(NYPost Photo Composite from 2017)
You may have heard"An ounce of prevention is worth a pound of cure" which credit has been given to Benjamin Franklin, one of the Founding Fathers of the United States of America, for speaking these words. I can't help but relate that quote to my ongoing interest and work in the arena of sports injury prevention. Injuries are a common finding amongst sports participants. Depending on the physical demands of the particular sport and commonalities amongst the participants, patterns of "common" injuries exist. This is specifically true with regard to running related injuries (RRIs).
It is no surprise that injuries at or below the knee are the most prevalent in the world of running. According to a 2021 systematic review of running related musculoskeletal injuries in runners by authors Nicolas Kakouris, Numan Yener, Daniel T.P. Fong, "For both ultramarathoners and non-ultramarathoners, the knee and ankle regions had the highest incidence proportion of injuries." https://www.sciencedirect.com/science/article/pii/S2095254621000454
It would be appear to be a worthwhile endeavor for all ultramarathoners and non-ultramarathoners to seek out preventative strategies to avoid running related knee and ankle injuries. This is especially true if runners wish to enjoy longevity of participation in their sport. This systematic review utilized a wider inclusion criteria compared to past systematic reviews, to be able include larger populations of runners, like me, in their findings. It is because of research studies and publications such as this one above, that "what we know" about running related injuries continues to expand. There are now, more than ever, a hefty list of modifiable and non-modifiable risk factors associated with RRIs. Of the risk factors that I will speak briefly about here are the modifiable risk factors.
Modifiable risk factors are the conditions or situations in which you can do something about to address or prepare for. An easy example would be that people who do not hydrate enough before running are more likely to suffer signs and symptoms of dehydration while participating. To modify that risk factor, a person could be sure to hydrate properly prior to, during, and after participating in running. This is a more well-known prevention strategy given all that we know from the sports and medical fields as it related to hydration.
Is there another really easy modifiable risk factor and prevention strategy that maybe the majority or the masses who regularly participate in running are not utilizing? I believe the answer to that question is YES. Enter Plyometrics and The Jump Rope....
With a quick internet search about the origin's of the jump rope, I now have in my possession a copy of Nicholas Dean Woodard's May 2020 Master's of Science Thesis paper from the University of Tennessee titled, "Jump Rope Connecting the Past, Present and Future". You can read it here: https://trace.tennessee.edu/cgi/viewcontent.cgi?article=7096&context=utk_gradthes
I am certain that Nicholas crushed his thesis and I will admit that I did not read all 83 pages of it (I'm not covering double dutch jump rope at this time). But what we do know, especially thanks to Nicholas, is that jumping rope has been around for at least a few hundred years. It might seem like it has been "a few hundred years" since you yourself jumped rope. Maybe you never have. I remember using a jump rope in grade school physical education classes. I also remember a game I used to play where one friend stood in the middle of a circle of other friends and they spun around with a jump rope in tow. The object of the game was to not let the jump rope hit your feet or you would be out. I believe it is or was called Helicopter.
I actually own a jump rope. I honestly don't entirely remember how I came to have it. Maybe it was a spontaneous buy at TJ Maxx by my wife or myself. I am guilty for buying things I don't immediately need at TJ Maxx and a lot of you probably are too :-) But after having heard about the potential benefits of jumping rope with regard to running I sought out more information to see how it might be something that might be able to help me and others who I work with. Can jumping rope help with injury prevention and running performance?
In an article titled, "Jump-Rope Training: Improved 3-km Time-Trial Performance in Endurance Runners via Enhanced Lower-Limb Reactivity and Foot-Arch Stiffness" from January 2019, García-Pinillos et al set out to determine the effects of incorporating jump rope during the warm up routine for amateur endurance runners. They concluded that, "Compared with a control warm-up routine prior to endurance-running training, 10 weeks (2–4 times/wk for 10-20 min/week total) of JR training, in place of 5 minutes of regular warm-up activities, was effective in improving 3-km time-trial performance, jumping ability, RSI, and arch stiffness in amateur endurance runners". Furthermore, "Improvements in RSI and arch stiffness were associated with improvements in 3-km time-trial performance." https://journals.humankinetics.com/view/journals/ijspp/15/7/article-p927.xml
Given that jumping rope is essentially another variation of plyometric training, the potential benefits of increased speed, power, and agility are appealing for any sports participant and especially runners. Running is an activity that exposes the body and all of its tissues to a significant amount of repetitive load. Arni Armason, was a guest author in Craig Liebenson's Functional Training Handbook. In a chapter titled, "The Role of Musculoskeletal Fitness in Injury Prevention in Sport" Arni defines injury as the moment when "biomechanical load becomes higher than the tolerance of the potential structure". It is further explained that, "this can occur either if the biomechanical load is too high or if the tolerance against a certain biomechanical load is reduced". García-Pinillos et al conclude that jump rope training drills and their positive effect, "are probably related to lower mechanical stress than other plyometric exercises like drop jumps performed from high heights". It is believed that, "this may help to 'preserve' the musculoskeletal system from excessive loading, especially before habitual running sessions".
So how easy is it to begin incorporating this into your running program? First you will need a jump rope. Here is a link from a Runner's World Article from January 2022. If you want to try to match the protocol that was used in the Garcia-Pinillos et al study, you will want to make sure that:
(1) rope rotation should be generated by the wrists with minimal movement of the elbows and shoulders
(2) jump height should be maximized and ground contact time should be minimized
(3) landing should be softened on the forefoot and with the knees slightly flexed.
Wirth regard to progressions or modifications, the participants used a 30s:30s work:rest ratio for each 5 minutes session until weeks 9-10 where they switched to a 40s:20s work: rest ratio. The # of weekly sessions of jump rope increased from 2x/week to 4x/week. Cadence increased from 100->120->140 rpm. And last of all, the type of jumping started with bilateral progressing to unilateral and finally alternating between the types.
In Conclusion:
It appears that jumping rope may serve a dual purpose by exposing the "jumper" to a reduced biomechanical load (compared to higher plyometric loads like drop jumps or running) while improving tolerance to biomechanical load which ultimately has the potential to reduce your risk of a running related injury. Research about plyometric training are showing that they are not only a critical component for the effectiveness of return to sport following an injury but is also critical to design and implementation of a well rounded injury prevention program.
Be well!
Dr. Matt
If you or someone that you know is struggling with a current sports or running related injury and you are stuck trying to find out where to begin or what to do/not to do, don't guess. You don't have be stuck in pain or feel hopeless any longer. Let VanSlyke Physical Therapy help get you back to doing the things that you love to do! You can start here to book an appointment with me.