Abstract
This study aimed to assess the calcaneal bone mineral density (BMD) of elite female trail runners and evaluate its reliability using a novel DXA method. It also examined the relationship between calcaneal BMD and other regions of interest to better understand bone health in this specific population. A cross-sectional study was conducted with 35 elite female trail runners from the Spanish national team. BMD was measured at six anatomical regions using DXA, with particular focus on the calcaneus. Intra- and inter-rater reliability were evaluated using intraclass correlation coefficients (ICC). Descriptive statistics and correlations between calcaneal BMD and other anatomical sites, such as the lumbar spine and femoral neck, were analyzed. Calcaneal BMD showed excellent reliability (ICC = 0.95–0.98), confirming the robustness of the proposed measurement method. The mean calcaneal BMD (0.660 ± 0.105 g·cm²) was higher than that of non-athletes but lower than athletes from other endurance sports, such as road running. Significant correlations were found between calcaneal BMD and other regions, including the femoral neck (r = 0.58) and lumbar spine (r = 0.50), indicating that calcaneal BMD may provide complementary information for assessing bone health. The study confirms the reliability of calcaneal BMD measurement in elite female trail runners and highlights its potential as a useful complementary tool for monitoring bone health. Further longitudinal studies are needed to determine whether calcaneal BMD can serve as an indicator for stress fractures and other bone-related injuries in endurance athletes.
