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Bone Health in Athletes: The Role of Exercise, Nutrition, and Hormones
Open accessAbstract
Context: The health of the skeletal system is important for athletes young and old. From the early benefits of exercise on bones to the importance of osteoporosis prevention and treatment, bone health affects the ability to be active throughout life. Evidence Acquisition: PubMed articles dating from 1986 to 2016 were used for the review. Relevant terms such as keywords and section titles of the article were searched and articles identified were reviewed for relevance to this article. Study Design: Clinical review. Level of Evidence: Levels 1 through 4 evidence included. Results: There is strong evidence that exercise benefits bone health at every age and is a critical factor in osteoporosis prevention and treatment. Vitamin D, calcium, and hormones play vital roles in ensuring optimal bone health. When there is an imbalance between exercise and nutrition, as seen in the female athlete triad, bone health is compromised and can lead to bone stress injuries and early osteoporosis. Both of these can lead to morbidity and lost time from training and competition. Thus, early recognition and appropriate treatment of the female athlete triad and other stress fracture risk factors are vital to preventing long-term bone health problems. Conclusion: To optimize bone health, adequate nutrition, appropriate weightbearing exercise, strength training, and adequate calcium and vitamin D are necessary throughout life.
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“A significantly greater bone density has been observed in athletic cohorts, with effects depending on the type, intensity, and duration of exercise training and the characteristics of the athletes [298].”
From Global consensus on optimal exercise recommendations for enhancing healthy longevity in older adults (ICFSR) (2025) · cites this paper as [298]
In the citing paper
“Exceptions include non-weight-bearing activities (e.g., swimming, cycling) and competitive distance runners, whose bone density appears similar to, or lower than the non-exercising controls.”
From Global consensus on optimal exercise recommendations for enhancing healthy longevity in older adults (ICFSR) (2025) · cites this paper as [298]
In the citing paper
“Exceptions include non-weight-bearing activities (e.g., swimming, cycling) and competitive distance runners, whose bone density appears similar to, or lower than the non-exercising controls.”
From Global consensus on optimal exercise recommendations for enhancing healthy longevity in older adults (ICFSR) (2025) · cites this paper as [298]
In the citing paper
“A significantly greater bone density has been observed in athletic cohorts, with effects depending on the type, intensity, and duration of exercise training and the characteristics of the athletes [298].”
From Global consensus on optimal exercise recommendations for enhancing healthy longevity in older adults (ICFSR) (2025) · cites this paper as [298]
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Citations
Cites
Writing Group for the Women's Health Initiative Investigators (2002) · JAMA: The Journal of the American Medical Association · doi:10.1001/jama.288.3.321 · Cited by 15,889 · cited 1×
“Because of these concerns and the availability of other osteoporosis medications, estrogen has a role but is no longer a first-line agent for postmenopausal osteoporosis.(14,16,24,88)”
BackgroundHolick, M. F. (2007) · New England Journal of Medicine · doi:10.1056/nejmra070553 · Cited by 13,720
Breast cancer and hormone-replacement therapy in the Million Women Study
Beral, V. (2003) · The Lancet · doi:10.1016/s0140-6736(03)14065-2 · Cited by 2,986
Holick, M. F. (2004) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/80.6.1678s · Cited by 2,799 · cited 1×
“Vitamin D insufficiency is defined as a level of 20 to 31 ng/mL, and a level of ≥32 ng/mL demonstrates sufficient levels.(45,46) The prevalence of vitamin D insufficiency and deficiency in athletes is about 56% overall with a higher incidence in the winter and spring, indoor sports, and mixed sports.”
BackgroundDietary Reference Intakes for Calcium and Vitamin D
Institute of Medicine (2011) · National Academies Press eBooks · doi:10.17226/13050 · Cited by 2,597
Normal Bone Anatomy and Physiology
Clarke, B. (2008) · Clinical Journal of the American Society of Nephrology · doi:10.2215/cjn.04151206 · Cited by 2,192 · cited 1×
“Cortical bone is dense, solid, and surrounds the marrow space, whereas trabecular bone consists of a honeycomb-like network of trabecular plates and rods distributed throughout the bone marrow compartment.(29) Mechanotransduction refers to bone’s recognition of and response to loading, with mechanoreceptors primarily…”
BackgroundSex Steroids and the Construction and Conservation of the Adult Skeleton
Riggs, B. L., Khosla, S., & Melton, L. J. (2002) · Endocrine Reviews · doi:10.1210/edrv.23.3.0465 · Cited by 1,846 · cited 1×
“It inhibits bone turnover and maintains balance between bone resorption and formation.(86) Estrogen acts on osteoblasts and osteoclasts in a receptor-mediated fashion and has indirect effects on other hormones, including calcitonin, parathyroid hormone, cytokines, and growth factors.”
BackgroundBlack, D. M., & Rosen, C. J. (2016) · New England Journal of Medicine · doi:10.1056/nejmcp1513724 · Cited by 1,790
(2007) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0b013e318149f111 · Cited by 1,554
Breast cancer and hormone-replacement therapy: the Million Women Study
Beral, V., Banks, E., REEVES, G. K., & Bull, D. (2003) · The Lancet · doi:10.1016/s0140-6736(03)14596-5 · Cited by 1,270
Research works printed but not linked: 5
- Bohon TM, 2013, Clin Med Insights Womens Health, 6, 67
- Kam GY, 2000, J Clin Endocrinol Metab, 85, 1918
- LeBlanc AD, 2007, J Musculoskelet Neuronal Interact, 7, 33
- Looker AC, 2012, NCHS Data Brief, 1
- Uchiyama Y, 2007, Tokai J Exp Clin Med, 32, 121
Cited by
Sorted by citations
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Izquierdo, M., Merchant, R. A., Morley, J. E., Anker, S. D., Aprahamian, I., Arai, H., Aubertin-Leheudre, M., Bernabei, R., Cadore, E. L., Cesari, M., et al. (2021) · The Journal of nutrition, health and aging · doi:10.1007/s12603-021-1665-8 · Cited by 1,247
Izquierdo, M., de Souto Barreto, P., Arai, H., Bischoff-Ferrari, H. A., Cadore, E. L., Cesari, M., Chen, L.-K., Coen, P. M., Courneya, K. S., Duque, G., et al. (2025) · The Journal of nutrition, health and aging · doi:10.1016/j.jnha.2024.100401 · Cited by 273
Kim, S. K. (2018) · PLOS ONE · doi:10.1371/journal.pone.0200785 · Cited by 185
Bioaccessibility and Bioavailability of Minerals in Relation to a Healthy Gut Microbiome
Bielik, V., & Kolísek, M. (2021) · International Journal of Molecular Sciences · doi:10.3390/ijms22136803 · Cited by 175
“Further, strong evidence suggests that exercise benefits bone health at all ages and is a critical factor in osteoporosis prevention and treatment in both sexes [33].”
BackgroundCondo, D., Lohman, R., Kelly, M., & Carr, A. (2019) · Nutrients · doi:10.3390/nu11050971 · Cited by 122
“Adequate intakes of calcium, which plays a vital role in bone health and injury risk [34,35], and iron, essential to carry oxygen and maintaining energy release [36], are important for females, in particular when performing high-intensity contact sport.”
BackgroundTranswomen in elite sport: scientific and ethical considerations
Knox, T. R., Anderson, L. C., & Heather, A. K. (2019) · Journal of Medical Ethics · doi:10.1136/medethics-2018-105208 · Cited by 102
Vitamin D and Stress Fractures in Sport: Preventive and Therapeutic Measures—A Narrative Review
Knechtle, B., Jastrzębski, Z., Hill, L., & Nikolaidis, P. Τ. (2021) · Medicina · doi:10.3390/medicina57030223 · Cited by 76
“, adequate calcium and 25(OH)D) together with appropriate weightbearing exercise and strength training are necessary throughout life [18].”
BackgroundAbsence of menstruation in female athletes: why they do not seek help
Verhoef, S. J., Wielink, M. C., Achterberg, E. A., Bongers, M. Y., & Goossens, S. M. T. A. (2021) · BMC Sports Science Medicine and Rehabilitation · doi:10.1186/s13102-021-00372-3 · Cited by 78
The female athlete triad: special considerations for adolescent female athletes
Brown, K. A., Dewoolkar, A. V., Baker, N., & Dodich, C. (2017) · Translational Pediatrics · doi:10.21037/tp.2017.04.04 · Cited by 56
Daily, J. P., & Stumbo, J. R. (2018) · Primary Care Clinics in Office Practice · doi:10.1016/j.pop.2018.07.004 · Cited by 62
Relative Energy Deficiency in Sport (RED-S) in Adolescents – A Practical Review
Gould, R. J., Ridout, A. J., & Newton, J. L. (2022) · International Journal of Sports Medicine · doi:10.1055/a-1947-3174 · Cited by 65
Cheng, J., Santiago, K. A., Abutalib, Z., Temme, K., Hulme, A., Goolsby, M. A., Esopenko, C., & CASEY, E. K. (2020) · PM&R · doi:10.1002/pmrj.12539 · Cited by 45
Self-citationOveruse Knee Pain in the Pediatric and Adolescent Athlete
Sweeney, E. A., Rodenberg, R. E., & MacDonald, J. P. (2020) · Current Sports Medicine Reports · doi:10.1249/jsr.0000000000000773 · Cited by 39
Książek, A., Zagrodna, A., & Słowińska-Lisowska, M. R. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17228567 · Cited by 44
“In addition, inadequate calcium intake combined with reduced energy availability increases the risk of lowering bone mineral density, which promotes injury [41,42].”
BackgroundNutritional Aspects of the Female Athlete
Rossi, K. A. (2017) · Clinics in Sports Medicine · doi:10.1016/j.csm.2017.05.007 · Cited by 34
Nose‐Ogura, S., Yoshino, O., Dohi, M., Kigawa, M., Harada, M., Kawahara, T., Osuga, Y., & Saito, S. (2018) · Clinical Journal of Sport Medicine · doi:10.1097/jsm.0000000000000571 · Cited by 33
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Gastrich, M. D., Quick, V., Bachmann, G. A., & Moriarty, A. M. (2020) · Journal of Women s Health · doi:10.1089/jwh.2019.8180 · Cited by 33
Hamstra-Wright, K. L., Bliven, K. C. H., & Napier, C. (2021) · Frontiers in Sports and Active Living · doi:10.3389/fspor.2021.665683 · Cited by 41
“Estrogen is an especially critical hormone in maintaining bone mass in both sexes (Goolsby and Boniquit, 2017).”
BackgroundTirla, A. G., Islam, F., Islam, M. R., Vicaş, S. I., & Cavalu, S. D. (2022) · Applied Sciences · doi:10.3390/app12178611 · Cited by 40
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Millward, D., Root, A. D., Dubois, J., Cohen, R. P., Valdivia, L., Helming, B., Kokoskie, J., Waterbrook, A. L., & Paul, S. (2020) · Orthopaedic Journal of Sports Medicine · doi:10.1177/2325967120966967 · Cited by 30
“Known risk factors for bone-related stress injuries include female sex, low bone density, female athlete triad (energy deficiency, menstrual irregularities, and low bone density), relative energy deficiency in sports, and other nutritional deficiencies.(7) Stress fractures result in significant pain for *Address corre…”
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Ayaz, A., Zaman, W., Radak, Z. O., & Gu, Y. (2024) · Heliyon · doi:10.1016/j.heliyon.2024.e32803 · Cited by 32
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Høeg, T. B., Miller, E. K., Skaggs, K. F., Sainani, K. L., Fredericson, M., Roche, M. D., & Kraus, E. (2021) · Clinical Journal of Sport Medicine · doi:10.1097/jsm.0000000000000956 · Cited by 24
“Unlike most other running injuries, injuries related to poor bone health are associated with long-term health consequences such as osteoporosis and fragility fractures later in life.(4) ABSI is an overuse injury resulting from the inability of bone to withstand repetitive loading.”
BackgroundSagayama, H., Kondo, E., Tanabe, Y., Ohnishi, T., Yamada, Y., & Takahashi, H. (2020) · Clinical Nutrition ESPEN · doi:10.1016/j.clnesp.2020.01.008 · Cited by 27
Bone stress injuries in female athletes
Bishop, M. E., Ahlmen, A., Rosendorf, J., Erickson, B. J., & Cohen, S. A. (2021) · Annals of Joint · doi:10.21037/aoj.2020.04.04 · Cited by 23
“However, trials evaluating the safety and efficacy of these medications in this young patient population are limited, particularly with bisphosphonates as they have possible long lasting teratogenic effects (46).”
BackgroundZanella, P. B., August, P. M., Alves, F. D., Matté, C., & de Souza, C. G. (2018) · Nutrition · doi:10.1016/j.nut.2018.10.017 · Cited by 23
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Shannon, N., Cable, B., Wood, T., & Kelly, J. D. A. (2020) · Current Sports Medicine Reports · doi:10.1249/jsr.0000000000000760 · Cited by 23
“25-hydroxycholecalciferol vitamin D levels should be ascertained because deficiency may potentiate bone stress injury (61).”
BackgroundClemente, F. M., González-Férnandez, F. T., Ceylan, H. İ., Silva, R., Younesi, S., Chen, Y., Bădicu, G., Wolański, P. M., & Murawska‐Ciałowicz, E. (2021) · Journal of Clinical Medicine · doi:10.3390/jcm10235576 · Cited by 26
Physical Activity and Bone Vascularization: A Way to Explore in Bone Repair Context?
Wazzani, R., Pallu, S., Bourzac, C., Ahmaı̈di, S., Portier, H., & Jaffré, C. (2021) · Life · doi:10.3390/life11080783 · Cited by 23
Álvarez‐Herms, J., González, A., Corbi, F., Odriozola, I., & Odriozola, A. (2023) · AIMS Public Health · doi:10.3934/publichealth.2023049 · Cited by 22
“Bone homeostasis is related to vitamin D levels, the capacity of calcium absorption, and other anabolic hormones such as estrogens [129].”
BackgroundMedical and Musculoskeletal Concerns for the Wheelchair Athlete: A Review of Preventative Strategies
Dutton, R. A. (2019) · Current Sports Medicine Reports · doi:10.1249/jsr.0000000000000560 · Cited by 21
Normative fat-free mass index values for a diverse sample of collegiate female athletes
Blue, M. N. M., Hirsch, K. R., Pihoker, A. A., Trexler, E. T., & Smith‐Ryan, A. E. (2019) · Journal of Sports Sciences · doi:10.1080/02640414.2019.1591575 · Cited by 19
“Low BMD may lead to increased risk of bone stress injuries and early osteoporosis in exercising females (Barrack et al., 2014; Goolsby & Boniquit, 2016).”
BackgroundThapa, M., Neupane, A., Shrestha, S. K. D., Nepal, P., Upadhyaya, A., Niraula, P., Shrestha, R. K., & Sunuwar, D. R. (2023) · BMC Sports Science Medicine and Rehabilitation · doi:10.1186/s13102-023-00691-7 · Cited by 27
Fields, J. B., Gallo, S., Worswick, J. M., Busteed, D. R., & Jones, M. T. (2020) · Journal of Functional Morphology and Kinesiology · doi:10.3390/jfmk5020032 · Cited by 15
Sebastiá-Rico, J., Sanz, J. M. M., Sanchis-Chordà, J., Alonso-Calvar, M., López-Mateu, P., Romero-García, D., & Soriano, J. M. (2024) · Healthcare · doi:10.3390/healthcare12040496 · Cited by 17
“However, it is important to consider the dietary needs of young soccer players, such as calcium, iron, and vitamin D, as their requirements differ from those of adults [5,74].”
BackgroundBone fracture healing within a continuum bone remodelling framework
Schmidt, I., Albert, J., Ritthaler, M., Papastavrou, A., & Steinmann, P. (2021) · Computer Methods in Biomechanics & Biomedical Engineering · doi:10.1080/10255842.2021.1998465 · Cited by 14
“At first, a fracture pattern motivated by Goolsby and Boniquit (2017) is considered, see Figure 1.”
Jeon, S., Cho, K. H., Ok, G., Lee, S., & Park, H. (2018) · Physical Activity and Nutrition · doi:10.20463/jenb.2018.0021 · Cited by 14
Investigation of bone toxicity in drug development: review of current and emerging technologies
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Wojtys, E. M. (2017) · Sports Health A Multidisciplinary Approach · doi:10.1177/1941738117692555 · Cited by 13
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Xu, A. L., Beck, J. J., Sweeney, E. A., Severson, M. N., Page, A. S., & Lee, R. J. (2022) · Orthopaedic Journal of Sports Medicine · doi:10.1177/23259671211067222 · Cited by 12
“Improving bone strength in adolescence may prevent age-related osteoporosis.(50,169) In addition, for women, the culture of a structured, femaledominated sport may reduce the risks of future substance dependence, learning and memory impairments, and unintentional injury or death.”
BackgroundBone health in Norwegian female elite runners: a cross-sectional, controlled study
Kyte, K. H., Haakstad, L. A. H., Hisdal, J., Sunde, A., & Stensrud, T. (2023) · BMJ Open Sport & Exercise Medicine · doi:10.1136/bmjsem-2022-001472 · Cited by 12
Dadgostar, H., Soleimany, G., Movaseghi, S., Dadgostar, E., & Lotfian, S. (2018) · Medical Journal of the Islamic Republic of Iran · doi:10.14196/mjiri.32.27 · Cited by 12
Rueda-Córdoba, M., Martín-Olmedo, J. J., Espinar, S., Ruiz, J. R., & Jurado‐Fasoli, L. (2025) · Nutrients · doi:10.3390/nu17071172 · Cited by 18
“Bone parameters are physiologically essential for athletes, providing structural support, reducing fracture risk, and enhancing resilience to the mechanical demands of intense physical activity [45].”
Jówko, E., Długołęcka, B., Cieśliński, I., & Kotowska, J. (2023) · International Journal of Molecular Sciences · doi:10.3390/ijms24043373 · Cited by 11
“Among different factors, androgens take part in building the skeleton of young men and help to prevent bone loss in elderly men [37] by having antiapoptotic effects on osteocytes and osteoblasts and apoptotic effects on osteoclasts [38].”
Backgroundda Gama, E. M. F., Kasuki, L., Paranhos‐Neto, F. D. P., Madeira, M., Mendonça, L., Schtscherbyna, A., & Farias, M. (2021) · Journal of Clinical Densitometry · doi:10.1016/j.jocd.2021.01.013 · Cited by 11
Predictive Factors for Vitamin D Concentrations in Swiss Athletes: A Cross-sectional Study
Zürcher, S. J., Quadri, A., Huber, A., Thomas, L., Close, G. L., Brunner-Agten, S., Noack, P., Gojanovic, B., & Kriemler, S. (2018) · Sports Medicine International Open · doi:10.1055/a-0669-0791 · Cited by 11
“In athletes, circulating 25(OH)D has been associated with maintained muscle function including improvements in muscle contractions, enhanced growth and regeneration following muscle damage, and optimal bone health [7, 17, 43, 48, 56].”
Influentialde Almeida‐Neto, P. F., Arrais, R. F., de Matos, D. G., Cesário, T. D. M., Bulhões-Correia, A., SILVA, L. F., Aidar, F. J., Santana, E. E., Dantas, P. M. S., & Cabral, B. G. D. A. T. (2021) · The Journal of Sports Medicine and Physical Fitness · doi:10.23736/s0022-4707.20.11497-x · Cited by 10
Brzeziański, M., Migdalska‐Sęk, M., Stuss, M., Jastrzębski, Z., Radzimiński, Ł., Brzeziańska‐Lasota, E., & Sewerynek, E. (2021) · Biology of Sport · doi:10.5114/biolsport.2022.109956 · Cited by 12
“It is documented that vitamin D stimulates bone formation and increases the level of parathyroid hormone (PTH), which stimulates the activity of osteoclasts in the bone [28, 37].”
BackgroundInfluentialBrown, A. F., Brooks, S. J., Smith, S. R., Stephens, J. M., Lotstein, A. K., Skiles, C. M., Alfiero, C. J., & Meenan, M. J. (2020) · Journal of Functional Morphology and Kinesiology · doi:10.3390/jfmk5010017 · Cited by 10
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Lyu, F. F., Ramoo, V., Chui, P. L., & Ng, C. G. (2023) · Clinical Nursing Research · doi:10.1177/10547738231198561 · Cited by 8
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Banerjee, A., Basu, B., Saha, S., & Chowdhury, A. R. (2023) · Journal of Biomedical Materials Research Part B Applied Biomaterials · doi:10.1002/jbm.b.35311 · Cited by 8
Weijer, V., van Dijk, J., van Dam, L., Risvang, L. C., Bons, J. A. P., Raastad, T., van Loon, L. J. C., & Jonvik, K. L. (2024) · Bone Reports · doi:10.1016/j.bonr.2024.101767 · Cited by 12
“Such a low BMD may predispose athletes to (stress)fractures as well as early osteoporosis (Goolsby and Boniquit, 2017).”
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Touron, J., Perrault, H., Julian, V., Maisonnave, L., Deat, P., Auclair-Ronzaud, J., Salles, J., Walrand, S., Hermet, J., Rigaudière, J., et al. (2019) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0000000000001992 · Cited by 7
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Lipszyc, R. T., Rodda, C. P., Wright, M., & Duckham, R. L. (2025) · Journal of Paediatrics and Child Health · doi:10.1111/jpc.70063 · Cited by 3
Fibula Stress Fractures: A Systematic Review
Encinas, R., Sharpe, J., Bakaes, Y., Mazoué, C. G., Jackson, B., & Gonzalez, T. A. (2023) · Foot & Ankle Specialist · doi:10.1177/19386400231184124 · Cited by 3
Parathyroid hormone and trabectedin have differing effects on macrophages and stress fracture repair
Zweifler, L. E., Sinder, B. P., Stephan, C., Koh, A. J., Do, J., Ulrich, E., Grewal, J., Woo, C., Batoon, L., Kozloff, K. M., et al. (2023) · Bone · doi:10.1016/j.bone.2023.116983 · Cited by 3
Nutritional Considerations for Female Rock Climbers
Leslie-Wujastyk, M., & Gibson-Smith, E. (2024) · Journal of Science in Sport and Exercise · doi:10.1007/s42978-023-00267-4 · Cited by 3
“Multidirectional load bearing exercise, such as climbing, has an independent positive effect on bone health [23].”
Bone health and the masters runner
Raiser, S. N., Schroeder, A. N., Lawley, R. J., & Tenforde, A. S. (2024) · PM&R · doi:10.1002/pmrj.13175 · Cited by 7
“32,33”
Knechtle, B., Jastrzębski, Z., & Nikolaidis, P. Τ. (2021) · Praxis · doi:10.1024/1661-8157/a003550 · Cited by 5
Florio, C. S. (2018) · International Journal for Numerical Methods in Biomedical Engineering · doi:10.1002/cnm.2976 · Cited by 3
Nutritional factors of bone health in athletes
Самойлов, А. С., Zholinsky, A. V., Рылова, Н. В., & Bolshakov, I. V. (2023) · Voprosy Pitaniya · doi:10.33029/0042-8833-2023-92-3-25-35 · Cited by 5
Stress fracture risk factors in soccer players: A systematic review
Hoveidaei, A. H., Oskouie, I. M., Karbasi, S., Eghdami, S., Hosseini-Asl, S. H., Nakhostin-Ansari, A., Forogh, B., Cham, M. B., & Conway, J. D. (2025) · Annals of Medicine and Surgery · doi:10.1097/ms9.0000000000003136 · Cited by 2
Evolution of Research on the Female Athlete Triad and Relative Energy Deficiency in Sport" (RED-S).
Emran, Z., & Ganti, L. (2026) · Orthopedic Reviews · doi:10.52965/001c.157624 · Cited by 2
Relative energy deficiency in sport: modern approaches to diagnostics, treatment and prevention
Самойлов, А. С., Zholinsky, A. V., Рылова, Н. В., & Bolshakov, I. V. (2022) · Voprosy Pitaniya · doi:10.33029/0042-8833-2022-91-3-32-41 · Cited by 2
Metabolic Workup for Bone Stress Injury: A Practical Approach for Evaluating Bone Health in Athletes
Nye, N. S., Kasper, K. B., Hoang, T. D., Gee, S. M., McClung, J. P., Crutchfield, A., Childress, M. A., Tenforde, A. S., & Boden, B. P. (2026) · Sports Health A Multidisciplinary Approach · doi:10.1177/19417381251398501 · Cited by 4
“47 When the demands of physical activity, particularly from sustained repetitive loading (ie, long-distance running or military training), exceed remodeling and adaptation, a BSI may result.”
MORAES, M. S., MARTINS, P. C., FERREIRA, F. E., & SILVA, D. A. (2022) · The Journal of Sports Medicine and Physical Fitness · doi:10.23736/s0022-4707.21.12297-2 · Cited by 2
Factors associated with stress fracture: A case-control study in a Peruvian navy medical center
Sandoval, J. C. B., Huamán, L. V., & Cruz-Vargas, J. A. D. L. (2020) · Medwave · doi:10.5867/medwave.2020.05.7936 · Cited by 2
Muscle Mass and Gait Characteristics in Older Women Fallers vs. Non-Fallers
Lin, Y., Tseng, I.-J., Lu, Y.-C., Yang, S.-W., Wu, C.-C., Lin, Y.-N., & Chan, W. P. (2021) · Journal of Clinical Medicine · doi:10.3390/jcm10173924 · Cited by 2
“Although optimal bone health may be obtained from nutrition (such as vitamin D and calcium) and hormones supplement [32], this study also demonstrated that exercise (such as increased gait speed) could have a role in improving bone mineral content.”
BackgroundCOMPARISON OF BONE PARAMETERS BY BODY REGION IN UNIVERSITY ATHLETES: SYSTEMATIC REVIEW
Moraes, M. S., Martins, P. C., & Silva, D. A. S. (2021) · Revista Brasileira de Medicina do Esporte · doi:10.1590/1517-8692202127062020_0051 · Cited by 2
Mendes, A. F., Tabet, C. G., Mendes, S. L., Abreu, M. D. M., & de Figueirêdo, N. C. (2021) · Revista Brasileira de Ortopedia · doi:10.1055/s-0041-1739404 · Cited by 2
Bone and body characteristics of freestyle and non-freestyle skiers
Schwarz, I., Houck, D. A., Shah, V. N., Jolly, A., Lindsay, A. D., Bravman, J. T., & Frank, R. M. (2022) · The Journal of Sports Medicine and Physical Fitness · doi:10.23736/s0022-4707.21.12055-9 · Cited by 1
Moraes, M. S., Fernandes, R. A., Moreno, Y. M. F., Pelegrini, A., & Silva, D. A. S. (2022) · The Journal of Strength and Conditioning Research · doi:10.1519/jsc.0000000000004132 · Cited by 1
“However, the simultaneous influence of other multiple factors that explain BMD and bone geometry variation in athletes, such as the other body composition components, training volume and intensity, dietary calcium, vitaminD and protein supplementation, andmenstrual status and use of oral contraceptives, has been littl…”
BackgroundInfluentialSíndrome de estrés tibial medial en deportistas: una mirada global en diagnóstico y tratamiento
Guzman, J. M., Rodríguez, J. P., & Sanhueza, A. N. (2023) · Archivos de la Sociedad Chilena de Medicina del Deporte · doi:10.59856/arch.soc.chil.med.deporte.v68i2.69 · Cited by 1
“Se debe realizar una evaluación nutricional y determinar el nivel de disponibilidad de energía e ingesta de calcio (38).”
BackgroundPrediction of Low Bone Mass for Japanese Female Athletes Using Machine Learning
Kruse, J. G. S., Kaneko, M., Nose‐Ogura, S., Kinoshita, S., Nakamura, H., Hiraike, O. W., Osuga, Y., & Kiyono, K. (2024) · Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC) · doi:10.1109/embc53108.2024.10781821 · Cited by 1
de Lima, T. R., Bim, M. A., Marco, J. C. P. D., Fernandes, R. A., & Pelegrini, A. (2025) · Sports Medicine and Health Science · doi:10.1016/j.smhs.2025.07.010 · Cited by 1
Nose‐Ogura, S., Yoshino, O., Kinoshita, S., Nakamura-Kamoto, H., Tabei, K., Komatsu, T., Hamai, A., Iida, K., Koshimizu, T., Nakayama, H., et al. (2025) · The Physician and Sportsmedicine · doi:10.1080/00913847.2025.2586448 · Cited by 1
“Awareness, early detection and timely intervention during the teenage years, when approximately 90% of maximum bone mass is acquired [24,36– 39], are particularly useful for preventing low BMD.”
Changes of Lower Limb Bone Mineral Density in Division I Female Athletes During an Athletic Season
Tolzman, J., Collins, K. A., Parmar, A. S., Grozier, C. D., Frederick, I., VanEtten, L., VanEtten, K. T., Ajit, S., & Harkey, M. S. (2025) · Open Access Journal of Sports Medicine · doi:10.2147/oajsm.s555396 · Cited by 1
Why Exercise as Punishment Doesn’t Work in Educational Athletics
Barnes, K. R. (2026) · Journal of Physical Education Recreation & Dance · doi:10.1080/07303084.2026.2619970 · Cited by 1
“Lastly, weight-bearing activities like running stimulate bone remodeling, leading to improved bone density, which is especially important for injury prevention in young athletes (Goolsby & Boniquit, 2017).”
Movement and Nutrition Principles
Güldaş, M., Yeşildemir, Ö., Gürbüz, O., Ozder, S., & Yıldız, E. (2023) · Springer eBooks · doi:10.1007/978-3-031-27184-7_27 · Cited by 1
Comprehensive multi-level expression profiling of key biomarkers in breast cancer patients.
Zia, T., Liu, B., Nadeem, A., Hussain, A., Abdel-Maksoud, M. A., Zakri, A. M., Bashir, M. K., Ali, M., Jabeen, N., Jamil, M., et al. (2023) · PubMed Central · Cited by 1
Saju, A., Swaminathan, N., Janani, G., & Sivaraman, A. (2023) · Journal of Datta Meghe Institute of Medical Sciences University · doi:10.4103/jdmimsu.jdmimsu_395_23 · Cited by 1
Waza, N. U. D., & Deol, N. S. (2025) · Physical Education Theory and Methodology · doi:10.17309/tmfv.2025.2.05 · Cited by 1
“These physical traits can be influenced differently by various sports, and it is crucial for athletes and healthcare professionals to understand these differences (Goolsby & Boniquit, 2017; Reza et al., 2024).”
Kussman, A. L., & Nattiv, A. (2020) · Springer eBooks · doi:10.1007/978-3-030-44754-0_11 · Cited by 1
Endothelial Dysfunction in Women Athletes: Integrative Review of the Literature
Lima, B. L., Cabral, F. D. S., de Jesus, S. S., Santana, K. S., & Fonseca, S. J. (2021) · Acta Scientific Orthopaedics · doi:10.31080/asor.2021.04.0401 · Cited by 1
Metadata
- Authors
- Goolsby, M. A., & Boniquit, N.
- Affiliations
- Hospital for Special Surgery (US)
- Rush University (US)
- Corresponding author
- Goolsby, Marci A.
- Venue
- Sports Health: A Multidisciplinary Approach
- Publisher
- SAGE Publications
- Published
- 2016-11-30
- Volume
- 9
- Issue
- 2
- Pages
- 108-117
- ISSN
- 1941-0921 (ISSN-L)
- 1941-7381
- PMC
- PMC5349390
- OpenAlex
- W2550789070
- Cited by
- 136
- References
- 111
- Citations by year
- 2026: 13 · 2025: 12 · 2024: 12 · 2023: 20 · 2022: 14 · 2021: 26 · 2020: 14 · 2019: 9 · 2018: 12 · 2017: 3
- FWCI
- 9.75
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Sports Health A Multidisciplinary Approach (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
- Physical Sciences › Engineering › Biomedical Engineering › Lower Extremity Biomechanics and Pathologies
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Physical Activity and Health
- Keywords
- bone health, athletes, osteoporosis prevention, exercise and bone health, female athlete triad, stress fractures, vitamin D, calcium, bone stress injuries, resistance training, nutrition and bone health
- MeSH terms
- Calcium, Dietary, Female, Hormones, Humans, Osteoporosis, Risk Factors, Vitamin D, Vitamin D Deficiency, Exercise, Bone Density, Fractures, Stress, Female Athlete Triad Syndrome, Sports Nutritional Physiological Phenomena
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