Osteoporosis International

, Volume 22, Issue 1, pp 207–216

Distal radius geometry and skeletal strength indices after peripubertal artistic gymnastics

Original Article



Development of optimal skeletal strength should decrease adult bone fragility. Nongymnasts (non) were compared with girls exposed to gymnastics during growth (ex/gym), using peripheral quantitative computed tomography (pQCT) to evaluate postmenarcheal bone geometry, density, and strength. Pre- and perimenarcheal gymnastic loading yields advantages in indices of postmenarcheal bone geometry and skeletal strength.


Two prior studies using pQCT have reported bone density and size advantages in Tanner I/II gymnasts, but none describe gymnasts' bone properties later in adolescence. The current study used pQCT to evaluate whether girls exposed to gymnastics during late childhood growth and perimenarcheal growth exhibited greater indices of distal radius geometry, density, and skeletal strength.


Postmenarcheal subjects underwent 4% and 33% distal radius pQCT scans, yielding: 1) vBMD and cross-sectional areas (CSA) (total bone, compartments); 2) polar strength-strain index; 3) index of structural strength in axial compression. Output was compared for ex/gym vs. non, adjusting for gynecological age and stature (maturity and body size), reporting means, standard errors, and significance.


Sixteen postmenarcheal ex/gym (age 16.7 years; gynecological age 3.4 years) and 13 non (age 16.2 years; gynecological age 3.6 years) were evaluated. At both diaphysis and metaphysis, ex/gym exhibited greater CSA and bone strength indices than non; ex/gym exhibited 79% larger intramedullary CSA than non (p < 0.05). Ex/gym had significantly higher 4% trabecular vBMD; differences were not detected for 4% total vBMD and 33% cortical vBMD.


Following pre-/perimenarcheal gymnastic exposure, relative to nongymnasts, postmenarcheal ex/gym demonstrated greater indices of distal radius geometry and skeletal strength (metaphysis and diaphysis) with greater metaphyseal trabecular vBMD; larger intramedullary cavity size was particularly striking.


Adolescence Bone geometry Bone strength Female Mechanical loading pQCT 


  1. 1.
    Daly RM, Rich PA, Klein R, Bass S (1999) Effects of high-impact exercise on ultrasonic and biochemical indices of skeletal status: a prospective study in young male gymnasts. J Bone Miner Res 14(7):1222–1230CrossRefPubMedGoogle Scholar
  2. 2.
    Bass S, Pearce G, Bradney M, Hendrich E, Delmas PD, Harding A, Seeman E (1998) Exercise before puberty may confer residual benefits in bone density in adulthood: studies in active prepubertal and retired female gymnasts. J Bone Miner Res 13:500–507CrossRefPubMedGoogle Scholar
  3. 3.
    Cassell C, Benedict M, Specker B (1996) Bone mineral density in elite 7 to 9 year-old female gymnasts and swimmers. Med Sci Sports Exerc 28:1243–1246PubMedGoogle Scholar
  4. 4.
    Dowthwaite JN, DiStefano JG, Ploutz-Snyder RJ, Kanaley JA, Scerpella TA (2006) Maturity and activity-related differences in bone mineral density: Tanner I vs II and gymnasts vs. non-gymnasts. Bone 39:895–900CrossRefPubMedGoogle Scholar
  5. 5.
    Gero N, Cole J, Kanaley J, van der Meulen M, Scerpella T (2005) Increased bone accrual in premenarcheal gymnasts: a longitudinal study. Ped Ex Sci 17:43–55Google Scholar
  6. 6.
    Laing EM, Wilson AR, Modlesky CM, O’Connor PJ, Hall DB, Lewis RD (2005) Initial years of recreational artistic gymnastics training improves lumbar spine bone mineral accrual in 4- to 8-year-old females. J Bone Miner Res 20:509–519CrossRefPubMedGoogle Scholar
  7. 7.
    Nurmi-Lawton JA, Baxter-Jones AS, Mirwald RL, Bishop JA, Taylor P, Cooper C, New SA (2004) Evidence of sustained skeletal benefits from impact-loading exercise in young females: a 3-year longitudinal study. J Bone Miner Res 19:314–322CrossRefPubMedGoogle Scholar
  8. 8.
    Scerpella TA, Davenport M, Morganti CM, Kanaley JA, Johnson LM (2003) Dose related association of impact activity and bone mineral density in pre-pubertal girls. Calcif Tissue Int 72:24–31CrossRefPubMedGoogle Scholar
  9. 9.
    Taaffe DR, Robinson TL, Snow CM, Marcus R (1997) High-impact exercise promotes bone gain in well-trained female athletes. J Bone Miner Res 12(2):255–260CrossRefPubMedGoogle Scholar
  10. 10.
    Dowthwaite JN, Flowers PPE, Spadaro JA, Scerpella TA (2007) Bone geometry, density, and strength indices of the distal radius reflect loading via childhood gymnastic activity. J Clin Densitom 10(1):65–75CrossRefPubMedGoogle Scholar
  11. 11.
    Martin RB (1991) Determinants of the mechanical properties of bones. J Biomech 24(Suppl 1):79–88CrossRefPubMedGoogle Scholar
  12. 12.
    Sievänen H, Kannus P, Nieminen V, Heinonen A, Oja P, Vuori I (1996) Estimation of various mechanical characteristics of human bones using dual energy X-ray absorptiometry: methodology and precision. Bone 18:17S–27SCrossRefPubMedGoogle Scholar
  13. 13.
    Bass SL, Saxon L, Daly RM, Turner CH, Robling AG, Seeman E, Stuckey S (2002) The effect of mechanical loading on the size and shape of bone in pre-, peri-, and postpubertal girls: a study in tennis players. J Bone Miner Res 17(12):2274–2280CrossRefPubMedGoogle Scholar
  14. 14.
    Ducher G, Courteix D, Même S, Magni C, Viala JF, Benhamou CL (2005) Bone geometry in response to long-term tennis playing and its relationship with muscle volume: a quantitative magnetic resonance imaging study in tennis players. Bone 37(4):457–466CrossRefPubMedGoogle Scholar
  15. 15.
    Kontulainen S, Sievänen H, Kannus P, Pasanen M, Vuori I (2003) Effect of long-term impact-loading on mass, size, and estimated strength of humerus and radius of female racquet-sports players: a peripheral quantitative computed tomography study between young and old starters and controls. J Bone Miner Res 18:352–359CrossRefPubMedGoogle Scholar
  16. 16.
    Dowthwaite JN, Kanaley JA, Hickman RM, Spadaro JA, Scerpella TA (2009) Muscle indices do not fully account for enhanced upper extremity bone mass and strength in gymnasts. J Musculoskelet Neuronal Interact 9(1):2–14PubMedGoogle Scholar
  17. 17.
    Dyson K, Blimkie CJR, Davison KS, Webber CE, Adachi JD (1997) Gymnastic training and bone density in pre-adolescent females. Med Sci Sports Exerc 29(4):443–450PubMedGoogle Scholar
  18. 18.
    Ward KA, Roberts SA, Adams JE, Mughal MZ (2005) Bone geometry and density in the skeleton of pre-pubertal gymnasts and school children. Bone 36:1012–1018CrossRefPubMedGoogle Scholar
  19. 19.
    Ward KA, Roberts SA, Adams JE, Lanham-New S, Mughal MZ (2007) Calcium supplementation and weight bearing physical activity—do they have a combined effect on the bone density of pre-pubertal children? Bone 41:496–504CrossRefPubMedGoogle Scholar
  20. 20.
    Eser P, Hill B, Ducher G, Bass SL (2010) Skeletal benefits after long-term retirement in former elite female gymnasts. J Bone Miner Res. doi:10.1359/jbmr.090521
  21. 21.
    Bailey DA (1997) The Saskatchewan pediatric bone mineral accrual study: bone mineral acquisition during the growing years. Int J Sports Med 18:S191–S194CrossRefPubMedGoogle Scholar
  22. 22.
    Dowthwaite JN, Hickman RM, Ploutz-Snyder RJ, Kanaley JA, Spadaro JA, Scerpella TA (2009) Distal radius strength: a comparison of DXA-derived vs. pQCT-measured parameters in adolescent females. J Clin Densitom 12(1):42–53CrossRefPubMedGoogle Scholar
  23. 23.
    Zemel B, Bass S, Binkley T, Ducher G, MacDonald H, McKay H, Moyer-Mileur L, Shepherd J, Specker B, Ward K, Hans D (2008) Peripheral quantitative computed tomography in children and adolescents: the 2007 ISCD pediatric official positions. J Clin Densitom 11(1):59–74CrossRefPubMedGoogle Scholar
  24. 24.
    Rauch F, Schoenau E (2005) Peripheral quantitative computed tomography of the distal radius in young subjects—new reference data and interpretation of results. J Musculoskelet Neuronal Interact 5:119–126PubMedGoogle Scholar
  25. 25.
    Rauch F, Neu C, Manz F, Schoenau E (2001) The development of metaphyseal cortex—implications for distal radius fractures during growth. J Bone Miner Res 16(8):1547–1555CrossRefPubMedGoogle Scholar
  26. 26.
    Heinonen A, Sievänen H, Kannus P, Oja P, Vuori I (2002) Site specific skeletal response to long-term weight training seems to be attributable to principal loading modality: a pQCT study of female weightlifters. Calcif Tissue Int 70:469–474CrossRefPubMedGoogle Scholar
  27. 27.
    MacDonald H, Kontulainen S, Petit M, Janssen P, McKay H (2006) Bone strength and its determinants in pre- and early pubertal boys and girls. Bone 39(3):598–608CrossRefPubMedGoogle Scholar
  28. 28.
    Ruff C (2005) Growth tracking of femoral and humeral strength from infancy through late adolescence. Acta Paediatr 94:1030–1037CrossRefPubMedGoogle Scholar
  29. 29.
    Cohen J (1988) Statistical power analysis for the behavioral sciences (2nd edition). Lawrence Erlbaum Associates, Hillsdale, NJ, p 532Google Scholar
  30. 30.
    Scerpella TA, Dowthwaite JN, Gero N, Kanaley JA, Ploutz-Snyder RJ (2010) Skeletal benefits of premenarcheal gymnastic activity are retained after activity cessation. Pediatr Exerc Sci 22(1): 21–33PubMedGoogle Scholar
  31. 31.
    Lenth RV (2006) Java applets for power and sample size (computer software). Retrieved November 13, 2009 from http://www.stat.uiowa.edu/∼rlenth/Power
  32. 32.
    Haapasalo H, Kontulainen S, Sievänen H, Kannus P, Järvinen M, Vuori I (2000) Exercise-induced bone gain is due to enlargement in bone size without a change in volumetric bone density: a peripheral quantitative computed tomography study of the upper arms of male tennis players. Bone 27(3):351–357CrossRefPubMedGoogle Scholar
  33. 33.
    Ashizawa N, Nonaka K, Michikami S, Mizuki T, Amagai H, Tokuyama K, Suzuki M (1999) Tomographical description of tennis-loaded radius: reciprocal relation between bone size and volumetric BMD. J Appl Physiol 86(4):1347–1351PubMedGoogle Scholar
  34. 34.
    Marjanovic EJ, Ward KA, Adams JE (2009) The impact of accurate positioning on measurements made by peripheral QCT in the distal radius. Osteoporos Int 20:1207–1214CrossRefPubMedGoogle Scholar

Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2010

Authors and Affiliations

  1. 1.Department of Orthopedic SurgerySUNY Upstate Medical University, Institute for Human PerformanceSyracuseUSA

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