Bone Health and Energy Availability in Adaptive Athletes.

Adaptive athletes are a high performing yet medically complex group, facing unique challenges related to bone health and energy availability. Bone health is fundamental to athletic performance, injury prevention, and long-term physical function. However, many adaptive athletes are predisposed to compromised bone integrity due to factors such as impaired mobility, reduced mechanical loading, hormonal dysregulation, and comorbid conditions. The purpose of this article is to synthesize current evidence on bone health and energy availability in adaptive athletes, examine mechanisms linking low energy availability to bone outcomes, and propose clinical recommendations for monitoring and intervention.