Br J Sports Med 41:664-668 doi:10.1136/bjsm.2006.030783
  • Original article

Regional bone mineral density in male athletes: a comparison of soccer players, runners and controls

  1. Michael Fredericson1,
  2. Kelvin Chew2,
  3. Jessica Ngo3,
  4. Tammy Cleek4,
  5. Jenny Kiratli5,
  6. Kristin Cobb6
  1. 1
    Department of Orthopaedic Surgery, Division of Sports Medicine, Stanford University, Stanford, California, USA
  2. 2
    Department of Orthopaedic Surgery, Sports Medicine Center, Alexandra Hospital, Singapore
  3. 3
    Stanford University, Stanford, California, USA
  4. 4
    School of Informatics & Engineering, Flinders University, Adelaide, Australia
  5. 5
    Spinal Cord Injury Center, Veterans Affairs Palo Alto Health Care System, Palo alto, California
  6. 6
    Health Research & Policy - Epidemiology, Stanford University, Stanford, California, USA
  1. Dr M Fredericson, Department of Orthopaedic Surgery, Division of Sports Medicine, Stanford University, 300 Pasteur Drive, Stanford, California 94306, USA; mfred2{at}
  • Accepted 27 March 2007
  • Published Online First 1 May 2007


Objectives: To investigate the association of soccer playing and long-distance running with total and regional bone mineral density (BMD).

Design: Cross-sectional study.

Setting: Academic medical centre.

Participants: Elite male soccer players (n = 15), elite male long-distance runners (n = 15) and sedentary male controls (n = 15) aged 20–30 years.

Main outcome measurements: BMD (g/cm2) of the lumbar spine (L1–L4), right hip, right leg and total body were assessed by dual-energy x-ray absorptiometry, and a scan of the right calcaneus was performed with a peripheral instantaneous x-ray imaging bone densitometer.

Results: After adjustment for age, weight and percentage body fat, soccer players had significantly higher whole body, spine, right hip, right leg and calcaneal BMD than controls (p = 0.008, p = 0.041, p<0.001, p = 0.019, p<0.001, respectively) and significantly higher right hip and spine BMD than runners (p = 0.012 and p = 0.009, respectively). Runners had higher calcaneal BMD than controls (p = 0.002). Forty percent of the runners had T-scores of the lumbar spine between −1 and −2.5. Controls were similar: 34% had T-scores below −1 (including 7% with T-scores lower than −2.5).

Conclusions: Playing soccer is associated with higher BMD of the skeleton at all sites measured. Running is associated with higher BMD at directly loaded sites (the calcaneus) but not at relatively unloaded sites (the spine). Specific loading conditions, seen in ball sports or in running, play a pivotal role in skeletal adaptation. The importance of including an appropriate control group in clinical studies is underlined.


  • Competing interests: None.

  • Abbreviations:
    bone mineral density
    dual-energy x-ray absorptiometry

Free sample

This recent issue is free to all users to allow everyone the opportunity to see the full scope and typical content of BJSM.
View free sample issue >>

Email alerts

Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.

Navigate This Article