Cyclists' Silent Injury: Weak Bones

Weakened bones and even the risk of stress fractures are topics not often discussed among cyclists.

Did you know that with long-term training of 20 hours a week or more, a cyclist's bone quality can resemble that of a 70-year-old? Most of us do not train that much, but that does not mean the risks associated with so-called "thin bones" do not apply to us.

I had no idea that cycling is one of the risk factors that can contribute to bone mass loss. Depending on the severity of the condition, we refer to it as osteopenia or full-blown osteoporosis.

Understanding how cycling can negatively affect bone strength is surprisingly simple.

Good Stress Helps

Muscles grow when we challenge them through use, and the same applies to bones. The body tries to strengthen them when it receives signals that doing so is necessary. The easiest way to imagine such a situation is through activities that stimulate bones, for example, through impacts or pressure. Running, hiking, and strength training probably illustrate this best.

Pay attention to pain in the hips, shins, or a persistent pulling sensation.

With this basic theoretical background, it is easy to understand why cycling does not help address this issue. The body is not exposed to forces that would signal it to strengthen bone tissue. Our body weight is distributed, and the lack of significant impacts spares our joints and tendons, but unfortunately, it also means less stimulation for our bones.

Anyone who does not exercise at all, or who does nothing other than cycling, may fall into a risk group. Moreover, other factors associated with cycling can make the situation worse.

Cyclists Don't Just Lack Impacts

The body cannot function properly when it lacks essential nutrients. These deficiencies can arise when an athlete is trying to lose weight by increasing training volume while restricting food intake.

Poor nutrition carries the risk that, in addition to excess calories, we may also lose important vitamins and other beneficial nutrients. Combined with demanding physical activity, this can even lead to hormonal changes, which in turn affect bone health.

For this reason, it is also important to be mindful of excessive sweating, through which we lose minerals such as calcium. Among cyclists, this typically occurs during summer, but we should not overlook winter indoor training sessions either.

From information I came across on an educational poster in a general practitioner's office, women appear to be at greater risk.

Why Bones Matter

Strong bones are especially important during falls. In some cases, a crash may end without serious consequences; in others, it may result in cracked or broken bones. Stress fractures are another concern that many athletes are familiar with.

Since impacts are beneficial for bones, road cyclists are likely at the greatest risk.

However, it is not only about accidents and extreme situations. It is well known that muscles attach to bones. Therefore, some studies suggest that healthy bones may also have a positive impact on performance. And that is something we all want, isn't it? 🙂

How Do I Know If I Have a Problem

I hope no one discovers they have fragile bones by repeatedly breaking them. Before it reaches that point, it is important to pay close attention to pain in the hips, shins, or a persistent pulling sensation. For those who want certainty, bone density testing is performed using a DEXA scan, which is available at osteoporosis centers, rheumatology clinics, and private diagnostic facilities.

Insurance companies may cover the test in certain cases with a doctor's recommendation; otherwise, you should expect to pay up to €50 privately. Follow-up examinations are usually performed every one to two years. This information is based on publicly available sources.

Help Is Not Complicated

The best prevention consists of activities that positively stimulate bone growth. As mentioned earlier, these include running, hiking, and strength training. In running, short interval sessions tend to be more beneficial than long, moderate-intensity workouts. For hiking, downhill walking is often highlighted, and in the gym, cyclists should not be afraid of lifting weights.

We have already discussed nutrition. The solution is ensuring an adequate intake of nutrients such as vitamin D and calcium. Vitamin D is primarily supported by sun exposure. Foods that can help include dairy products, fish, fortified plant-based milks, poppy seeds, nuts, broccoli, tofu, and leafy greens.

When supplementing these nutrients, caution is advisable; the ideal solution is obtaining them through a high-quality diet. Just the basics.

The Season Doesn't End

The older I get, the easier it becomes to appreciate recommendations like these. If I neglect something, the consequences appear immediately and unmistakably. 🙂 That is why I participate in sports other than cycling throughout the year. In summer, that mainly means general exercise, while autumn and winter are dedicated to running, hiking, and strength training.

I will finish with one final thought. Since impacts are beneficial for bones, road cyclists are likely at the greatest risk. Next, I would place traditional mountain biking, followed by enduro and downhill riding.

Based on my own experience, I can confidently say that gravel cyclists must have the strongest bones. They experience so many impacts that their bones must be made of titanium or carbon. Am I right? 🙂

For those looking for more detailed information, it is also worth becoming familiar with the term BMD (Bone Mineral Density).