How can I prevent injuries during step aerobics?Step aerobics was first introduced in Atlanta by a injured aerobics instructor, Gin Miller. She started climbing her porch steps as a form of rehabilitation
for a knee injury and realized that "stepping" was not only a low impact, non-irritating form of exercise for her knee but also provided a good cardiovascular workout.
Ms. Miller then began introducing step aerobics into the health clubs at which
she taught. Shortly afterwards Ms. Miller teamed up with Reebok and formed Step
ReebokTM. The rest is fitness history.
Force platform studies have shown that step aerobics is a low impact activity
yet has a high energy cost and produces a good cardiovascular workout. A comparison
that is usually made equates an hour of step aerobics with the same energy expenditure
as running seven miles yet with the impact of walking at a three mile a hour
pace. A key factor that contributes to this low impact/high intensity situation
is that one foot is in contact with the ground or bench at all times, compared
to running when both feet can be off the ground. However the participant can
however increase the stressful loads on the feet and legs by raising the bench
height, hopping on and off the bench, using hand weights or using improper technique.
Many of the reported step aerobic injuries are caused by technique errors
or using a bench height that is too high for the participant's leg size. One
of the more common technique errors is poor foot placement on the bench. By
not having the foot fully placed on the bench, the heel can extend over the
edge of the bench. This allows the heel to drop below the top of the step bench
and done repetitively the Achilles tendon may get over stretched causing an
Achilles tendinitis.
Another technique error is bouncing or hopping up and down off the bench. This
puts a greater force load on the feet and legs especially if the participant
is jumping off the bench with hand weights instead of stepping down. Stress
fractures, shin splints and forefoot injuries, such as, metatarsalgia ( toe
joint inflammation) and sesmoiditis ( inflammation of the two small bones below
the first metatarsal- ball of the foot) can result.
A bench that is too high for the participant's leg size also causes its fair
share of problems. As the bench height increases a greater force load is placed
on the knee joint and patellar tendon in the step up position since the knee
needs to flex more to accommodate the step height. A good rule of thumb is never
to use a bench higher than what is required for the knee to flex 83°-90°.
As the bench height increases the participant's foot lands farther away from
the bench when stepping down and back. This requires a lot of flexibility in
the toe joints. If the participants foot has any structural deformities that
cause limited toe joint motion such as bunions or hammertoes the likelihood
of developing metatarsalgia or sesamoiditis is greater.
An increase in bench height will increase the load on the leg and foot setting
the stage for the development of stress fractures. At the first sign of knee,
foot or leg pain during step aerobics try to lower the bench height: this will
reduce the force load on the injured area. Also evaluate fitness shoes for wear;
shoes should have good forefoot padding and not be too flexible.
Ayne Furman, D.P.M. Fellow, American Academy of Sports Medicine
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