What do runners, cyclists, and swimmers all have in common? They are all great at propelling themselves forward.
Endurance athletes are adapted to moving as efficiently as possible for long periods of time in the sagittal plane. This means that the body has to make sacrifices: other planes of movement, changes in direction and speed, and motor patterns that are “superfluous” to their main goal can easily fall by the wayside.
Unfortunately, this means that if endurance athletes don’t counteract those trends, they are at greater risk of injury due to repetitive stress and muscular imbalances.  In fact, recent research suggests that endurance athletes likely have inferior bone density compared with athletes in other sports. 
Why is that? Several studies suggest that distance running—despite being a high-load activity through a single leg—can actually suppress bone formation and induce lower bone density in the limbs and spine. [3, 4] This is likely because bone health is reliant on high-impact, multi-directional, irregular, and multiplanar loads…and endurance sports don’t have a lot of that!
Don’t worry, the solution is not to quit your sport. And you don’t have to go through hours of arbitrary “hip strengthening” or arduous powerlifting drills to sidestep the risk. Here are some simple exercises you can start today to mitigate your risk of bone stress injuries and other repetitive stress injuries.
Workout of the Week: Plyos
Progression 1: Plyometric Drills
The simplest solution to your monoplanar problem is to sprinkle in some high-impact jumping in other planes. You can have fun with this. One option is to throw on your favorite tune and jump around, changing direction and being irregular with what foot you land on.
If you need a more precise list, try this one up to three times in a week, ideally before your training activity for the day. You should feel your muscles working but not fatigued to the degree that your form suffers.
- 10 box jumps, forward and backward
- 10 side-to-side box jumps
- 2 × 15 ea. lateral bounds
- 2 × 10 ea. lunge jumps
Progression 2: Targeted Strengthening
You do not need to spend hours making your body good at everything. There’s a reason you’re good at your sport, and you should spend your time mitigating your risk while continuing to improve in performance. With that in mind, these exercises are proven to help endurance athletes with lower bone density and/or a history of repetitive stress injuries.
- 2 × 15 single-leg calf raises with straight leg
- 2 × 15 single-leg calf raises with bent leg
- 4 × 10 lateral band walks each way
- 3 × 15 sec. each side plank
For information on plyometric interventions, reach out to me here.
- Lowry, Maryn E., “Bone Stress Injuries in Collegiate Distance Runners: Review of Incidence, Distribution, and Risk Factors” (2019). Graduate Student Theses, Dissertations, & Professional Papers. 11424.
- Hetland ML, Haarbo J, Christiansen C. Low bone mass and high bone turnover in male long distance runners. J Clin Endocrinol Metab. 1993;77:770–775.
- Effects of Resistance Exercise on Bone Health.Hong AR, Kim SWEndocrinol Metab (Seoul). 2018 Dec; 33(4):435-444.
- Brahm H, Ström H, Piehl-Aulin K, Mallmin H, Ljunghall S. Bone metabolism in endurance trained athletes: a comparison to population-based controls based on DXA, SXA, quantitative ultrasound, and biochemical markers. Calcif Tissue Int. 1997;61:448–454.