Alan K. Sokoloff, DC, CCSP
This is the 10th anniversary of a relatively new sport called competitive aerobics. It was developed in 1984 by Karen and Howard Schwartz when "they decided to create a standard competitive format from a recreational one that would give gifted athletes an unparalleled opportunity to challenge their abilities in head-to-head competition." Originally a primarily showmanship sport, this event has developed into a world-class event with olympic potential, and over 35 countries involved. Unlike the regular aerobics class you may take at a health club, or along with your favorite TV star on their new workout video, competitive aerobics is an individual or team sport, for men and women, that places athletes against each other in judged performances.
Though it is a world-class event, the present governing bodies have developed competitions for the novice, as well as the elite athlete. The importance of this is the difference in injury sites and frequency of these conditions seen at each level. At the present time, through the National Aerobic Championships (NAC), there are nine regional events around the country with a national open, and the national finals, an accumulation of all the regional winners. The next level of competition takes you into the United States preliminaries for selection of the athletes to represent the U.S. in the World Aerobic Championships.
As the event coordinator for the ACA Council of Sports Injuries and Physical Fitness, in conjunction with the NAC for the last five years, I have had the privilege of working with some of the finest sports chiropractors in the country, who have and continue to help accumulate data regarding the injuries seen at all levels. For our purposes, we will focus on the more elite athletes who compete. As you will see, there is a great difference between novice competitors and athletes at the national level.
Competitive aerobics encompasses moves and exercises from disciplines such as gymnastics, figure skating, dance, and the basic aerobic class combined into a unique event of its own. The actual performance is 1:40-1:50 seconds of high intensity, powerful moves demonstrating strength and flexibility in a safe, well coordinated/choreographed routine.
At the competitive level, as well as in generic aerobic classes, injuries can be broken into two categories, overuse and acute/traumatic. Because this sport is primarily weightbearing on the lower extremities, a majority of the injuries are seen in this region. This is consistent with the data I have received from field doctors as well as recent research.
The single most important aspect for evaluating and then treating these athletes, as in other sports, is the mechanism of injury. Following establishing the biomechanics of the injury, the athlete's history is essential. As a majority of the injuries and conditions seen in competitive aerobics are due to overuse, inquiring about preexisting conditions or prior injuries becomes a necessity.
One of the primary differences between recreational aerobics and competitive aerobics is the occurrence of upper extremity injuries. As many of the weightbearing exercises are executed on the hands/wrists, a larger number of injuries are being reported here. The use of presses and balances, supporting full body weight on one or both dorsi-flexed hands, has become a common and essential way to achieve higher scores. This combined with moves involving the body leaving the ground and landing on hands, produces wrist injuries/instabilities. Common conditions found, which must be differentiated, include dorsal radiocarpal impingement syndromes, entrapment neuropathies, and possibly carpal fractures. Follow up must be recommended to the athlete after the initial evaluation.
Naturally, the more common areas involved are the lower extremities. Foot and ankle injuries have been found to occur slightly more frequently than knee-thigh. Acute ankle injuries, primarily occurring to the lateral ligaments and the peroneal tendons, is consistently the most common injury. The mechanism usually involves improper landing following a jump. In some cases, fashionable footwear during competition is substituted for good support. Chronic functional instability is also a leading cause of injury.
Musculotendinous involvement about the knee and thigh are frequently seen with compulsory moves that must be performed, and other exercises selected to demonstrate strength and flexibility. Usual predisposing factors to injury of these areas, as in other regions, include insufficient warm-up, fatigue, or inadequate rehabilitation of a previous injury. Hamstring strain or pulls, represent a perfect example of a condition occurring in high frequency, to different degrees, in many athletes.
Knee injuries will again rely on mechanism of the incident for proper initial diagnosis, along with inspection, palpation, tests for ligamentous instability and tests for possible meniscal tears. Again, since no intentional contact with others is involved, the more traumatic knee injuries are rarely seen. Peripatellar pain, including patellar tendinitis is commonly found.
Other conditions seen in this consistently growing sport, not unique to competitive aerobics, frequently occur in the feet (plantar fascitis), lower leg and calf area (medial tibial syndrome, posterior tibialis tendinitis).
Many overuse injuries come from exposure to repetitive forces placed on a specific site. In training for competition, precision moves are practiced over and over again, placing undue stress on a particular area. Other causes of overuse injuries usually don't apply to these athletes, such as poor training regime, improper/unstable flooring and inadequate shoe support while training, as commonly seen in beginner aerobic enthusiasts.
Competitive aerobics, though relatively new to the general public, has grown greatly in the decade since its inception. The doctors working with these athletes must incorporate a comprehensive history, physical examination, proper diagnostic testing, and a goal-oriented treatment plan with complete rehabilitation program. These athletes respond well to conservative therapy with great, lasting results.
Dr. Alan K. Sokoloff, DC, CCSP
Glen Burnie, Maryland
