Many people think of bones as inert or inactive – only being stimulated by growth or repair after a bone breaks. However, bones are continually remodeling themselves in response to daily/weekly/monthly load demands – bone is one of the most highly active and alive tissues in our body! In basic terms, when we expose our bones to impact such as running and jumping, the bone adapts itself by increasing the harder part of the bone along the lines of stress we put through it. In essence the bone gets stronger as direct response to the directional demands we put through it. If that load or demand is taken away, then the bone will gradually resorb (chew up) the excess hard bone that it no longer needs. When we increase or decrease weight-bearing load and impact gradually, the bone adapts beautifully to the changed demands. The body has time to process the demand and produce a suitable conditioning response to prepare it for the next time that load is placed on it. Physio’s call this adaptation. Problems can occur if that load on the bone is changed suddenly or excessively. Adolescents and children are more vulnerable to bony problems rather than soft tissue problems when compared with adults.

During this current COVID period of time away from the gym or studio, many coaches have provided home programs for strength and flexibility. It is important to also ensure that gymnasts/dancers (and competitors in other impact sports such as basketball/soccer/football) maintain a level of impact training to help minimize the chance of bony injuries (and other injuries) on return to regular training.

A recent paper released by the Australian Institute of Sport, entitled “Prescription of training load in relation to loading and unloading phases of training,” states that ‘if an athlete trains at 60% of their normal volume and intensity for 2 weeks, it takes 10 days to progressively return to full training load to reduce injury risk. Longer breaks in training and greater drops in volume and intensity require a longer progressive return to full training to reduce injury risk’. Think about the training level you or your child has undertaken during this isolation period compared with normal levels during organised sport – it is likely to have been significantly less than 50 % of normal and maybe MUCH less when considering impact.

Given this knowledge, it would be sensible to start introducing some impact loading at home before a return to gym/studio/other, which is now thankfully not far away. Keep in mind that in jumping athletes like gymnasts and dancers we are talking about vertical loads that are equivalent to between 8 and 14 times body weight – if you weigh 50kg, you may need to absorb around 500kg of force every landing: you need strong bones (and muscles and tendons)!

It can be quite simple, particularly in the beginning. For example:

  • jumping off a step and controlling the landing (bottom back, knees behind toes – see image)
  • jumping off a step and rebounding straight into another jump
  • “stomp” skipping (skipping with an exaggerated stomp and push off each foot)
  • Repeated hops on each leg (perhaps 5 to begin and gradually increase) – controlling the leg position (good to do in front of a full length mirror to ensure the knee doesn’t roll in on landing)
  • Running and “punch” like a beat-board take off or a front sault take off
  • Short sprints at an oval

It is important to perform these impact based activities a few times per week to stimulate the bony remodeling that will help prevent injury. Just make sure for landing drills that the athlete maintains technique, namely:

  • Feet hip width apart
  • toes, knees, hips, and shoulders close to inline (generally)
  • core engaged in relative neutral (not excessively hollowed or arched)
  • proper angular displacement of the hip and knee joints
  • hip angle generally 30 degrees, and trunk / tibial lines close to parallel

Remember too that some drills should be practiced when fatigued – don’t always do these drills when fresh, try at times to practice technique when tired. Specific programs can be designed at the clinic dependent upon the level of training the athlete will return to.

Image courtesy of hybridperspective.wordpress.com

Jen Turner

SSPC Physiotherapist