Enhanced bone mass and physical fitness in young female handball players
Introduction
Bone health later in life may rely on the bone mass accumulation during growth [1]. In fact, the risk of osteoporosis is affected by the peak bone mass attained, in general, before the age of 20 [1], the bone mass accrual being most marked between 11 and 14 years of age in girls [2]. It has been demonstrated that weight-bearing physical activities increase bone mass acquisition, particularly in weight-loaded skeletal regions in young population [3], [4]. It becomes interesting to determine what kind and duration of sporting activities are the most beneficial for bone mass development during growth.
Most of the investigations studying bone mass accrual in girls had been carried out with a gymnast population [3], [5]. Ground reaction forces during gymnastic participation are close to 10 times body mass in child [6]. This high-impact loading has been associated with greater BMD in the whole body [5], spine, and lower extremities [3]. However, these studies show unreal training volumes in day-to-day exercise practice of ordinary physically active girls. The latter, combined with the increasing problem of sedentary behavior in children, has intensified the interest in exercise modes easy to prescribe with clear osteogenic effects for the general child population.
There is clear evidence demonstrating that weight-bearing sporting activities involving rapid directional changes, starts, stops, and great ground reaction forces, promote bone deposition in prepuberal [7], [8] and postpuberal [9] age. We have recently observed that prepuberal boys involved in this kind of activities had higher BMC and areal density than their weight-matched nonphysically active counterparts [7].
Girls are usually less physically active than boys [10]. However, handball is a sport widely practiced by girls around the world. In fact, apart from the recreational participants, 736,326 (26,291 from Spain) junior girls were affiliated to the International Handball Federation (IHF) in 2003 (Frank Birkefeld, IHF Managing Director, personal communication). This sport involves several sprints, which provoke high mechanical stress on lower extremity bones due to high reaction forces during sprinting [11]. During handball participation, a great number of rapid directional changes, starts, stops, jumps, and landings occur. Additionally, the upper extremities have a relevant role in this sport, as they are involved in different actions like throwing, fall landings, and ball blocks during defensive actions. All together, handball actions may entail excellent osteogenic properties on axial and appendicular bones [12]. However, to the best of our knowledge, we are not aware of studies examining the effect of recreational handball participation on bone mass in girls. This information could be used to propose scientifically grounded guidelines for sport participation designed to promote bone accumulation in girls.
Therefore, the purpose of our study was to determine whether young girls participating in handball, at least 3 h per week, for a minimal period of 1 year, have additional osteogenic benefits to those obtained from the compulsory school physical education sessions (60–90 min of effective practice in Spain). A secondary aim was to determine to what extent BMC and BMD could be predicted by physical-fitness-related variables in girls.
Section snippets
Subjects
A representative sample of Gran Canaria child and adolescent population was obtained by multiage stratified sampling, using as a reference the database of the ISTAC (Instituto Canario de Estadística). In total, 325 healthy children and adolescent girls, aged between 7 and 20 years, were recruited from different schools and sports clubs of Gran Canaria. However, only 52 (14.2 ± 0.4 year, mean ± SEM) were included in the present investigation. Both parents and children were informed about the
Physical characteristics and physical fitness
The subject's age, anthropometric, body composition, calcium intake, and physical fitness data are summarized in Table 1. When comparing handball and control groups, both were similar in height, age and body mass, but the handballers had 11.5% (P = 0.05) higher body lean mass than the control group, while no differences were observed in the percentage of body fat between groups.
The handballers attained better results in aerobic maximal power, anaerobic capacity, running speed, and mean power in
Discussion
This study shows that handball participation is associated with higher axial and appendicular BMC and BMD during early puberty in girls. Moreover, as expected, handballers have enhanced muscle mass and better physical fitness than their nonactive matched counterparts. Another relevant finding of this study is that the same stimuli producing skeletal muscle hypertrophy produces a proportional development of bone mass in young girls.
These findings add further evidence of the response of growing
Acknowledgments
Special thanks are given to José Navarro de Tuero for their excellent technical assistance and to Betty Burgess for the revision of the English style and grammar. This study was supported by Ministerio de Educación, Cultura y Deportes (AP2000-3652), Universidad de Las Palmas de Gran Canaria, Gobierno de Canarias (PI2000/067), Consejo Superior de Deportes (27/UNI10/00), and Ministerio de Ciencia y Tecnología (BFI2003-09638).
References (32)
- et al.
Enhanced bone mass and physical fitness in prepubescent footballers
Bone
(2003) - et al.
Sociocultural determinants of physical activity among children
Prev. Med.
(1999) - et al.
Inter-arm asymmetry in bone mineral content and bone area in postmenopausal recreational tennis players
Maturitas
(2004) - et al.
Bone density at various sites for prediction of hip fractures. The study of osteoporotic fractures research group
Lancet
(1993) - et al.
Estrogen deposits extra mineral into bones of female rats in puberty, but simultaneously seems to suppress the responsiveness of female skeleton to mechanical loading
Bone
(2003) - et al.
Growth, physical activity, and bone mineral acquisition
Exerc. Sport Sci. Rev.
(1996) - et al.
A six-year longitudinal study of the relationship of physical activity to bone mineral accrual in growing children: the university of Saskatchewan bone mineral accrual study
J. Bone Miner. Res.
(1999) - et al.
Premenarcheal gymnasts possess higher bone mineral density than controls
Med. Sci. Sports Exerc.
(2000) - et al.
Type of physical activity, muscle strength, and pubertal stage as determinants of bone mineral density and bone area in adolescent boys
J. Bone Miner. Res.
(1998) - et al.
Bone mineral density in elite 7- to 9-yr-old female gymnasts and swimmers
Med. Sci. Sports Exerc.
(1996)
Effects of high-impact exercise on ultrasonic and biochemical indices of skeletal status: a prospective study in young male gymnasts
J. Bone Miner. Res.
The prepubertal years: a uniquely opportune stage of growth when the skeleton is most responsive to exercise?
Sports Med.
A 3-year longitudinal study of the effect of physical activity on the accrual of bone mineral density in healthy adolescent males
Calcif. Tissue Int.
Relationship between rearfoot and forefoot orientation and ground reaction forces during running
Med. Sci. Sports Exerc.
High bone mineral content in male elite professional volleyball players
Osteoporos. Int.
Adolescents' self assessment of sexual maturation
Pediatrics
Cited by (106)
Composite Indices of Femoral Neck Strength in Young Adult Male Handball Players
2022, Journal of Clinical DensitometryIs low frequency and volume sports training beneficial to bone density in female adolescents?
2020, Science and SportsBone mineral density and bone mineral content among female elite athletes
2019, BoneCitation Excerpt :Football is a sport with special biomechanical characteristics: changes of direction, speed, jumps and kicks that offers additional mechanical stress in lower extremities due to the force of reaction against the ground during these actions [31] that facilitates mineral accretion, from the cortical to the trabeculae in its entire functional dimension, depending on length and intensity. Volleyball is a sport with long, fast short movements, both in defensive and offensive actions to adjust the position of the body to the position of the ball in a short period of time since the ball takes 1.2–1.4 s to go from one side of the court to the other [32], jumping, change of direction, speed and power work seems beneficial for the formation of an adequate bone from childhood and in adulthood, as happens with artistic gymnastics, volleyball or handball [33–35]. Some authors conclude that variable sports loads, like in basketball, are more effective to increasing BMD and BMC than other activities more stressful as parachuting with constant loads at specific sites [36].
Does Muscular Power Predict Bone Mineral Density in Young Adults?
2019, Journal of Clinical DensitometryJudo Practice in Early Age Promotes High Level of Bone Mass Acquisition of Growing Boys’ Skeleton
2018, Journal of Clinical DensitometryCitation Excerpt :However, during ground fight sessions, our judo players favor the dominant arm to set adversary. This contributes to generate an asymmetric repartition of mechanical constraints in favor of the dominant upper extremities, which is in partial agreement with other findings that showed obvious variations in BMD in the dominant and contralateral upper extremities in adolescent female handball players (32). However, Ducher et al found that practicing tennis contributed to increase the baseline BMC of the playing arms, which was 16%–18% greater than the nonplaying one in both the pre/peri and postmenarcheal female tennis player group (33).