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Effects of age and starting age upon side asymmetry in the arms of veteran tennis players: a cross-sectional study

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Abstract

Summary

While tennis playing results in large bone strength benefits in the racquet arm of young players, the effects of tennis playing in old players have not been investigated. Large side asymmetries in bone strength were found in veteran players, which were more pronounced in men, younger players and childhood starters.

Introduction

Regular tennis results in large racquet arm bone and muscle strength advantages; however, these effects have not been studied in old players. The non-racquet arm can act as an internal control for the exercising racquet arm without confounding factors, e.g. genotype. Therefore, veteran tennis player side asymmetries were examined to investigate age, sex and starting age effects on bone exercise benefits.

Methods

Peripheral quantitative computed tomography (pQCT) scans were taken at the radius, ulna and humerus mid-shaft and distal radius in both arms of 88 tennis players (51 males, 37 females; mean age 63.8 ± 11.8 years). Thirty-two players began playing in adulthood, thereby termed ‘old starters’; players were otherwise termed ‘young starters’.

Results

Muscle size and bone strength were greater in the racquet arm; notably, distal radius bone mineral content (BMC) was 13 ± 10 % higher and humeral bone area 23 ± 12 % larger (both P < 0.001). Epiphyseal BMC asymmetry was not affected by age (P = 0.863) or sex (P = 0.954), but diaphyseal asymmetries were less pronounced in older players and women, particularly in the humerus where BMC, area and moment of resistance asymmetries were 28–34 % less in women (P < 0.01). Bone area and periosteal circumference asymmetries were smaller in old starters (all P < 0.01); most notably, no distal radius asymmetry was found in this group (0.4 ± 3.4 %).

Conclusions

Tennis participation is associated with large side asymmetries in muscle and bone strength in old age. Larger relative side asymmetries in men, younger players and young starters suggest a greater potential for exercise benefits to bone in these groups.

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References

  1. Riggs BL, Melton Iii LJ, Robb RA, Camp JJ, Atkinson EJ, Peterson JM, Rouleau PA, McCollough CH, Bouxsein ML, Khosla S (2004) Population-based study of age and sex differences in bone volumetric density, size, geometry, and structure at different skeletal sites. J Bone Miner Res 19:1945–1954

    Article  PubMed  Google Scholar 

  2. Kelsey JL, Browner WS, Seeley DG, Nevitt MC, Cummings SR (1992) Risk factors for fractures of the distal forearm and proximal humerus. The Study of Osteoporotic Fractures Research Group. Am J Epidemiol 135:477–489

    CAS  PubMed  Google Scholar 

  3. Jónsson B, Bengnér U, Redlund-Johnell I, Johnell O (1999) Forearm fractures in Malmö, Sweden. Changes in the incidence occurring during the 1950,1980s and 1990s. Acta Orthop Scand 70:129–132

    Article  PubMed  Google Scholar 

  4. Hagino H, Yamamoto K, Teshima R, Kishimoto H, Kuranobu K, Nakamura T (1990) The incidence of fractures of the proximal femur and the distal radius in Tottori prefecture, Japan. Arch Orthop Trauma Surg 109:43–44

    Article  CAS  PubMed  Google Scholar 

  5. Schuit SC, van der Klift M, Weel AE, de Laet CE, Burger H, Seeman E, Hofman A, Uitterlinden AG, van Leeuwen JP, Pols HA (2004) Fracture incidence and association with bone mineral density in elderly men and women: the Rotterdam Study. Bone 34:195–202

    Article  CAS  PubMed  Google Scholar 

  6. 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 27:351–357

    Article  CAS  PubMed  Google Scholar 

  7. Bass S, Saxon L, Daly R, Turner C, Robling A, 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 17:2274–2280

    Article  CAS  PubMed  Google Scholar 

  8. Ayalon J, Simkin A, Leichter I, Raifmann S (1987) Dynamic bone loading exercises for postmenopausal women: effect on the density of the distal radius. Arch Phys Med Rehabil 68:280–283

    CAS  PubMed  Google Scholar 

  9. Adami S, Gatti D, Braga V, Bianchini D, Rossini M (1999) Site-specific effects of strength training on bone structure and geometry of ultradistal radius in postmenopausal women. J Bone Miner Res 14:120–124

    Article  CAS  PubMed  Google Scholar 

  10. Sanchis-Moysi J, Dorado C, Vicente-Rodríguez G, Milutinovic L, Garces GL, Calbet JA (2004) Inter-arm asymmetry in bone mineral content and bone area in postmenopausal recreational tennis players. Maturitas 48:289–298

    Article  CAS  PubMed  Google Scholar 

  11. Ireland A, Maden-Wilkinson T, McPhee J, Cooke K, Narici M, Degens H, Rittweger J (2013) Upper limb muscle-bone asymmetries and bone adaptation in elite youth tennis players. Med Sci Sports Exerc 45:1749–1758

    Article  PubMed  Google Scholar 

  12. Kallman DA, Plato CC, Tobin JD (1990) The role of muscle loss in the age-related decline of grip strength: cross-sectional and longitudinal perspectives. J Gerontol 45:M82–M88

    Article  CAS  PubMed  Google Scholar 

  13. Kohrt WM (2001) Aging and the osteogenic response to mechanical loading. Int J Sport Nutr Exerc Metab 11(Suppl):S137–S142

    PubMed  Google Scholar 

  14. Wilks DC, Winwood K, Gilliver SF, Kwiet A, Sun LW, Gutwasser C, Ferretti JL, Sargeant AJ, Felsenberg D, Rittweger J (2009) Age-dependency in bone mass and geometry: a pQCT study on male and female master sprinters, middle and long distance runners, race-walkers and sedentary people. J Musculoskelet Neuronal Interact 9:236–246

    CAS  PubMed  Google Scholar 

  15. Kannus P, Haapasalo H, Sankelo M, Sievänen H, Pasanen M, Heinonen A, Oja P, Vuori I (1995) Effect of starting age of physical activity on bone mass in the dominant arm of tennis and squash players. Ann Intern Med 123:27–31

    Article  CAS  PubMed  Google Scholar 

  16. Rittweger J (2008) Ten years muscle-bone hypothesis: what have we learned so far?—almost a festschrift–. J Musculoskelet Neuronal Interact 8:174–178

    CAS  PubMed  Google Scholar 

  17. Frost H (2004) The Utah paradigm of skeletal physiology, vol II. ISMNI, Athens

    Google Scholar 

  18. Kontulainen S, Sievänen H, Kannus P, Pasanen M, Vuori I (2002) 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 17:2281–2289

    Article  PubMed  Google Scholar 

  19. Nieves JW, Formica C, Ruffing J, Zion M, Garrett P, Lindsay R, Cosman F (2005) Males have larger skeletal size and bone mass than females, despite comparable body size. J Bone Miner Res 20:529–535

    Article  PubMed  Google Scholar 

  20. 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 86:1347–1351

    CAS  PubMed  Google Scholar 

  21. Haapasalo H, Sievanen 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 70:469–474

    Article  Google Scholar 

  22. Rittweger J, Simunic B, Bilancio G, De Santo NG, Cirillo M, Biolo G, Pisot R, Eiken O, Mekjavic IB, Narici M (2009) Bone loss in the lower leg during 35 days of bed rest is predominantly from the cortical compartment. Bone 44:612–618

    Article  PubMed  Google Scholar 

  23. Abbassi V (1998) Growth and normal puberty. Pediatrics 102:507–511

    CAS  PubMed  Google Scholar 

  24. Neu CM, Manz F, Rauch F, Merkel A, Schoenau E (2001) Bone densities and bone size at the distal radius in healthy children and adolescents: a study using peripheral quantitative computed tomography. Bone 28:227–232

    Article  CAS  PubMed  Google Scholar 

  25. Wey HE, Binkley TL, Beare TM, Wey CL, Specker BL (2011) Cross-sectional versus longitudinal associations of lean and fat mass with pQCT bone outcomes in children. J Clin Endocrinol Metab 96:106–114

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  26. Xu L, Nicholson P, Wang Q, Alén M, Cheng S (2009) Bone and muscle development during puberty in girls: a seven-year longitudinal study. J Bone Miner Res 24:1693–1698

    Article  PubMed  Google Scholar 

  27. Rittweger J, Michaelis I, Giehl M, Wüsecke P, Felsenberg D (2004) Adjusting for the partial volume effect in cortical bone analyses of pQCT images. J Musculoskelet Neuronal Interact 4:436–441

    CAS  PubMed  Google Scholar 

  28. Rittweger J, Beller G, Ehrig J et al (2000) Bone-muscle strength indices for the human lower leg. Bone 27:319–326

    Article  CAS  PubMed  Google Scholar 

  29. Rubin CT, Bain SD, McLeod KJ (1992) Suppression of the osteogenic response in the aging skeleton. Calcif Tissue Int 50:306–313

    Article  CAS  PubMed  Google Scholar 

  30. Klein-Nulend J, Sterck JG, Semeins CM, Lips P, Joldersma M, Baart JA, Burger EH (2002) Donor age and mechanosensitivity of human bone cells. Osteoporos Int 13:137–146

    Article  CAS  PubMed  Google Scholar 

  31. Ferretti JL, Capozza RF, Cointry GR, García SL, Plotkin H, Alvarez Filgueira ML, Zanchetta JR (1998) Gender-related differences in the relationship between densitometric values of whole-body bone mineral content and lean body mass in humans between 2 and 87 years of age. Bone 22:683–690

    Article  CAS  PubMed  Google Scholar 

  32. Schiessl H, Frost HM, Jee WS (1998) Estrogen and bone-muscle strength and mass relationships. Bone 22:1–6

    Article  CAS  PubMed  Google Scholar 

  33. Sievänen H (2005) Hormonal influences on the muscle-bone feedback system: a perspective. J Musculoskelet Neuronal Interact 5:255–261

    PubMed  Google Scholar 

  34. Bassey EJ, Rothwell MC, Littlewood JJ, Pye DW (1998) Pre- and postmenopausal women have different bone mineral density responses to the same high-impact exercise. J Bone Miner Res 13:1805–1813

    Article  CAS  PubMed  Google Scholar 

  35. Ackerman KE, Nazem T, Chapko D, Russell M, Mendes N, Taylor AP, Bouxsein ML, Misra M (2011) Bone microarchitecture is impaired in adolescent amenorrheic athletes compared with eumenorrheic athletes and nonathletic controls. J Clin Endocrinol Metab 96:3123–3133

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  36. Cardoso HF (2008) Age estimation of adolescent and young adult male and female skeletons II, epiphyseal union at the upper limb and scapular girdle in a modern Portuguese skeletal sample. Am J Phys Anthropol 137:97–105

    Article  PubMed  Google Scholar 

  37. Nara-Ashizawa N, Liu LJ, Higuchi T, Tokuyama K, Hayashi K, Shirasaki Y, Amagai H, Saitoh S (2002) Paradoxical adaptation of mature radius to unilateral use in tennis playing. Bone 30:619–623

    Article  CAS  PubMed  Google Scholar 

  38. Ojanen T, Rauhala T, Häkkinen K (2007) Strength and power profiles of the lower and upper extremities in master throwers at different ages. J Strength Cond Res 21:216–222

    Article  PubMed  Google Scholar 

  39. Caspersen CJ, Pereira MA, Curran KM (2000) Changes in physical activity patterns in the United States, by sex and cross-sectional age. Med Sci Sports Exerc 32:1601–1609

    Article  CAS  PubMed  Google Scholar 

  40. Martin B (1993) Aging and strength of bone as a structural material. Calcif Tissue Int 53(Suppl 1):S34–S39, discussion S39–40

    Article  PubMed  Google Scholar 

  41. Viljakainen HT, Saarnio E, Hytinantti T, Miettinen M, Surcel H, Mäkitie O, Andersson S, Laitinen K, Lamberg-Allardt C (2010) Maternal vitamin D status determines bone variables in the newborn. J Clin Endocrinol Metab 95:1749–1757

    Article  CAS  PubMed  Google Scholar 

  42. Koo WW, Walters J, Bush AJ, Chesney RW, Carlson SE (1996) Dual-energy X-ray absorptiometry studies of bone mineral status in newborn infants. J Bone Miner Res 11:997–102

    Article  CAS  PubMed  Google Scholar 

  43. Lei SF, Deng FY, Li MX, Dvornyk V, Deng HW (2004) Bone mineral density in elderly Chinese: effects of age, sex, weight, height, and body mass index. J Bone Miner Metab 22:71–78

    Article  PubMed  Google Scholar 

  44. Zofková I (2008) Hormonal aspects of the muscle-bone unit. Physiol Res 57(Suppl 1):S159–S169

    PubMed  Google Scholar 

  45. Cianferotti L, Brandi ML (2013) Muscle-bone interactions: basic and clinical aspects. Endocrine. doi:10.1007/s12020-013-0026-8

  46. Lang TF (2011) The bone-muscle relationship in men and women. J Osteoporos 2011:702735

    Article  PubMed Central  PubMed  Google Scholar 

  47. Sumnik Z, Land C, Coburger S, Neu C, Manz F, Hrach K, Schoenau E (2006) The muscle-bone unit in adulthood: influence of sex, height, age and gynecological history on the bone mineral content and muscle cross-sectional area. J Musculoskelet Neuronal Interact 6:195–200

    CAS  PubMed  Google Scholar 

  48. Klein CS, Allman BL, Marsh GD, Rice CL (2002) Muscle size, strength, and bone geometry in the upper limbs of young and old men. J Gerontol A Biol Sci Med Sci 57:M455–M459

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Institute for Biomedical Research into Human Movement and Health, Manchester Metropolitan University, John Dalton Building, Chester Street, Manchester, M1 5GD, UK

    A. Ireland, T. Maden-Wilkinson, H. Degens & J. Rittweger

  2. Institute of Aerospace Medicine, German Aerospace Centre, Linder Höhe, 51147, Cologne, Germany

    B. Ganse & J. Rittweger

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  1. A. Ireland
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  2. T. Maden-Wilkinson
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  3. B. Ganse
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  4. H. Degens
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  5. J. Rittweger
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Correspondence to A. Ireland.

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Ireland, A., Maden-Wilkinson, T., Ganse, B. et al. Effects of age and starting age upon side asymmetry in the arms of veteran tennis players: a cross-sectional study. Osteoporos Int 25, 1389–1400 (2014). https://doi.org/10.1007/s00198-014-2617-5

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  • DOI: https://doi.org/10.1007/s00198-014-2617-5

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