Scofield · Current sports medicine reports 2012 · narrative review · n=?

Bone health in endurance athletes: runners, cyclists, and swimmers.

Cited 165 times in the scientific literature.

Level 5 - mechanism / opinion, no new human data

Narrative review without systematic search or meta-analysis

PubMed 23147022 · doi:10.1249/JSR.0b013e3182779193 · record verified 2026-08-30

What was done

This narrative review summarizes the literature on bone health across endurance disciplines, including distance running, cycling, swimming, and triathlons. It addresses bone-loading characteristics, energy expenditure, stress and fragility fracture risks, and clinical strategies for the diagnosis, prevention, and management of low bone mineral density (BMD) in endurance athletes.

What was found

The abstract reports no numerical data or effect sizes. It notes qualitatively that adolescent and adult endurance athletes, particularly those in non-weight-bearing sports such as cycling and swimming, frequently have lower BMD than athletes in ball and power sports and occasionally lower BMD than inactive peers, increasing their susceptibility to stress and fragility fractures.

Why it matters

It emphasizes that high-volume endurance exercise—particularly non-impact sports—does not inherently build skeletal density and may place athletes at risk for impaired bone health and fractures.

Limits

The paper is a narrative overview without systematic search criteria or meta-analytic pooling. The abstract provides no sample sizes, sport-specific quantitative comparisons, or empirical effect estimates.

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