ARE HIGH-IMPACT EXERCISES
NO MORE STRAINING THAN
RUNNING?
by Owen Anderson, Ph. D.
Copyright 2002-2004
Individuals who run in their sports are sometimes told to
avoid "high-impact" exercises for their legs, including "plyometric" activities
which involve bounding and "drop-jumping" from benches and platforms, in the
belief that such exertions carry with them a high risk of injury. As a result,
many running athletes avoid high-impact drills, even though such efforts are
believed to increase running power. Are the high-impact-exercise naysayers
correct? Should athletes who run really stay clear of such activities?
In an attempt to find out, researchers at the Hebrew
University Medical School in Jerusalem, Huddinge University Hospital in Sweden,
and the Indiana University Medical Center recently took a look at the forces
acting on the shin bones (tibias) of athletes during both running and jumping
activity (1). The choice of bone as a general tissue to study and the selection
of the tibia as a specific bone to monitor were excellent decisions. The tibia
is very prone to stress fractures in athletes who run (in fact, about 50% of all
stress fractures in athletes occur in the tibia), and it is believed that
jumping exercises may increase the risk of such fractures. In addition, bone is
a highly mechanically responsive organ which must be strong enough to withstand
both high, sudden forces as well as low-level repetitive impacts; it is
important to understand which kinds of forces are most likely to induce bone
injury.
The forces placed on the tibia during running and jumping are
the result of both muscular "pulling" on the bone during activity and (of
course) gravity. Bone strains are measured in units called "microstrains," and
most forces placed on the tibia during activity produce strains which are only
20 to 30% of its "yield strength" (breaking point) of about 10,000 microstrains.
This makes it seem as though the tibia would almost never be fractured during
normal sporting actions, but one problem is that repetitive activity can create
small-scale damage in the tibia which can accumulate and eventually cause the
bone to fail at stresses considerably below 10,000 microstrains.
Research reveals that military recruits are at a very high
risk of experiencing tibial stress fractures, possibly because their leg muscles
are weak and fatigue easily (leg muscles can act to absorb impact forces and
thus protect underlying bone, but they do this poorly when they are tired); in
addition, the recruits’ biomechanics may be sub-optimal (flexion of the knee and
ankle during jumping can diminish the amount of "hammering" the tibia receives,
while failure to achieve such flexion puts added pressure on the tibia), and
they may have low rates of repair of tibial microdamage as a result of
previously sedentary lifestyles (it is possible that bone-repair rates are a
function of fitness; as training level increases, within reason, bone-synthesis
rates may also accelerate). Fairly well-trained athletes who increase their
volume of training quite suddenly, however, are also at risk of tibial stress
fractures, presumably because the increased number of impact forces associated
with the new training creates a large amount of microdamage, which can
eventually lead to failure in one section of the bone.
The "man on the street," of course (and the "woman on the
street," too), would expect that jumping exercises would produce greater tibial
strains and therefore a great risk of tibial stress fracture than mere running
(and of course there are a lot of men on the street in the coaching and
sports-publishing ranks – and that is one reason why runners are often told to
avoid plyometrics). After all, jumping activities allow the tibia to fall from
greater heights, thus enhancing tibial acceleration toward the ground and the
resultant impact forces with terra firma. To see if things really work
this way from a tibial perspective, the Jerusalem-Huddinge-Indiana researchers
worked with six subjects (four males and two females aged 27 to 52), stapling
strain gauges to the middle, inside portions of their right tibias (surgical
implantation of the strain gauges was performed on an outpatient basis at the
Hadassah University Hospital in Jerusalem). Happily, the gauges – and staples –
were removed on the same day after completion of the data collection.
The gauges were utilized to measure tibial strain as the
subjects ran for 100 meters on a cinder track at a velocity of 17
kilometers/hour (about 5:41 per mile), which was set by a pacer. The drop-jump
measurements were made sequentially as the athletes jumped from wooden blocks of
26-, 39-, and 52-cm (10-, 15-, and 20-inch) heights onto a force plate.
Interestingly enough, there was no statistically significant
difference in tension, shear strain, or compression forces on the tibia as
drop-jump height increased from 26 to 52 cm. In addition, there was an actual
reduction in shear strain rate (the rapidity with which shearing
force is applied to the tibia after impact) as jumping height increased. With
the highest wooden block (52 cm or 20 inches), sheer strain rate was actually
reduced by 30%, compared with the lowest block! Similarly, compression and
tensile strain rates at the greatest height were reduced by 35%, compared with
the rates associated with jumping from the lowest box.
Since there was no difference in the total magnitude
of the compression strain of the tibia associated with the height of the drop,
it was clear that the subjects were able to dissipate part of the potential
energy of successively higher jumps and not transmit that energy to their
tibias. Video recordings of the jumps suggested that this dissipation of force
occurred as a result of increased knee flexion and ankle dorsiflexion during
landing. To put it another way, changes in the subjects’ mechanics of landing
protected their tibias.
Video analyses of the athletes revealed that the ankle was
particularly important in dissipating force; in fact, ankle dorsiflexion (ankle
movement which brings the top of the foot and the shin closer together)
increased by roughly 66% at the greater jumping heights. Other studies have also
shown that athletes naturally modify their landing techniques according to the
height of a jump (2).
Now, here are the key findings which will help us resolve our
original question about the dangers of high-impact activities for athletes who
run: The principal strains and forces associated with drop-jumping from the
greatest height of 20 inches were not significantly different from the strains
and forces associated with running. In fact, compression and tension strain
rates were actually greater during running than they were during
drop-jumping! So much for the idea that two-leg drop-jumping produces
dramatically higher forces on athletes’ tibias, compared with running!
One of the beauties of the present study was that it employed
in-vivo measurements of bone strain; previous work had utilized force
plates, video-motion analysis, and accelerometry to estimate – rather than
directly measure – the strains placed on leg bones during landing. This
Jerusalem-Huddinge-Indiana work gives us a much better picture of the forces
which the tibia actually experiences during running and jumping.
One factor to keep in mind, however, is that muscular
shock-absorbing mechanisms in the legs are most effective when an athlete is not
in a fatigued state. One study found that the strains on the tibia increase by
about 30% during walking when leg muscles become tired, for example (3). A basic
problem which muscles must confront when they are fatigued is that they transfer
energy from their stretched states to their contracted states more slowly, an
effect which can produce a 50-% increase in tibial acceleration during normal
gait (4). Thus, it is critically important to carry out high-impact exercises
when one is "fresh" and non-fatigued. Naturally, a thorough – but non-fatiguing
– warm-up should always precede high-impact activity. The astute reader will
also note that an athlete, particularly one who is susceptible to stress
fractures, should also avoid running when the leg muscles are
particularly fatigued. Completing a second or long workout on a day when one is
significantly fatigued can be an invitation for stress fractures to begin
developing.
Running produces greater accelerations of the legs than does
walking, and running consequently induces tibial strains and strain rates which
are two to three times greater than those associated with walking. Drop-jumping
can produce downward-directed accelerations of the legs which are larger than
those produced during running, and thus it is only natural to expect that
drop-jumping would create tibial forces higher than those linked with running.
However, note that running is a "one-leg activity," with full body weight and
impact forces being absorbed by one leg at a time, not two. In this study,
drop-jumping was carried out on two legs, which should help to mitigate the
forces experienced by each appendage; indeed, most athletes begin plyometric
programs with two-leg drop-jumping and build up significant coordination and
strength with the technique before moving on to one-leg dropping. In addition,
the research shows that athletes naturally modify their mechanics in order to
moderate the strains experienced by their tibias when jumping from increasing
heights. The two-leg technique and the biomechanical alterations are quite
effective, as witnessed by the actual decreases in tension and
compression strain rates exhibited by the athletes in this study during
drop-jumping, compared with running. The Jerusalem-Huddinge-Indiana researchers
were quite justified in concluding that two-leg drop-jumping exercises do not
produce higher tibial strains and strain rates, compared with running, and thus
would be unlikely to increase the risk of bone fatigue stress fracture in the
running athlete who carries out drop-jump training in a reasonable way.
Interestingly enough, drop-jumping exercises actually tend to
increase bone density in the legs (5), an effect which should help to
decrease – not increase – the risk of stress fractures. Drop-jumping
should also improve coordination, an effect which can lower injury rates. So –
the next time you hear someone say that drop-jumping activities and their ilk
will hurt you, it’s OK to chuckle a bit. If the purveyor of such "wisdom" is one
of your competitors, there is no need to provide a retort. If not, however, you
can help the young ignoramus by indicating that two-leg drop jumping should
actually be an anti-injury technique, not an injury promoter, and it may help
improve running speed, too. ©
References
(1) "Do High Impact Exercises Produce Higher Tibial Strains
than Running?" British Journal of Sports Medicine, Vol. 34, pp.
195-199, 2000
(2) "The Evaluation and Prediction of Impact Forces during
Landings," Medicine and Science in Sports and Exercise, Vol. 22, pp.
370-377, 1990
(3) "The Effects of Muscle Fatigue on Bone Strains,"
Journal of Experimental Biology, Vol. 188, pp. 217-233, 1994
(4) "What Leads to Age and Gender Differences in Balance
Maintenance and Recovery?" Muscle Nerve Supply, Vol. 5, pp. 60-64, 1997
(5) "Pre- and Postmenopausal Women Have Different Bone
Mineral Responses to the Same High-Impact Exercise," Journal of Bone
Mineral Research, Vol. 13, pp. 1805-1813, 1998
Thank you Dr. Anderson for giving permission to republish this article.