One of the greatest cyclists to ever race in the professional peloton crashed out of the Tour de France yesterday. Fabian Cancellara was wearing the yellow jersey when he was involved in a high speed crash that took out several riders. Unfortunately, Cancellara did not ride away unscathed. He suffered fractures of his lumbar spine, effectively ending his Tour and the rest of his season.
Broken clavicles are a frequent occurrence among competitive cyclists. But broken bones of the spine? That usually happens in little old ladies, right?! Granted, Cancellara was likely racing at over 30mph and landed directly on cement, the accident got me thinking, are cyclists at risk for poor bone health?
I already had a good idea of the answer, but I wanted to dig into the research a bit more. Although, cycling has been shown to confer several health benefits, improving bone health is unfortunately not one of them. News Flash: cycling is a non-weight bearing activity and as a result it is associated with lower bone mass. In fact, two-thirds of the professional and master adult road cyclists could be classified as osteopenic, or having a bone density lower than normal. Many times it is the lumbar spine, or lower back, that is found to be osteopenic. This is the part of the spine that was fractured in Fabian Cancellara’s case.
Interestingly, calcium intake and hormonal influences on bone health, were found to be within normal ranges in the cyclists studied, suggesting that it is the lack of impact on the bones that leads to the low density.
Speaking from experience, when you are really training and racing hard the last thing you want to do is exert more energy off the bike, so what do you do? You put your feet up and lie on the couch all day further reducing the needed stress on your bones to maintain their density.
Although, we don’t know if Fabian Cancellara has osteopenia, I’d be willing to bet that many cyclists in the elite and professional pelotons do. With a high incidence of crashes in road cycling, bone health is not a topic that receives it’s needed attention. And the research is pretty darn clear: those of us who compete in road cycling are more likely to develop osteopenia and osteoporosis.
So do we add in weight training to prevent bone density loss? For many cyclists this is an absolute no-no. If that’s the case for you, other forms of resistance training can be added instead, including pilates and plyometrics. Interestingly, it does appear that mountain biking, with its more impactful riding, is not associated with as much bone density loss.
It’s also important to think about getting screened for osteopenia if you consider yourself a competitive road cyclist. Screening would include a few lab test including hormone levels, calcium, and Vitamin D, as well as a bone density scan, or DXA (fyi: when you tell your doctor that you want to be screened for low bone density he or she will laugh at you, assuming you don’t have the normal risk factors for osteopenia, and rattle off what the USPSTF recommends and try to send you on your merry way. At that time please take out your phone and show him or her the link to this study and then politely ask again for a DXA).
It was a sad day, losing Fabian Cancellara to a crash just as he had donned the leader’s yellow jersey. He will be back, better than ever I’m sure. To make sure you’re able to bounce back from injury too, and perhaps prevent it from occurring in the first place, consider checking on the status of your bone health...or just go get yourself a mountain bike!