Avoiding Step Aerobics Injuries

What should I do to prevent getting an injury during step aerobics? During the winter months I stop running outside and begin doing indoor fitness training. This winter I was thinking of staying in shape with step aerobics.

Answer, provided by Ayne Furman, D.P.M. Fellow, American Academy of Sports Medicine

Q: How can I prevent injuries during step aerobics?

A: 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.

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