Our bones don’t just hold up not our bodies, but our entire lives. Whether it’s dancing your heart out at a wedding, crossing a frozen Himalayan lake, or training for a personal best, we owe life’s important moments to our bones - which is why good bone health should be a high priority for every one of us. However, this is especially true of athletes.
We don’t just mean elite athletes. Whatever you sport of choice, if you are physically active on a regular basis, or if you train for competitive events, you need to pay attention to your bone health.
With every kilometer you run or every kick you aim at the net, your body is under high impact. Who takes the brunt of this high impact? That’s right – your bones. Your bones are also the body’s feedback mechanism to let you know that you need to be careful. The word ‘stress’ in the term ‘stress factures’ is of significance here- these fractures, which are among the most common sports-related injuries are your body’s way of saying ‘enough!’
In general, women are more susceptible to osteoporosis and bone disease than men, but this risk is higher in women athletes given the high impact of endurance activities. Additionally, bone density in women is directly linked to levels of the hormone Oestrogen and the menstrual cycle. At different times in the month, hormone levels in menstruating women fluctuate, which has an impact on bone density. The risk of stress fractures and osteoporosis is higher in older women athletes because of lower levels of Oestrogen. When high-impact sport and exercise is factored into this equation, it becomes evident that women athletes need to be particularly mindful of their bone health.
A landmark US study of female navy recruits showed that supplementation with vitamin D and calcium decreased the incidence of stress fractures by 20%. Calcium and vitamin D3 are crucial to facilitating the uptake of other nutrients by the bones, thus, having a direct role in improving bone density.
When it comes to supplementation, finding the right one is key. Most mainstream calcium supplements are derived from inorganic calcium sources like calcium carbonate and calcium citrate, which have a very low utilization rate by the body (around 10%). There are now calcium supplements available in the Indian market sourced from algae - an organic source - with a high utilization rate of around 80%. These supplements are also additionally fortified with vitamin D3 and vitamin K2-7. Vitamin K2-7 activates the bone protein, Osteocalcin, which helps nutrients bind to bones and increases bone density. Vitamin D3 is key to effective calcium absorption by the bones.
Along with supplementation, women athletes (especially veteran athletes) should ensure that they get a bone density test done. Bone density is the amount of mineral matter present per sq.cm of bones, and in clinical medicine, bone density is used as an indicator of osteoporosis risk and stress fractures. It is recommended that women athletes also incorporate weight lifting into their training regimen. Evidence suggests that weight lifting improves bone density and wards off the risk of osteoporosis, especially in post-menopausal women. Weight lifting exercises focused on the hip and spine area like hip adduction, hip flexion and hip extensions are recommended.
There also exists a strong link between low body fat/low BMI and osteoporosis risk as low BMI impacts the menstrual cycle, and thus, also affects bone density. Women athletes need to make sure that their caloric intake is commensurate with the intensity of their training and their recommended daily intake. Leafy greens, almonds and soy milk are some examples of excellent food sources of calcium.
It is also advisable for serious recreational athletes to get a biomechanical analysis of their form to identify injury-prone areas and areas of high impact. Making adjustments in your form today could be the answer to preventing an injury tomorrow.
Your bones help you soar to the highs of your life, and take life’s falls for you (quite literally!). Giving back to your bones is one of the biggest investments you can make towards your training and ensuring that you have a long, injury-free career. Start today – trust me, you will feel it in your bones.
Dr. Jasmine R Shah (MBBS) is a practicing family physician in Mumbai. She started her running journey under the guidance of Savio D’Souza four years ago. Dr. Shah has 4 half marathons under her belt and successfully attempted her first full marathon this year with a sub-5 timing.