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feature
X-ray pelvisCycling can make your bones brittle; here's how to stop it
"Go running over cycling to avoid brittle bones, men told" announced a headline in The Telegraph, reigniting a long-running (ahem!) discussion about cycling and osteoporosis.
The article referred to a study – Bone Mineral Density Among Men and Women Aged 35 to 50 Years – published in the The Journal of the American Osteopathic Association.Â
Lead researcher Martha Bass says the best way to maintain bone mineral density (BMD) is through weight-bearing exercises, like walking, running and jumping. Moderate weight lifting is also beneficial, although older adults are warned to maintain good form and avoid overly heavy weights.
Bass also notes that many of the men participating in her study had strong exercise habits, although a majority reported cycling as their workout of choice, and cycling is not weight-bearing.
"The body [relies] on weight-bearing exercise to keep bones strong," says Martha Bass. "It really does boil down to use it or lose it."
Of course, cycling has many health benefits – improved cardiovascular fitness, reduction in mortality, reduced cardiovascular risk factors, reduced risk of cancer – but creating strong bones isn't among them. On the contrary, research suggests that a lot of cycling could even reduce your bone density, and that's not scaremongering.
In 2012, Cycling and Bone Health: a Systematic Review was published, looking at the findings of 31 studies on the subject.Â
The authors said, "From our comprehensive survey of the current available literature it can be concluded that road cycling does not appear to confer any significant osteogenic [relating to the formation of bone] benefit. The cause of this may be related to spending long hours in a weight-supported position on the bike in combination with the necessary enforced recovery time that involves a large amount of time sitting or lying supine, especially at the competitive level."
Well, that's encouraged in cycling! There's that old maxim among professionals and other serious racers: don't stand if you can sit, and don't sit if you can lie down. The idea is to avoid weight bearing activities in order to maximise recovery from training and racing.
Even if you're not purposely following this advice, it's likely that if you're doing a lot of miles you'll be doing a lot of sitting around on your arse afterwards on the basis that you're knackered. It's the natural thing to do.
According to one study, two-thirds of professional cyclists had abnormally low BMD values, and it's not just the pros who are at risk. Another recent study compared recreational riders (training 3-8hrs a week) and trained male road cyclists (training more than 8hrs a week) and found, "Areal bone mineral density (aBMD, the bone mineral content divided by the area) is lower in trained male road cyclists compared with recreational, specifically at the hips. Lumbar aBMD is low in both trained and recreational cyclists."
The issue can be compounded by restrictive eating habits adopted by cyclists keen to gain a performance advantage by keeping their weight low, and by the low weight itself which reduces skeletal loading forces. Â
We could go on but the bottom line is that the evidence suggests cycling won't improve your bone density and could even lead to it deteriorating. The more years you cycle, the more likely you are to develop osteoporosis and osteopenia (which is essentially a midway point on the way to osteoporosis), putting you at a higher risk of fracturing bones.
That's put a downer on your day, hasn't it? You think you're doing the right thing for your health by getting out on the bike regularly and then... bam!Â
It is worth noting that most of the research is based on competitive road cyclists. What the research does at least tentatively suggest is that if you're a recreational cyclist – or any other type of cyclist – you probably don’t need to worry about your riding having a negative effect on your bone density if you ride for less than about 8hrs per week. On the other hand, no matter how much or how little you cycle, it won't have a positive effect on your bone density.
Naturally, you don't want to avoid riding your bike – and that's hardly what we'd be advocating here at road.cc – so what can cyclists do to improve their bone density? Let's go back to the research...
A review titled Exercise and Bone Mass in Adults looked at studies into training and bone measurement and said, "Cross-sectional studies show in general that exercise modalities requiring high forces and/or generating high impacts have the greatest osteogenic potential... Not all exercise modalities have shown positive effects on bone mass. For example, unloaded exercise such as swimming has no impact on bone mass, while walking or running has limited positive effects. It is not clear which training method is superior for bone stimulation in adults, although scientific evidence points to a combination of high-impact (ie jumping) and weight-lifting exercises."
Jumping? Well, some cyclists include plyometrics in their training programme – where muscles exert maximum force in short intervals of time – in order to develop power. Maybe that's a good place to start. Then there's weight training...
An article was published in the Journal of Strength and Conditioning Research last year with the title: Resistance Training Is Associated With Higher Lumbar Spine and Hip Bone Mineral Density in Competitive Male Cyclists.Â
The title pretty much gives away the plot! The researchers measured BMD at four specific points in 40 cyclists at the start of a cycling season and found: "Weight training was associated with higher BMD of the lumbar spine, hip, femoral neck [the femur being the thighbone], and femoral trochanter [at the top of the femur]. No other factor was a predictor of preseason BMD in this sample. These data emphasise the need for competitive male cyclists to participate in weight training to maintain or increase bone mass of the lumbar spine and hip."
In a review of the available literature titled Effects of Resistance Exercise on Bone Health published last year, A Ram Hong and Sang Wan Kim said, "Resistance exercise has been highlighted as the most promising intervention to maintain or increase bone mass and density. This is because a variety of muscular loads are applied on the bone during resistance exercise, which generate stimuli and promote an osteogenic response of the bone."
Resistance exercise in this context refers to free weights, weight machines, medicine balls, elastic bands, and different movement velocities. More specifically, it includes "weighted lunges, hip abduction/adduction, knee extension/flexion, plantar-/dorsi-flexion, back extension, reverse chest fly, and abdominal exercises or a smaller number of compound movements of squats and deadlifts, targeting the major muscle groups attached to the hip and spine".Â
"The intensity and type of resistance exercise should be individualised according to tolerance and ability of adults, particularly in the presence of pain," the report continues. "At least two sets of one exercise for each major muscle group should be performed at a target intensity of eight to 12 repetition maximum."
Repetition maximum, or reps max, is the most weight you can manage for a given number of repetitions.
It must be said that most of this literature refers to older people who have developed osteoporosis, not specifically to athletes wanting to avoid it, but the advice for maintaining strong bones is to bring resistance training into your life along with something like plyometrics.Â
One study, this time based on post-menopausal women, found that power training is more effective than strength training for maintaining bone mineral density. What's the distinction? In this study, strength training repetitions were performed slowly (4secs for the concentric/ muscle shortening movement, 4secs for the eccentric/ muscle lengthening movement) whereas power training reps were fast (explosive for the concentric phase). Incorporating that into your resistance training is relatively straightforward, but build up to it slowly in order to avoid injury.
Unfortunately, there's no study out there that gives the perfect programme for cyclists who want to look after their bones, but you might want to make use of these guidelines gleaned from the available literature:
• Add resistance exercise (see examples above) and plyometrics to your training programme
• Don't be afraid of heavy weights!
• Developing bone strength is site-specific so perform two sets of a resistance exercise for each major muscle group
• Use the heaviest weight that allows you to perform 8-12 reps per set
• Rest sufficiently between sets to allow maximal efforts
• Some form of bone strengthening training is recommended 2-3 times per week
• Sports that involve unevenly applied impacts – 5 aside football, tennis, and so on – also stimulate bone strengthening
Diet
The loss of calcium through prolonged periods of sweating has been suggested as one of the reasons behind the poor bone health of many cyclists. A study from 2015 looked at:Â The Effects of a Calcium-Rich Pre-Exercise Meal on Biomarkers of Calcium Homeostasis in Competitive Female Cyclists.Â
The researchers found that a calcium-rich breakfast meal (containing about 1,350mg of calcium) consumed 2hrs before a 90min high-intensity ride reduced the levels of bone breakdown during exercise.Â
The NHS suggests that most adults need around 700mg of calcium a day for healthy bones. Bear in mind that you get 544mg in a pint of whole milk. More good sources of calcium include other dairy foods, green leafy vegetables, and nuts.
Vitamin D is also crucial for bone health. Dietary sources of vitamin D include eggs and oily fish but we get most that we need from the action of sunlight on our skin. You might get enough from being out on your bike although everyone is advised to consider taking a daily vitamin D supplement.
Mat has been in cycling media since 1996, on titles including BikeRadar, Total Bike, Total Mountain Bike, What Mountain Bike and Mountain Biking UK, and he has been editor of 220 Triathlon and Cycling Plus. Mat has been road.cc technical editor for over a decade, testing bikes, fettling the latest kit, and trying out the most up-to-the-minute clothing. He has won his category in Ironman UK 70.3 and finished on the podium in both marathons he has run. Mat is a Cambridge graduate who did a post-grad in magazine journalism, and he is a winner of the Cycling Media Award for Specialist Online Writer. Now over 50, he's riding road and gravel bikes most days for fun and fitness rather than training for competitions.
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54 comments
Shin Splints from Running. Cycling is Cardio Endurance, although Muscles will adapt and build endurance too. If you do a Strength session in the morning and then go Cycling in the evening, the Strength session may do nothing, if it's too intensive or long. And if you don't, you might just be burning through all the nutrition you have stored up, including some Bone Density (that hunger). Vitamin D requires Calcium to work, or something like that, and we're in short supply of Vit D from October to March
"that old maxim among professionals and other serious racers: don't stand if you can sit, and don't sit if you can lie" and don't lie if you may be found out, unless you're Boris Johnson in which case lying will be expected of you.Â
This is why i do a little jump rope on days im not on the bike. I do 20-30mins of jump rope in the garden. some people go for longer.
Carrying heavy sacks with camping kit up and down mountains is one good way to do it, or even just going up and down mountains- the pounding you get descending must be a good signal to the bones. I attribute avoiding a fracture in a very hard hip bashing fall on the ice on Christmas Eve to these methods.
Whoever said that cycling is low impact clearly hasn't seen the pot-hole ridden roads on my commute.
How much of a problem is this in reality rather than in theory?
I have not heard that professional cyclists get worse fractures due to low BD. Â
The 60yr plus veterans in my current and previous cycle clubs are the healthiest and strongest people I know for their age. I’m sure if it really was a problem it would have been well publicised.Â
As a 66yr year old vegan cyclist my bone density is good for my age. I just eat a balanced diet with no calcium supplements and don't do any bone specific excercises.  There can of course be a large genetic element to age related LBD.
its easy to get, or pay privately for a DEXA scan to a true assessment for anyone who has concerns.
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It's one of the reasons Chris Boardman has cited for hanging up his wheels when he did, he was getting to the point where it could become an issue. I know that's only one rider out of many, but I think it's an issue for a good few, they just obviously take steps to avoid it.
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You should take the warning seriously!Â
I am mid-50's, trained and rode hard for 10 years, broke my hip 2 years ago in a bike fall, and found out that femur density was low (T-score -2.9, osteoporosis). I did little other exercise, apart from occaisional squats. No underlying hormonal causes for low bone density. Decided to try to reverse (improve) naturally:Â more dairy, weights, yoga, rebounding and running (although running is not as good for bones as most people think). Bone scan a month ago showed hip back to near normal for age (T-score -1.0).
Make your own minds up about this, but for me, my cycling regime caused my osteoporosis and by changing regime, I am back to normal.
Medical profession yet to acknowledge the growing (but small) amount of research on this topic.
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Was it the dietary changes or the yoga/weights that changed you T-score?
Given I don't spend my time when not riding, levitating, I don't think I'll suffer from much osteoporosis due to cycling.
Couple of obvious comments:
1. How many people on here have cycling as their only form of exercise? Personally, I cycle (aerobic, very low impact), walk (aerobic, medium impact - it's fast walking), climb (mostly anaerobic & high impact) & use a gym (mix of aerobic & anaerobic, fairly high impact) & I'd guess almost any serious cyclist would have a similar story.
2. Yes, road cycling is mostly sitting & spinning, but how many of us are purely roadies? Off road (gravel or MTB) is a very different story, with anaerobic & high impact passages, standing up to attack those 1-in-2 hills & gnarly descents, bunny-hopping roots on twisty woodland singletracks etc.
No, I have lots of things to worry about but I don't think bone mass is one of them.
Just to throw things leftfield, I've just been on holiday and as dad, most of activities revolved around the pool, so I've not ridden all week. I can swim but don't bother unless it's holiday time. Is there any benefits to swimming that can carry over to cycling or is the best thing for cycling, more cycling?Â
Cross-training of any type is generally better than doing nothing but your main sport. There are several components of fitness and I don't think any single sport hits them all, so variety will provide an overall improvement.
https://www.bbc.com/bitesize/guides/zxd4wxs/revision/2
Swimming is very good aerobically and is a whole-body activity. It is particularly good for upper body strength, specifically the lats, pecs and triceps, which cyclists tend to neglect - compare the bodies of top swimmers and cyclists to see the difference!
If you can work up to swimming 1600 metres or more a couple of times a week you will see a lot of benefit. You could probably do 1600m in about 45 minutes or less, so you could be done, showered and changed in less than hour. Ride there and back and you'll have had a fairly decent workout.
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Perhaps somebody could explain to me why "cycling can make your bones brittle", because the article doesn't. I get the bit about lack of load bearing exercise making your bones brittle. But nothing said about cycling causing brittle bones except a title unsupported by further argument.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3554602/
"Results
Heterogeneous studies in terms of gender, age, data source, group of comparison, cycling level or modality practiced among others factors showed minor but important differences in results. Despite some controversial results, it has been observed that adult road cyclists participating in regular training have low bone mineral density in key regions (for example, lumbar spine). Conversely, other types of cycling (such as mountain biking), or combination with other sports could reduce this unsafe effect. These results cannot yet be explained by differences in dietary patterns or endocrine factors.
Conclusions
From our comprehensive survey of the current available literature it can be concluded that road cycling does not appear to confer any significant osteogenic benefit. The cause of this may be related to spending long hours in a weight-supported position on the bike in combination with the necessary enforced recovery time that involves a large amount of time sitting or lying supine, especially at the competitive level."
Yes, I've read the report, which is why I don't understand the road.cc headline.
Your quoted conclusion above , like the conclusions of the report, refers to the lack of benefits to bmd from cycling, rather than any detriment. The authors acknowledge that there is not a consistent set of data - you have quoted a case of lower bmd in cyclists, but reports showing no difference are also referenced. However after no doubt spending many months poring over the raw data in much more detail than you or I, the authors do not claim any causal link between cycling and low bmd as suggested by the road.cc headline. What they actually say is that some other sports are beneficial to bmd, cycling isn't.
"They found that cyclists had lower BMD at all body sites than weightlifters, but no differences were observed with other sports or with controls [19]. "
"Subsequent studies reinforced the finding that no differences in BMC or BMD were observed between cyclists and controls, in both males and females..."
"The two studies by Duncan et al. showed no differences in BMD between cyclists and controls..."
"Cycling is considered to be a highly beneficial sport for significantly enhancing cardiovascular fitness in individuals, yet studies show little or no corresponding improvements in bone mass."
"Using MRI, Duncan et al. found that female adolescent cyclists had lower bone cross-sectional area, moment of inertia and mid-femur vBMD than their runner counterparts, while no differences were observed with controls..."
"From our comprehensive survey of the current available literature it can be concluded that road cycling does not appear to confer any significant osteogenic benefit."
"In conclusion, road cycling at a competitive level is less effective at improving bone mass when compared with weight-bearing sports."
So time and time again the report comes back to lack of bmd benefits compared to some other sports, rather than any causal detrimental effects due to cycling. Which once again confirms that a bit of variety in life does you good!
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you seem to be only quoting parts that support your claim. There are other parts, including the summary that I quoted, which state that different groups of road cyclists have lower BMD than the controls, and they offer a plausible explanation. They are very conservative in their conclusions because the overall picture is unclear and merits further research.
In the meantime it would seem wise particularly for older road cyclists to take the advice of the NHS to all people, cyclists or not, and include some weight-bearing/impact exercise in their regime.
But that plausible explanation doesn't appear to involve cycling causing more brittle bones, as the headline suggests. Rather, it seems to be that people who cycle a lot tend not to do so much of the weight-bearing exercise that helps to maintain stronger bones.
Don't get me wrong, I made no claim, nor do I have an issue with the original report. I do have an issue with the press, including road.cc, attaching sensational headlines which the report does not support.
it is a sensational headline, but in my view the report does support it - cycling can give you brittle bones. It's not the whole truth, and it allows people to over-interpret it, but the report shows some road cyclists can develop lower BMD than non-athletic controls if they don't take some osteogenic exercise.
The headline is designed to get people reading who wouldn't ordinarily read medical literature, and to think about whether or not the matter affects them personally, so that they can learn more, do something about it if they choose. Maybe the writer could have done a more nuanced job in the accompanying article, but there has been a fairly brisk set of comments about it, so I guess it's served its purpose.
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a micronutrient deficiency is more likely a cause I'd say, caused by endurance exercise.
Cycling is great and I love busting my a*& on my bike , but I lift weights . It’s had no effect on my cycling performance. I’d point out that i like to climb , but not into 5 hours of flat riding zzzzzzz. If your competing in endurance events or racing pro the im sure being little and skinny will help .
but I personally like to climb one or two mountains  and that’s it for me . I do it easy ,no stress (unless I feel like putting the gas down ) and enjoy myself . I’m all about the power rather than the spinny tiny cog brigade. But  I hit the weights most days and feel so much better for it . Infact a few few years ago I did go for the power to weight ratio thing and my riding suffered for it . Doesn’t suit me at all . You have to find your own thing and imo hitting the weights is going to benefit your health .Â
The answer, surely, is to mix a bit of cyclocross style in your riding. Or even go the whole hog and slip on your speedos...
My commute to work includes running up six flights of stairs to the office with the bike. The bike may be light, but I'm not, so my bones get a bit of a pounding.
Lifting a weight is all about resistance, we established that. You can ride a bike with little effort and have little resistance, but my point is you can also ride a bike in a way that provides high resistance. I honestly can’t see a difference, from a physiological point of view, between doing squats and pressing all your body weight as hard as you can into a crank repeatedly, one leg after the other. It’s the same effort from the same muscles and bones
Because the hardest you can press into a pedal is 1x your bodyweight, if you're leaning against a wall with the brakes on so the cranks don't turn. You can do that for your strength routine if you want but you'll look a bit silly. As soon as the cranks start turning then you can't be putting any more force through than that.
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aha, but you’re only pressing one leg on the crank at a time so in effect you are pressing a potential maximum of 2x body weight if you compare it to a regular squat which uses double the legs. Squatting your own body weight isn’t too shabby, not competition weightlifting but better than most gym goers can do
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Hopefully you don't have your see set so low that pedalling mimics squatting - though I'm sure the extra effort required from putting your seat too low would provide plenty of extra exercise.
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Anway... what I wanted to point out is:
 A. There doesn't seem to be anything in the article(s) that says cycling reduces bone density (unless I completely missed it).
B. It doesn't appear to appreciate that there are different forms of cycling - is riding on rougher terrain more beneficial for bone density?
if you carried whatever weight you squat, say .75 of your bodyweight, you might achieve the same effect. I don't know if anyone has tested that.
cycling as you describe doesn't have the same bone-strengthening effect as weighted squats because in a squat the weight is crushing you into the ground, so the entire chain of bones responds.
i don't know if you've ever done squats - if not, try it, and you will feel the difference in your shoulders, spine and legs between that and cycling up a hill.
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i ride with a single chain ring 53 t . I climb on my 53 t x23 /26/27  quite easy . I  have climbed most of the famous french climbs and some Italian climbs and some very steep  Spanish climbs were I wish I had a 32 at the back .  When i started to get more serious about riding I applied the same kind of methods I used when I was body building. I  would hit a few climbs near me in north London and try and do the climbs on a smaller cog at the rear always staying on the 53 at the front  gradually my bike strength increased. I’m still pushing now but feel there is definitely a limit .Â
I did this from day one and it’s been quite a few years and for me it works fine .  But when I started cycling more seriously I stopped doing weights . I noticed a decrease in my leg size which I thought I would keep working in the harder gears but my legs size decreased .  I started hitting the weights a few years ago . I noticed straight away that I’d lost a lot of strength in my legs . I may have been strong on the bike and getting stronger but  I lost a lot of strength hitting the weights . A lot of my leg size has now come back due to hitting the weights .  I’ feel a lot better for hitting the weights but cycling and lifting weight are so different and pushing hard gears is not the same in anyway as working your legs off the bike . Track cyclist get big legs through their use of squatting etc, your not getting the same benefit from cycling .Â
I know it said some impact was good for maintaining bone density, but I still think you're probably better off lifting the weights, rather than hitting them.
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