As fitness leaders, we desire to be creative, motivating and fresh. However, we must balance this creative drive with our responsibility to teach safe classes. To achieve a successful balance, we must not only increase our knowledge, but also apply this knowledge. We can minimize risk and maximize continued participation by applying common sense and science to the factors likely to cause injury in step classes. No definitive answer exists on how to avoid injuries completely. But by combining the results of step research with the experience of seasoned fitness professionals, we can derive some general teaching benchmarks.
One of our first tasks is to determine our participants’ level, which—especially in step classes—can vary widely. Therefore, we must distinguish between novice, beginner, intermediate and advanced abilities and lead accordingly. According to the 1997 Revised Guidelines for Step Reebok:
Novice indicates someone who has never taken part in any regular exercise class or has not done so for some time. Novice participants require low-intensity, low-complexity step classes to develop overall conditioning and gain step-specific skills.
Beginner denotes a regular exerciser who has never done step training. Beginner participants require low-complexity choreography.
Intermediate refers to the participant who is a regular step exerciser.
Advanced refers to a highly conditioned and skilled stepper.
The 1997 Step ReebokSM guidelines suggest that participants’ skill and conditioning levels (see above) should determine stepping speed. The recommendations are based on a comprehensive research review conducted by Michele Scharff-Olson, PhD, of Auburn University at Montgomery, Alabama, and Step Reebok pioneer Gin Miller.
According to Miller, “At 126 beats per minute (bpm), the average participant can work well within the target heart rate zone. People are getting an effective workout! When music speed exceeds 128 bpm, step becomes a high-impact activity with the participant no longer controlling intensity and impact. Momentum and gravity take over.”
Sherri Kwasnicki, an international step presenter from British Columbia, Canada, and the 1998 IDEA Personal Trainer of the Year, adds, “Beginners do not have the body awareness and proper alignment to perform step at speeds over 120 bpm, whereas intermediate and advanced level participants have developed better body awareness and more strength in their musculoskeletal system to perform the movements correctly at the faster speeds.”
Brazilian Paulo Akiau, another well-known international step presenter, observes, “Beginners require more time to respond to instructors’ commands, necessitating slower music compared to more advanced participants.”
Research and experience have also shown that participants with limited experience are likely to have disparate landing patterns because these steppers cannot dampen forces on the body as effectively as more experienced participants. According to Scharff-Olson, “The risk of acute injuries can possibly be decreased if bench stepping is initiated on lower steps at slower speeds and increased only after a period of adjustment.” Because beginners often lack the balance and coordination skills necessary to perform step movements safely, we need to choose music speed based on the least experienced person in the class.
If we maintain the cadence within the listed recommended limits, participants will be able to remain at an appropriate level of intensity while avoiding excessive fatigue. The optimal exercise intensity for improving cardiorespiratory fitness without increasing injury risk is between 73 and 87 percent of maximum heart rate (Powers & Dodd 1996). Beyond this level, fatigue increases, which in turn increases participants’ susceptibility to injury. To reduce injury risk, you should decrease music speed and introduce less-complicated choreography, especially toward the end of class.
Some instructors may find it difficult to resist the urge to increase music speed for fear of losing participant interest and energy. Even though the fitness music industry generally adheres to Step Reebok cadence guidelines when formatting and entitling music, pitch control allows us to override preset cadences. Although the labels on professional music produced at speeds above 128 bpm may state that those particular products are intended for other exercise modes, such as isolation work (Lasky 1996), the reality is we occasionally ignore such caveats. Yet the bottom line is that the primary responsibility for music and movement speed lies with us.
Novices and beginners are not the only participants at risk. Steppers with flexibility deficits (Krivickas 1997) or a prior history of injury (Neely 1998) are also vulnerable, especially when the music is too fast. If the speed is excessive, such participants are more likely to lose their balance, use improper technique and incur increased stresses on the body.
Lack of flexibility limits range of motion, predisposing participants to overuse injuries and possibly aggravating those injuries (Krivickas 1997). Poor flexibility also increases the likelihood of acute injuries, such as cartilage and ligament tears. Injury risk is higher for steppers with previous injuries (depending on their location). Oftentimes, abnormal mobility—either hypermobility (too much) or hypomobility (not enough)—at a previously injured site increases stress to the surrounding soft tissues and joints. As a general rule, participants with limited flexibility or a history of injury, especially to the lower extremity, should reduce their stepping speed and modify complex movements.
Another aspect of step safety involves platform height. You should advise novice and beginner steppers to set their platforms at between 4 and 6 inches. However, the platform should never be so high that the weight-bearing knee has to flex more than 90 degrees (Scharff-Olson & Miller 1997; Smith et al. 1998). If the step tends to move or the participant has to hop up to the platform, it is too high. As novice and beginner participants adapt and become more proficient, they may want to increase their intensity by raising platform height. Before they attempt this, check their form, technique and alignment; once you are sure of their abilities, you can suggest they raise the platform height 2 to 4 more inches.
Gin Miller recommends participants at all levels “consider adjusting their step height to the maximum their leg limb length will allow.” However, participants who already have or develop knee pain should either reduce the step height so knee flexion does not exceed 60 degrees or avoid stepping altogether. As knee flexion increases, the compressive force on the patellofemoral (PF) joint also increases. Excessive force on the PF joint can cause pathological changes to the patella and lead to chronic PF joint pain.
Using hand weights while stepping tends to increase stress on the joints and magnifies the risk of injury, especially if participants are relatively unfit and unfamiliar with step (La Forge 1991). Although some studies have shown a modest cardiovascular benefit when using 1- to 2-pound hand weights while stepping (Goss et al. 1989; Blessing et al. 1991; Scharff-Olson et al. 1991), Miller says the use of additional weight also increases the risk of shoulder injuries.
Most experts generally agree that the benefits of using hand weights while stepping do not outweigh the risks. Jay Blahnik of Laguna Beach, California, 1996 IDEA Fitness Instructor of the Year and international step presenter, advises against the use of hand weights. “They are typically too light to build significant strength and do not greatly affect cardiovascular endurance,” he says. Kwasnicki, on the other hand, advises those who want to present a step/interval class to control the movements when using hand weights and to step at half speed.
If you do decide to use weights, avoid using them while stepping in tempo toward and away from the step platform. Slowing down the tempo decreases the need to concentrate on coordination and balance. Participants can instead focus on proper strength training form.
Because step has been around for more than 10 years, instructors may assume that participants are familiar with proper stepping techniques. As a result, for fear of sounding repetitive to our regulars, we may neglect to inform newcomers of how to step safely, modify choreography and choose an appropriate step height. To avoid “repetition autopilot,” use specific examples when covering these basics or ask for volunteers from the class to demonstrate correct step technique. Alternatively, give newcomers handouts with written explanations of proper technique. Add variety and a new perspective for your long-time steppers.
Blahnik emphasizes the need to educate participants on proper technique when they are first introduced to a specific mode of exercise. “Students can have bad form regardless of music speed,” he says. “Slower music doesn’t necessarily guarantee that students will have proper technique. They have to be taught.” If you teach your participants correct technique, you will help them develop the coordination and strength they need to progress to a more advanced level, while minimizing their risk of developing overuse injuries and muscle imbalances.
Overuse injuries typically occur as a result of repetitive loading that exceeds the body’s ability to repair itself. Because step training is repetitive in nature, many of the injuries sustained are due to overuse. Muscle imbalances common to step occur in the medial and lateral quadriceps muscles. During step workouts, many movements—such as over-the-top, L-step and traveling steps—are done side to side. As a result, the lateral quadriceps muscle may become overdeveloped compared to the medial quadriceps. This imbalance can cause excessive lateral pull on the patella, predisposing step participants to overuse injuries such as iliotibial band (ITB) and PF stress syndromes.
Anatomical malalignments can also cause excessive lateral forces at the knee joint and predispose the patella to pathological changes. Such malalignments include an abnormally large Q angle (> 20 degrees), genu valgum (knock-knee), pronation of the foot, and excessive femoral anteversion (internal femoral torsion). To reduce the risk of these injuries, encourage your clients to cross train and to recognize potential imbalances before they become injuries.
All the experts interviewed for this article agree that the benefits of cross training outweigh the potential risks (primarily due to inadequate preparation). Kwasnicki advocates cross training to “create a balanced body and reduce the risk of repetitive stress injuries.” To encourage cross training, instructors need to stay alert to regulars who rely solely on step for their cardiovascular workouts. Although we may want our step classes to remain full, we need to take a long-term view and encourage exercisers to try other workout modes.
Although cross training may reduce the risk of repetitive use injuries, foot injuries like plantar fasciitis can still occur as a result of improper stepping technique. Plantar fasciitis is the result of repetitive stretching of the plantar fascia, located on the bottom of the foot (Norkin & Levangie 1992). This type of stress takes place when the foot is allowed to hang over the edge of the step or when the entire foot does not contact the supporting surface (i.e., when participants step on the balls of the feet).
To reduce the risk of developing foot injuries, advise exercisers to make sure their entire foot contacts the supporting surface when they step onto the bench and to step down close to and toward the step, not away from it. Staying in close to the step platform prevents participants from leaning forward and minimizes stresses to the foot, ankle joint, Achilles tendon and calf (Kravitz & Deivert 1992).
Fast-tempo music can also predispose participants to plantar fasciitis. Miller observes that at faster speeds, steppers are less able to land their heel properly. “They stay on the balls of their feet and bounce through the heel, increasing the impact forces.” The bounce may indicate that the music is too fast, the step is too high and/or participants need more reminders about landing technique.
Knee injuries are also common in step classes, possibly as a result of increasingly complex choreography. Meniscal injuries, especially to the medial meniscus, are often caused by the sudden rotation of the femur on the fixed tibia when the knee is in flexion (Norkin & Levangie 1992). Meniscal tears occur during movements like hop pivots over the bench, turn steps initiated on a flat foot, or abrupt changes in direction.
Ligament injuries are also commonly seen and result from an applied force that causes the joint to exceed its normal range of motion. A ligament injury can manifest as an actual ligament tear or as a disruption of a ligament already weakened by aging, disease, immobilization, steroids or vascular insufficiency (Norkin & Levangie 1992).
To avoid acute injuries to the knee, perform—and cue—pivots and turns on the ball of the foot. If the pivot requires that the foot completely leave the step, such as during a hop pivot over the step, have participants perform the pivot after the foot leaves the supporting surface. During movements initiated by a turn on one foot—a turn step, for example—rotate the lead hip in the direction of the turn before placing the foot on the bench. During movements performed in the frontal plane—for instance, an over-the-top—caution participants to avoid crossing one leg in front or behind the other while both legs are bearing weight. Showing and cuing these techniques will reduce torque on the knee and stress to the weight-bearing joints.
To create a safe exercise environment, not only do we need to teach proper technique; we also need to choose choreography that is within the range of our participants’ abilities. We can achieve this goal with the help of several basic teaching guidelines. See “Choreography Safety Tips” on this page for practical suggestions.
Two aspects of step choreography that require special attention are stepping forward off the platform and making transitions.
Acute injuries can occur during movements that require greater–than–normal balance skills—for example, stepping forward off the step. Opinions vary on the appropriateness of this move. Step Reebok guidelines and Paulo Akiau take a conservative stand, recommending that participants not step forward off the platform. Jay Blahnik believes stepping forward is acceptable, provided it is not followed by stepping backward onto the step again. He also recommends that stepping forward be performed no more than once every 32 counts. Sherri Kwasnicki agrees that stepping forward is permissible if followed by a lateral movement, such as a step–touch or grapevine. Her rationale is that turning back onto the step immediately after stepping forward off it is too risky. Ultimately, you will need to weigh whether the choreography benefits justify the injury risk in your particular class.
Injuries also occur when complex choreography is not separated by more basic transitions or when too many variables are changed at one time. Gin Miller emphasizes that “plenty of safe movement patterns can be creatively combined without incorporating moves that have no practical modifications or that put anyone at risk.”
As instructors, we are often so concerned with designing new and exciting choreography that we forget to plan how we are going to teach these movements in a safe and progressive manner. As a result, participants can end up frustrated—and injured—not necessarily because of complex choreography, but as a result of ineffective progressions. Challenging choreography needs to be separated by transition steps that require minimal balance and coordination. When participants can reorient themselves and prepare for the upcoming moves, the risk potential decreases. See “Choosing Low-Risk Transitions” on page 6.
It’s no secret that the most effective way to prevent step injuries is first to be familiar with proper techniques ourselves, then to teach our participants to employ those techniques, and communicate why we make the choices we do. Instead of succumbing to pressures to increase the music speed or the complexity of our choreography, we need to use our knowledge and creativity to design classes that maximize benefits while minimizing risk. That way, our participants can reap the joys of step for years to come—free from pain and regrets.
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