Cortical and trabecular bone at the forearm show different adaptation patterns in response to tennis playing

Bone responds to impact-loading activity by increasing its size and/or density. The aim of this study was to compare the magnitude and modality of the bone response between cortical and trabecular bone in the forearms of tennis players. Bone area, bone mineral content (BMC), and bone mineral density (BMD) of the ulna and radius were measured by dual-energy X-ray absorptiometry (DXA) in 57 players (24.5 +/- 5.7 yr old), at three sites: the ultradistal region (50% trabecular bone), the mid-distal regions, and third-distal (mainly cortical bone). At the ultradistal radius, the side-to-side difference in BMD was larger than in bone area (8.4 +/- 5.2% and 4.9 +/- 4.0%, respectively, p < 0.01). In the cortical sites, the asymmetry was lower (p < 0.01) in BMD than in bone area (mid-distal radius: 4.0 +/- 4.3% vs 11.7 +/- 6.8%; third-distal radius: 5.0 +/- 4.8% vs 8.4 +/- 6.2%). The asymmetry in bone area explained 33% of the variance of the asymmetry in BMC at the ultradistal radius, 66% at the mid-distal radius, and 53% at the third-distal radius. The ulna displayed similar results. Cortical and trabecular bone seem to respond differently to mechanical loading. The first one mainly increases its size, whereas the second one preferentially increases its density.