Bone Health in Handball Players: The Role of Exercise

Exercise has an indirect but significant effect on bone mass by generating mechanical stress on the skeleton. It is widely recommended to enhance bone quality and counteract the loss of bone and muscle mass, particularly in the elderly. Dual-energy X-ray absorptiometry (DEXA) is a relatively inexpensive and effective method for assessing bone mineral density (BMD) and bone mineral content (BMC), both of which are strong predictors of fracture risk. Team handball is a high-impact sport, which is characterized by frequent jumping, landing, and torsional strains on the upper and lower limbs, as well as the spine. These mechanical loads are important regulators of bone mass. The literature highlights the potential positive role of handball training and participation on both BMD and BMC. Specifically, handball players have been shown to exhibit higher BMD and BMC values compared to age-matched active and inactive individuals. The observed improvements in bone parameters among handball players may be attributed to repetitive muscle contractions and the high mechanical loading associated with the sport, which stimulate bone tissue activation and remodeling. Furthermore, a significant difference has been observed between dominant and non-dominant limbs in handball players, with the dominant side showing higher BMD and BMC values in both upper and lower extremities. This review underscores the beneficial role of high-impact sports, such as handball, in promoting bone health, preventing bone loss, and reducing the risk of osteopenia and osteoporosis later in life.