Bone Health of Adolescent Athletes

Abstract

Bone health is important for adolescent athletes to be able to participate safely and effectively in their chosen sport. In general, weight-bearing exercise is associated with increased bone strength and density, but when exercise is excessive or in the setting of energy expenditure exceeding energy output over an extended period, a stress fracture can result. Known risk factors for stress fractures include female gender, a history of previous stress fracture, and menstrual dysfunction. There are also particular sports that are associated with certain types of stress fractures, and runners are at high risk. The diagnosis of stress fracture is based on history and physical examination and supported by diagnostic imaging. Magnetic resonance imaging (MRI) is the most sensitive tool for detecting a stress fracture. Stress fractures are classified as high or low risk based on potential complications. Generally low-risk stress fractures heal with conservative therapy, whereas high-risk stress fractures may require surgical intervention. Diet and exercise are important lifestyle components affecting bone health. Athletes presenting with restrictive eating habits and/or menstrual dysfunction, calcium and vitamin D deficiencies, or a history of bone injuries may have increased calcium and vitamin D needs. Practitioners should stress the importance of consuming adequate energy and a diet focused on food variety (while still meeting the RDAs for calcium and vitamin D) for optimal performance, bone health, and injury prevention.