It 's probably fair to say that most Masters-age female endurance and ultra-endurance athletes, and their physicians, are well aware of the risk of osteopenia (low bone density) and osteoporosis. But male Masters athletes are at risk too, particularly if they indulge in endurance and ultra-endurance training and racing.
In the general population, one in eight men will be afflicted by osteoporosis in their lifetime. Endurance athletes may be at greater risk and not know it. Allow me to relate a true story about "Jack", one of my coached athletes, an experienced Masters-age (50s) Ironman triathlete in good shape. I referred Jack to a local sports med physician for a soft tissue injury. The doctor was wise enough to order a DEXA scan of Jack. Turns out Jack had osteopenia, requiring the prescription of Fosamax. Jack was surprised by his diagnosis, but I was not. Of the three sports of triathlon, Jack loved cycling best, but really didn't like to spend time in the weight room. I suggested that Jack ask his doctor to check his free testosterone. It came in low, again not to my particular surprise, and Jack was prescribed supplemental transdermal testosterone gel to correct the imbalance.
I think we can agree that swimming and cycling aren't the type of weight bearing activities that encourage the building of bone mass. Indeed, cyclists of both sexes are known to be at greater risk of developing osteopenia. But how about running? Well, that seems to depend on HOW FAR you're running. More may not promote increased bone mineral density (BMD); although most studies show that moderate running does help. Pushing much past 45-50 miles a week? That seems to be the point of significantly diminished returns, if not unhelpful results.
So what's going on here for the men? Well, if you're a "chronically trained endurance athlete" - in which case you probably know who you are - some of the literature suggests that you may have significantly lowered testosterone levels. Masters athletes, whose testosterone levels are on the downward swing anyway, may be particularly affected. The literature is divided on whether testosterone levels Impact BMD, but some certainly suggest that corrected testosterone levels at least halt the decline in BMD, if not encourage improvement.
nother factor is acidosis - how acidic or alkaline your system is. Joe Friel is one of the few mainstream authors to address this issue, which he does in his book "The Paleo Diet for Athletes". Extended endurance training encourages acidosis (an acidic system) -- as does ageing, as some have suggested; something your body will correct by leaching minerals from the bones and nitrogen from your muscles.. So not only is acidosis a bad thing for bones - but for your muscles and recovery from exercise too.
A lack of physical impact in your exercise certainly does not encourage BMD increases. So swimming and biking are out. And if you're very light - great for speed - running ain't that great either.
Additionally, and it's only my speculation, I believe hormonal imbalances, particularly between sex and stress hormones may well turn out to be a contributory factor to reduced BMD in endurance and ultra-endurance athletes.
So what's to be done? First, if you think you're at risk, get tested. DEXA bone mass scans and serum free testosterone assays aren't hard to get (that's free testosterone - not the more common total testosterone check that really doesn't impart usable information). Then work with your knowledgeable physician to fix any problems found. Stress hormone tests can be done at home using saliva tests.
Second, check your acid base balance. This you can do with PH papers you can buy at most good health food stores. The fix to an overly-acidic base is mostly dietary. Finally, exercise right. And that means lifting weights.
And when we say lifting weights, we mean heavy weights - that's what it takes to stimulate BMD. I recommend the "big four" : squat, deadlift, bench press and military press. You probably need to be lifting in the 6-8 rep range, given that you have attained good technique, to really stimulate improved BMD. Or, consider a Finnish study that found weightlifting (that's Olympic lifts like the clean, snatch and press) and squash racquets (lots of impact!) to best benefit bone health.
Men, you can't ignore this. Learn something from the women. High blood pressure is called the silent killer. Osteoporosis, which is the result of unchecked osteopenia, should be thus labeled too. Most seniors who fall and break a hip die within a relatively short period. I recently read that men die quicker than women.
Me? I'd just like you to maintain good bone health so you can train, compete, stay fit and enjoy our sports for as long as you want.
Anthony C. "Woofie" Humpage is a Certified Strength & Conditioning Specialist and USA Triathlon Certified Coach who specializes in the training of Masters athletes for endurance and ultra-endurance sports. His focus blends performance enhancement with athletic longevity. E-mail: woofie@teamwoofie.com
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