From the Guidelines
Athletes do not need DEXA scans as a routine part of their training or health monitoring unless there are specific medical concerns, such as a history of nutritional deficiencies, hypoestrogenism, stress fracture, or other secondary clinical risk factors for fracture, as indicated by studies including 1. DEXA (Dual-Energy X-ray Absorptiometry) scans are primarily used to measure bone mineral density and body composition, including fat and lean muscle mass. For most athletes, other assessment methods like skinfold measurements, bioelectrical impedance, or performance metrics provide sufficient information for training purposes without the radiation exposure or cost of DEXA scans. However, DEXA scans may be beneficial in certain situations, such as for athletes with suspected bone density issues, female athletes with amenorrhea who may be at risk for osteoporosis, or athletes recovering from injuries where bone health is a concern, as suggested by 1 and 1. Some key considerations for DEXA scans in athletes include:
- A history of nutritional deficiencies, hypoestrogenism, stress fracture, or other secondary clinical risk factors for fracture, which may warrant a DEXA scan, as indicated by 1.
- Athletes in weight-bearing sports should have a BMD that is 5%–15% higher than non-athletes, and a BMD Z-score less than −1 SD warrants further attention, as noted in 1 and 1.
- DXA assessments should be repeated in at-risk adults every 12 months and in at-risk adolescents at a minimum of every 6 months, preferably using the same DXA machine, as recommended by 1 and 1. If an athlete is concerned about bone health or wants detailed body composition analysis, they should consult with a sports medicine physician who can determine if a DEXA scan is appropriate based on their individual circumstances and medical history.
From the Research
Importance of DEXA Scans for Athletes
- DEXA scans are a diagnostic tool used to assess bone density, which is crucial for athletes, especially those at risk of osteoporosis or fractures 2, 3.
- Athletes, particularly female athletes, are at a higher risk of developing osteopenia or osteoporosis due to factors such as hormonal deficiency, excessive exercise, or inadequate nutrition 3.
- Regular DEXA scans can help identify athletes with low bone density, allowing for early intervention and prevention of fractures 4.
Benefits of DEXA Scans for Athletes
- DEXA scans can help athletes and coaches monitor bone health and make informed decisions about training and competition 2.
- By identifying athletes with low bone density, DEXA scans can help prevent fractures and other injuries, reducing the risk of long-term damage and improving overall performance 5, 3.
- DEXA scans can also be used to monitor the effectiveness of treatment and prevention strategies, such as exercise and nutrition programs, in improving bone density and reducing the risk of fractures 6, 4.
Current Practices and Recommendations
- Despite the importance of DEXA scans for athletes, current practices suggest that they are underutilized, with only a small percentage of patients being referred for DEXA scanning after a fracture 4.
- Recommendations suggest that athletes, particularly those at high risk of fracture, should prioritize balance, functional, and resistance training, and consider regular DEXA scans to monitor bone health 5.
- Coaches, athletes, and healthcare professionals should work together to promote bone health and prevent fractures, using DEXA scans as a valuable tool in this effort 2, 3.