On the bench: how to keep training when you’re recovering from an injury

During injury or rehabilitation periods, many runners are resigned to cross-training. But which activities are best? The short answer is anything that doesn’t exacerbate your problem or cause pain. But while your heart and lungs don’t have a clue what type of exercise you are doing, your neuromuscular system certainly does, which is why the more similar an activity is to running – in terms of movement patterns and muscle recruitment – the greater the “transfer of training” (that is, the crossover benefit to your running). So, how do the options stack up?

(Note: calorie expenditure below is based on standardised metabolic equivalent tasks – METs – an estimate of the energy requirement for a given activity compared to being at rest, for a person weighing 140lbs, or 10st. Expect individual variation, influenced by gender, age and body composition.)

Aqua-jogging

Water running or “aqua-jogging” is one of the most running-specific cross-training options there is. It entails exactly what it says on the tin – running in water, usually with a flotation belt around the hips to help keep you upright and afloat. It’s a great choice for impact-related injuries like stress fractures and shin splints.

Muscle usage: A Japanese study found no difference in muscle activity in the hamstrings, quads and shins compared to running on dry land, but lower levels of calf activity mean this could be a good option for those suffering calf or achilles tendon issues. But you may have to work a bit harder – a study from the University of Nevada found that exercisers needed to reach a higher rate of perceived exertion (RPE) to achieve the same overall magnitude of muscle activation as normal running. An RPE of 15 (rated “hard”) in water running elicited a similar level of muscular activity as a rating of 11 (fairly light) on a treadmill.

Calorie expenditure: High-intensity water running will burn around 570 calories an hour. If your efforts are more akin to treading water, it’s around 350 calories.

Make it count: Monitor your effort level, not heart rate, to ascertain intensity – heart rate is always lower in water-based activity. Focus your aqua efforts on interval training to make sessions shorter and curb boredom. And don’t try to achieve the same cadence (steps per minute) as you would on dry land – researchers from the Auckland University of Technology say cadence is significantly slower at an equivalent intensity.

Stepper

This is a low-impact option which mimics the alternate-leg action of running. A study from Trinity College Dublin found that the stepper and elliptical trainer (see below) compared well to running in terms of fitness gains. In a 12-week study, improvements in maximal oxygen uptake (V02 max) made by a group of women assigned to one of the three modes of training for the same duration and at the same intensity were equally good.

Muscle usage: The entire lower body musculature is used – particularly the quads, glutes and calves. In a comparison study from the University of Wisconsin-La Crosse of the stepper and an elliptical trainer, hip flexion was significantly greater on the stepper, so perhaps it is not the best choice for those with hip injuries. Texas A&M University recommends the stair-climber as a good adjunct or alternative to cycling for those rehabbing anterior cruciate ligament (ACL) injuries.

Calorie expenditure: Around 382 calories per hour for moderate intensity stepping.

Make it count: Don’t slump forward over the control panel. Stand upright and if possible, go hands-free. Use a relatively swift cadence and don’t pile on too much resistance, which makes the action less similar to running.

Cycling

There’s no doubt that cycling is a great complementary activity for runners – a study in the journal Medicine & Science in Sports & Exercise found that when runners added interval training on a bike to their usual running regime, they improved their 5km times by an average of 30 seconds within six weeks. That’s not to say they wouldn’t have done so by adding running interval sessions – but doing so might have tipped the balance of intensity a little too far.

Muscle usage: Cycling is heavy on the thighs, with 39% of the total work performed by the quadriceps. The hip extensors (glutes) also play a big role, contributing 27% and the calves, 20%. The Scandinavian researchers who calculated these muscular usage contributions recommend cycling for the rehabilitation of knee ligament and achilles tendon problems.

Calorie usage: It all lies in the speed and terrain. A leisurely 12mph would burn 509 cals per hour. A racier 18mph would take you closer to 763 calories (the equivalent of a running pace of 8.15 per mile for our 140lb person). An hour-long spin class comes in at 540 calories.

Make it count: Ride at whatever cadence (revolutions per minute) feels best to you. In recent years, it’s been popular to suggest trying to “match” your cycling and running cadence (for example, 90 steps or revs per minute per leg) but a recent study from the University of Western Australia (pdf) found no evidence to support this, while other research in the Journal of Sports Physiology and Performance (pdf) found that attempting to maintain a high cycle cadence during low-to-moderate intensity riding was uneconomical and fatiguing.

Swimming

The obvious distinction (apart from the fact that your body position is horizontal) is that your body weight is supported by the water when swimming, which can be a great way of unloading injured joints or soft tissue.

Muscle usage: Varies according to stroke. As much as 80% of the work in crawl is done by the back, shoulders and arm muscles which can make it the best option for those with leg injuries, while in breast stroke, the lower body musculature does the lion’s share (best avoided if you have knee problems). Backstroke offers more of a balance between upper and lower body.

Calorie expenditure: Again, it differs according to stroke, and also efficiency (thrashing around in the water burns more calories than slicing through it). As a snapshot, swimming front crawl laps at a moderate to vigorous pace burns 528-623 calories per hour (9.8 METs). More sedate swimming, or slower strokes such as backstroke and breaststroke, approximately 445 calories per hour.

Make it count: Learn proper technique for every stroke. Don’t swim with your head out the water, which puts extra stress through your neck and spine.

Elliptical trainer

As mentioned above, research showed that the elliptical trainer (or cross-trainer) matched up to the treadmill very well in terms of fitness gains, but the kinematics are subtly different.

Muscle usage: Of course, it’s low impact, but joint flexion angles at the knee, hip and ankle are greater, which, say researchers in the journal Medicine & Science in Sport & Exercise, may not be beneficial in the case of injuries to these areas (they specifically mention the knee). However, a study of muscle activation in Physical Therapy (Feb 2010) found lower activation of both major calf muscles, even compared to walking, so it could be a good bet for runners with calf or achilles problems. Calorie expenditure: 318 calories per hour for moderate effort

Make it count: To make the action more running-specific, ditch the arm poles – a study published in Research Quarterly for Exercise and Sport noted a higher rate of perceived exertion but not higher heart rate, when using the arm poles compared to legs only. In other words, it feels harder but it isn’t.

Walking

Travelling over ground by putting one foot in front of the other, walking is very similar to running all but for the absence of a “flight” phase, when both feet are off the ground simultaneously. The forces exerted on the joints are consequently much lower during walking than running (approximately 1x body weight compared with 2-3x body weight) which can make it kinder on the joints. The problem is getting the intensity high enough to challenge the cardiovascular system. For runners, adding hills is more effective than increasing speed.

Muscle usage: A study from the University of Texas at Austin (pdf) found that muscle usage between running and walking at the same pace differed surprisingly little after monitoring activity in 10 muscle groups, including all the major muscles of the legs. Power output was lower in walking, however.

Calorie expenditure: At a comfortable 3mph pace, you’d burn around 210 calories. A brisker 4mph clip? 255 calories.

Make it count: Be prepared to walk for longer than you would run for to get the same benefits. A study earlier this year from Lawrence Berkeley National Laboratory in California estimates that a 4.3-mile walk at a brisk pace would be needed to substitute a 3-mile run.

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