Bone health and high-performance sport

Physical activity at regular intervals enhances healthy bone metabolism and density: however, in some forms of sport female athletes have a higher prevalence of low bone density and increased rates of stress fractures. Often the cause is a relative energy deficit (RED) in combination with high mechanical load and intensive training. The occurrence of RED in sports (RED-S) is often underdiagnosed; therefore, a systematic multidisciplinary approach employing standardized tests, such as the relative energy deficit in sport clinical assessment tool (RED-S CAT) has been shown to be helpful. Treatment strategies primarily aim at correcting the negative energy balance of the patient as well as psychotherapeutic interventions. Furthermore, in severe cases a pharmaceutical treatment can be necessary for support as well as a balanced hormonal situation and to correct dysfunctional bone metabolism.