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From Recruitment to Recovery: Dr. Dengel on DXA’s Role in University Athletics – Part 2

During part one of our conversation with Dr. Donald Dengel, we spoke about using DXA for the development of athletic training programs and bone health evaluations at the University of Minnesota. Dr. Dengel has more than 25 years of experience researching DXA and has explored its intersection with human performance in-depth, creating Dexalytics.com as a go-to source of news and insights about the technology.

Now, during part two of our series discussing DXA’s role in the college sports world, we cover how DXA is used before players even hit the field—and how to get them back on it after an injury.

Innovative Approach to Injury Prevention and Recovery

To a certain extent, injuries are an inevitable part of collegiate athletics. However, DXA systems can play an important role in preventing injuries as much as possible, and just as importantly, helping trainers evaluate recovery and when it’s safe to put a player back on the field.1 Dr. Dengel described situations like an ACL tear or a knee injury where one limb is injured, and the other is able to act as the uninjured “control” limb for which to base measurements upon. 

Given that it’s expected for the injured limb to see a loss of muscle and perhaps a loss of bone, “Using DXA, you can track these two limbs and go, ‘If I have a baseline, I know what to try to get back to, and I know what level I’m willing to accept on that injured limb before thinking we’re at a safe point’—where maybe that athlete can be put back into more strenuous practice, or back into the game itself.”

Similarly, DXA metrics of the compromised limb from before injury can be used as that marker for recovery. Dr. Dengel described an example of waiting for an injured leg to measure 10-20% on a DXA metric of where it was pre-injury, and then being able to base re-entry on concrete variables, instead of just saying, “Yeah, [they] seem okay now.” The ability to base an athlete’s timeline for returning to the game on these exact metrics, rather than estimates, has clear implications for player safety and long-term wellness—as well as positive benefits to overall team performance by ensuring all players are at their best.

Unique Applications to Player Recruitment

While it’s clear universities rely on DXA for training established players, did you know DXA systems can also play an important role before an athlete is even officially on the team? Dr. Dengel spoke about how the technology is used during player recruitment by allowing coaches to say, “We are looking for an athlete that looks a certain way because, in our experience, this is the ‘look’ that will help us.” The “look” he’s referring to is a player’s composition as evaluated by DXA. The tool allows coaches to identify what they’re looking for in players based on body composition metrics, which both saves time and can provide stronger recruiting results. 

As an example, Dr. Dengel told of his experience seeing DXA technology used during the NFL Combine Training Program. “We had 330 players, and you don’t want to have to shake through all 330 players to find the seven draft choices you get. You want to get down to a very small pool. So using these [DXA] metrics, you can kind of say, ‘That wide receiver doesn’t fit what we want, we need our wide receivers to look like this’—or ‘this guy has that composition we want.’” Based on this ability to more quickly filter through potential drafts based on their body composition measurements, “That took us from 30 wide receivers down to eight, and then we could spend our time looking at those eight and deciding which of those eight is the best one.” 

Dr. Dengel explained it’s helpful for coaches to know upfront what they’re searching for, as “some teams won’t realize until they look at the compositions that, ‘Wow, for the past 10 years we’ve been drafting this same kind of player. I wish we could have saved ourselves a lot of time … because we know what they look like if we look at the composition.’” These additional applications to draft picks are truly bringing in a new wave of athletic recruitment, both at the collegiate and national levels. 

Stacking Up Against the Competition

During part one of our conversation with Dr. Dengel, he spoke to the speed of the system and the Hologic support portal as two factors that make Horizon DXA System stand out from the competition—but that’s not all!

Dr. Dengel also discussed how a key differentiator of Hologic’s system is the inclusion of the NHANES database, the public database created by the United States to track bone health. Horizon DXA System’s reference database is made up of over 20,000 individuals from an NHANES study conducted by the CDC2 to ensure the system is backed up by the most clinical research possible.

 “If I’m interested in using the [public health information] data … I would prefer that I have a Hologic. Even though the scanners are measuring the same thing, there are little subtle differences between them and I’d want to have the scanner that has that NHANES data as its core,” Dr. Dengel explained.

In terms of versatility of scan angles, Horizon DXA System comes out on top again according to Dr. Dengel. “When we have the Hologic system, you’re looking at a C-arm system with the table and the arm moving, which allows you to get a few different angle scans that you’re not going to get from the single tracking scanner. If you really want to get those different angles, then the Hologic scanner speaks better to that style.” 

Horizon A DXA Systems are the only DXA systems on the market with a rotating C-arm, which allows for supine IVA™ scans and fast whole body scans3 using a large, 24” clearance. Getting visibility into a variety of angles can be crucial for areas like vertebral or hip scanning, where single tracking imaging might not be able to capture the entire area. 

It’s safe to say between the speed, access to support, inclusion of NHANES data, and rotating C-arm capabilities, Horizon DXA  System is truly the gold standard choice for the University of Minnesota. 

The Future of DXA

Dr. Dengel is a firm believer there’s more room for DXA to grow, both in the athletic sphere and beyond. “I think there’s a lot more potential in DXA than we’re scratching right now. Where else can we go with it? How do we make it better for the sports population, and not just exist in the clinical world?” If you’re looking for answers to these questions, Dexalytics.com is a good first stop for the latest insights in Dr. Dengel’s research.

DXA is just getting started—reach out to a rep to talk about how you can get ahead of the game.


  1. Shepherd et al, Body Composition by DXA,  Bone (2017)
  2. Kelly TL, Wilson KE, Heymsfield SB (2009) Dual Energy X-Ray Absorptiometry Body Composition Reference Values from NHANES. PLoS ONE 4
  3. Market assessment as of April 2021 has three major companies on the market – GE, Hologic, and Norland.

GE iDXA and Prodigy do NOT have rotating C-arms.

Norland systems do NOT have rotating C-arms.

Smaller DXA brands such as Osteosys or DMS also do NOT have rotating C-arms.

Disclaimers: Dr. Donald Dengel is a paid Hologic consultant. The content in this piece is for information purposes only and is not intended to be medical advice. Please contact your medical professional for specific advice regarding your health and treatment. This information may be relevant in the U.S. and other markets and is not intended as a product solicitation or promotion where such activities are prohibited. Because Hologic materials are distributed through websites, eBroadcasts and tradeshows, it is not always possible to control where such materials appear. For specific information on what products may be available in a particular country, please write to womenshealth@hologic.com.

Hologic, Science of Sure, and Horizon are trademarks or registered trademarks of Hologic, Inc. and/or its subsidiaries in the United States and/or other countries. All other trademarks, registered trademarks, and product names are the property of their respective owners.

*Rx Only – use of the Hologic DXA System is restricted by or on the order of a physician.



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