to geometric markers of bone strength. Available technology and regional differences in cortical bone dictate how bone strength is reported. Examination of bone strength at two differentially-loaded skeletal sites using hip structure analysis (HSA) and bone strength index (BSI) is under-explored in adolescent sporting populations. The purpose of this study was to compare HSA at the femoral neck and BSI at the distal tibia in adolescent middle-distance runners and age- and gender-matched controls. Four groups of 20 adolescents aged 14–18 years were composed of male and female middle-distance runners, and male and female controls. Distal tibial BSI was calculated using data from dual energy X-ray absorptiometry (DXA) and magnetic resonance imaging (MRI). Calculations for femoral neck strength were acquired from DXA-derived HSA software. Female athletes displayed greater distal tibial BSI than controls t(38) = 3.4, p = 0.002, but femoral neck bone measures did not differ. In males, no group differences were found at either the distal tibia or femoral neck. In conclusion, exposure to similar high training loads may advantage female adolescent athletes more than male adolescent athletes compared with less active peers in bone strength at the distal tibia.


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        • Petit M.A.
        • McKay H.A.
        • MacKelvie K.J.
        • et al.
        Randomized school-based jumping intervention confers site and maturity-specific benefits on bone structural properties in girls: a hip structural analysis study.
        J Bone Miner Res. 2002; 17: 363-372
        • Beck T.J.
        • Oreskovic T.L.
        • Stone K.L.
        • et al.
        Structural adaptation to changing skeletal load in the progression toward hip fragility: the study of osteoporotic fractures.
        J Bone Miner Res. 2001; 16: 1108-1119
        • Duncan C.S.
        • Blimkie C.J.
        • Kemp A.
        • et al.
        Mid femur geometry and biomechanical properties in 15- to 18- year- old female athletes.
        Med Sci Sports Exerc. 2002; 34: 673-681
        • Bradney M.
        • Pearce G.
        • Naughton G.
        • et al.
        Moderate exercise during growth in prepubertal boys: changes in bone mass, size, volumetric density and bone strength: a controlled prospective study.
        J Bone Miner Res. 1998; 13: 1814-1821
        • Bolotin H.H.
        • Sievanen H.
        Inaccuracies inherent in dual-energy X-ray absorptiometry in vivo bone mineral density can seriously mislead diagnostic/prognostic interpretations of patient-specific bone fragility.
        J Bone Miner Res. 2001; 16: 799-805
        • Nelson D.A.
        • Koo W.W.
        Interpretation of absorptiometric bone mass measurements in the growing skeleton: Issues and limitations.
        Calcif Tissue Int. 1999; 65: 1-3
        • Ferretti J.L.
        • Capozza R.F.
        • Zanchetta J.R.
        Mechanical validation of a tomographic (pQCT) index for noninvasive estimation of rat femur bending strength.
        Bone. 1996; 18: 97-102
        • Tanner T.M.
        Growth at adolescence.
        2nd ed. Blackwell Scientific Publications, Oxford1968 (p. 167–205)
        • Matsudo S.M.M.
        • Matsudo V.K.R.
        Self-assessment and physician assessment of sexual maturation in Brazilian boys and girls – concordance and reproducibility.
        Am J Hum Biol. 1994; 6: 451-455
        • Fielsler C.M.
        The female runner.
        in: O’Connor F.G. Wilder R.P. Textbook of Running Medicine. McGraw Hill, New York2001: 435-446
        • Bouchard C.
        • Tremblay A.
        • Leblanc C.
        • et al.
        A method to assess energy expenditure in children and adults.
        Am J Clin Nutr. 1983; 37: 461-467
        • Gilger J.W.
        • Geary D.C.
        • Eisele L.M.
        Reliability and validity of retrospective self-reports of the age of pubertal onset using twin, sibling, and college student data.
        Adolescence. 1991; 26: 41-53
        • Carter D.R.
        • Hayes W.C.
        The compressive behaviour of bone as a two-phase porous structure.
        J Bone Jt Surg. 1977; 59A: 954-962
        • Milgrom C.
        • Finestone A.
        • Segev S.
        • et al.
        Are overground or treadmill runners more likely to sustain tibial stress fracture?.
        Br J Sports Med. 2003; 37: 160-163
        • Beck T.J.
        • Ruff C.B.
        • Warden K.E.
        • et al.
        Predicting femoral neck strength from bone mineral data.
        Invest Radiol. 1990; 25: 6-18
        • Frost H.M.
        Bone “mass” and the “mechanostat”: A proposal.
        Anat Rec. 1987; 219: 1-9
        • Heinonen A.
        • Sievanen H.
        • Kannus P.
        • et al.
        Site-specific response to long-term weight training seems to be attributable to principal loading modality: a pQCT study of female weightlifters.
        Calcif Tissue Int. 2002; 70: 469-474
        • Rittweger J.
        • Beller G.
        • Ehrig J.
        • et al.
        Bone-muscle strength indices for the human lower leg.
        Bone. 2000; 27: 319-326
        • Schoenau E.
        • Frost H.M.
        The “Muscle-Bone Unit” in children and adolescents.
        Calcif Tissue Int. 2002; 70: 405-407
        • Milgrom C.
        • Finestone A.
        • Levi Y.
        • et al.
        Do high impact exercises produce higher tibial strains than running?.
        Br J Sports Med. 2000; 34: 195-199
        • Omasu F.
        • Kitagawa J.
        • Koyama K.
        • et al.
        The influence of VDR genotype and exercise on ultrasound parameters in young adult Japanese women.
        J Physiol Anthropol Appl Hum Sci. 2004; 23: 49-55
        • Rogol A.D.
        Growth at puberty interaction of androgens and growth hormone.
        Med Sci Sports Exerc. 1994; 26: 767-770
        • Daly R.M.
        • Saxon L.
        • Turner C.H.
        • et al.
        The relationship between muscle size and bone geometry during growth and in response to exercise.
        Bone. 2004; 34: 281-287