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Low Impact Training

What is low impact training?

Impact training describes forms of exercise where there is high force transmission through the body, via the legs, arms, trunk or head and neck. Impact training can be good for us as it helps our
bones strengthen and promotes muscular development. This is required during childhood when we are growing and throughout adulthood to maintain good bone and muscle density
(particularly over the age of 50).

However, too much training that involves repetitive contact with the ground or other objectives, thus creating high reaction forces, coupled with inadequate recovery time, can be harmful to our
bodies. Higher impact training activities include running, contact sports and high-intensity interval training (HIIT). Getting the balance between low and high impact training is therefore important in order to maintain a healthy musculoskeletal system.

How can excessive high impact training affect us?

Excessive high impact or loading typical causes injury to our joints, bones, tendons and muscles. Common injuries may include bone stress injury, tendinitis and overload syndromes. Depending on the type of high impact training this may affect our:

Lower limbs

(feet, ankles, legs and hips)

High impact exercises such as running, football and activities that involve jumping are relevant here.

Upper limbs

(shoulders, arms, wrists and hands)

Activities such as racket sports, climbing, diving and gymnastics may produce high impact forces and therefore lead to injury.

Trunk

(spine, head and neck)

Contact sports such as rugby or those sports that require excessive rotation of the spine (e.g. golf) are applicable here.

How can low impact training help us?

Low impact training, on the other hand, has little or no force transmission through the body whilst being performed. This is useful when we are trying to offload, protect or recover.

There are lots of times when introducing and incorporating low impact training into our exercise regimes may help. Below, we describe three common scenarios where low impact training is very useful.

Scenario 1 – Protecting joints

Although most forms of exercise are great for our joints, sometimes we can cause more pain or injury when the impact or intensity is too high. A common example of this is in people with osteoarthritis (wear and tear) of their joints, particularly the knees. Low impact training can provide the right environment for joints that may need protecting, whilst ensuring we are able to continue to work them out, keeping them healthy and supple.

Scenario 2 – Healing after injury

Some injuries, e.g. stress injuries or fractures, require time away from high impact training to heal. Low impact training can provide enough stimulation through the bone to encourage healing, but not too much force so that healing is disrupted.

Scenario 3 – As a recovery strategy

Incorporating low impact exercise into your training can reduce the overall “training load” across the week. Low impact training can also be used as a “recovery or rest session” after higher intensity training.

Types of low impact training

An easy rule of thumb to follow in order to keep training low impact is to “keep your feet on the ground or platform” (not applicable for pool-based training). This means avoiding stepping, jumping or running.

pool low impact training Low Impact Training

Pool based low impact training

Pool-based exercise (e.g. aquarobics) provides a minimal impact environment, but also a high resistance environment. The level of resistance provided by the water can be easily changed by the level of the water exercised (a higher water level creates more resistance). This means that we can exercise our joints and muscles in a safe environment whilst getting a great strength and cardiovascular workout.

cardiovascular low impact training Low Impact Training

Cardiovascular low impact training

It is certainly still possible to get a good cardiovascular workout whilst maintaining low impact. The following are examples of cardiovascular exercises that can be performed safely in all 3 of the above scenarios:

  • Static or outdoor cycling
  • Cross-training (elliptical machine)
  • Rowing
  • Arm bike

Please note that if any of the above exercises are done excessively, they may also lead to overuse injury.

strength low impact training Low Impact Training

Strength-based low impact training

The following are examples of strength-based exercises that can be performed with low impact and can be applied in all three of the above scenarios:

  • Lower limb open chain exercises. These are exercises where your feet are not in contact with the ground or a platform. Examples include knee extensions and hamstring curls.
  • Lower limb closed chain exercises. These are exercises where your feet are in contact with the ground or a platform. Examples include leg press, squats, deadlifting and calf raises.
  • Upper body weighted workouts. Most upper body training does not put force through the lower limbs but can be traumatic for the upper limbs and spine.

Please note that if any of the above exercises are done excessively, they may also lead to injury.

golf low impact training Low Impact Training

Sports-based low impact training

Most sports require some element of high impact training. However, it may be possible to adapt your chosen sport to reduce the level of impact sustained. Below are some examples of sports that are more low impact based:

  • Swimming. Particularly when combined with other pool-based exercises, swimming provides one of the best environments for exercise, recovery and healing. The hydrostatic pressure of the water also helps our joints, muscles and tendons stay healthy and recover quicker.
  • Pilates and Yoga. Both these exercise modalities are low impact on the body and great for improving core strength and flexibility. Strategies such as massage and foam rolling also help reduce muscle tension and reduce pressure on our joints.
  • Golf. Golf is a great recreational sport that allows us to exercise without putting much force through the lower limbs. However, when played at a higher level, golf can produce larger force transmission through the hips, pelvis and spine.
  • Nordic walking. The use of Nordic walking poles can help distribute ground reaction forces throughout all four limbs. This is particularly useful for people with lower-limb joint pain e.g. knee arthritis, who still want to keep active.
  • Soft surface training. Some training surfaces are much more forgiving on the body than others and can allow you to continue exercising in an adapted training environment. These include carpet, grass, sand, trampoline/trampette, cushioned floor (e.g., gymnastics matt), sprung floor/platform, and aerofloor.
  • Hand-eye coordination sports. Sports that continue to develop hand-eye coordination may be a good alternative when trying to reduce the amount of impact going through the body. Examples include Frisbee, throwing and catching, Darts and Snooker.

How long do I need to continue low impact training for?

This depends on the extent of your injury or illness. It may be appropriate for you to switch your training completely to low impact training, for example, to protect joints. If this is the case, you will certainly not be at a disadvantage as you will still be able to have a robust and well-rounded training programme which includes strength, flexibility and cardiovascular training.

If you are recovering from an injury (e.g. stress fracture), please consult with your LBSM physician as to when and how it is appropriate to reintroduce higher impact training.

Ultimately, having a well-rounded, balanced training plan is the best way of maximising your performance and reducing the risk of injury.

low impact training Low Impact Training
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    Orla Mulligan
    Administration and Social Media Manager
    Administration, LBSM

    Orla Mulligan is the administration and social media manager for LBSM. She has a strong background in sport having herself played netball at an elite standard for the U21s Northern Ireland team in the European Championships as well as the U21s competition for Saracen Mavericks.

    She understands youth sport pathways having herself played and training in the netball Kent regional pathway. She has a keen interest in most sports and a good understanding of how injury and illness can impact on the mind and body, as well as rehabilitation pathways.

    She looks forward to speaking and assisting LBSM patients and gives her best support to them during their treatment pathway.

    A day in the life of Orla involves communicating with patients via phone and email, managing and organising clinics, operations and media management.

    Outside of work, Orla is a gym enthusiast, enjoys tennis and still finds the time for an occasional game of netball.

    Maddie Tait
    BSc, MSc
    Associate, LBSM
    Musculoskeletal and Sports Podiatrist

    Maddie treats and manages complex foot and ankle injuries in London and Surrey.

    She is particularly interested in helping her patients improve their quality of life and achieve their personal goals, working closely with Foot and Ankle Consultants, Sports Medicine Doctors and Physiotherapists.

    Maddie has a sporting background herself having previously represented England in Hockey. She understands the demands of elite sport and the importance of physical and mental health. In her spare time, Maddie continues to enjoy an active lifestyle by running, cycling and attending a Pilates class.

    Having graduated from University of Brighton with a MSc (hons) in Podiatry, Maddie focused her career in Podiatric Sports Injuries and Biomechanics. Previously she completed a BSc (hons) in Sport Science at Loughborough University.

    A day in the life of Maddie involves consulting patients in clinic, performing gait and biomechanical assessments, measuring and fitting orthotics and braces. She also regularly teaches and presents at sports medicine and podiatry conferences.

    Outside of work, Maddie still finds time to play hockey and enjoys running and skiing.

    Mr Prakash Saha
    MBBS, PhD, FRCS
    Consultant Partner, LBSM
    Consultant in Vascular Surgery

    Mr Prakash Saha is a Consultant Vascular Surgeon at LBSM. He takes pride in providing the best possible results for his patients by using the most appropriate non-surgical and surgical methods based on clinical evidence, patient results and satisfaction.

    He treats fit and active people suffering with a range of cardiovascular issues, from painful leg swelling associated with exercise to venous insufficiency, post-thrombotic syndrome and leg ulcers. He also treats people with arterial system problems including poor circulation, compression syndromes and aneurysms. He carries out both endovascular and open aortic repair and has some of the best outcomes in the country.

    Mr Saha studied medicine at the United Medical & Dental Schools at Guy’s and St. Thomas’ Hospitals before completing his higher surgical training in London and the South East. During this time, he was awarded the prestigious NIHR Clinical Lectureship in Vascular Surgery at St. Thomas’ Hospital, giving him comprehensive training in open and endovascular techniques for treating arterial and venous disease. Prakash completed his aortic surgery training at the St. George’s Vascular Institute before carrying out a specialist fellowship at the Royal Prince Alfred Hospital, Sydney.

    Mr Saha regularly lectures and runs workshops across the globe on the latest surgical techniques to treat vascular disease. He has also been awarded a number of research grants from the Royal College of Surgeons, the Circulation Foundation, the Wellcome Trust, the Academy of Medical Sciences, and the British Heart Foundation, which has led to over 80 publications and the development of innovative technologies to help treat patients. For this work, Prakash has received a number of prizes, including the Venous Forum prize from the Vascular Society of Great Britain and Ireland, an International Young Investigator Award, and an Early Career Investigator Award from the American Heart Association.

    A day in the life of Mr Saha involves seeing patients in clinic, operating in surgical theatre or lecturing at his university. He also regularly teaches and presents at vascular and sports medicine conferences.

    Mr Saha is an avid cyclist and tennis player (although yet to get a set of Dr Seth!). Outside of work, he spends time with his family who consists of 3 children and enjoys travelling.

    Dr Gajan Rajeswaran
    MBBS, FRCR
    Consultant Partner, LBSM
    Consultant in Sports and Musculoskeletal Radiology

    Dr Gajan Rajeswaran is a Consultant Musculoskeletal Radiologist at LBSM, with an extensive background of working in elite sport. He is one of the most recognised radiologists in the sports medicine field. He provides top level imaging and medical diagnostic services for patients and athletes.

    Dr Gajan Rajeswaran completed his undergraduate medical training at Imperial College London and his radiology training at Chelsea & Westminster Hospital. He has obtained two post-CCT fellowships in musculoskeletal imaging. He was appointed as a consultant at Chelsea & Westminster Hospital in 2011.

    He has a passion for all sports having worked as a radiologist at the Glasgow Commonwealth Games and London World Athletic Championships and continues to support The Championships, Wimbledon. He also continues to work with a number of Premier League and Championship Football Clubs, Premier League Rugby Clubs, England Sevens Rugby, British Athletics and the Lawn Tennis Association.

    A day in the life of Dr Rajeswaran involves giving his expert opinion on investigations such as MRI and CT scans, x-rays and ultrasound. He also performs injection lists under ultrasound, CT and X-ray including spinal injections. He also regularly teaches and presents at sports medicine conferences.

    Dr Gajan Rajeswaran is an avid football fan and life-long fan of Tottenham Hotspur (for which he offers no apologies!). Outside of work, he spends time with his family and has a keen passion for photography.

    Dr Ajai Seth
    MBBS, BSc, MSc, MRCS, MRCGP, FFSEM
    Medical Director, LBSM
    Consultant in Sport and Exercise Medicine

    Dr Ajai Seth is a Sport and Exercise Medicine Physician. He has dedicated his career to helping people with sport and exercise related injury and illness. He consults and treats everyone from the elite athlete to the weekend warrior.

    Dr Ajai Seth is part of the British Tennis Sports Physician team at the LTA and has also provided cover to elite athletes at Wimbledon Tennis, European Tour Golf, Premier League Football, British Athletics, and the Men’s England Football academies as part of the FA.

    He also prides himself for working in disability sport and is currently the Chief Medical Officer for Team GB Wheelchair Tennis which has taken him to the Olympics and Paralympics.

    Dr Ajai Seth is dedicated to education, training and research and is a Senior Lecturer in Sports Medicine at King’s College London where he lectures in all aspects of Sports Medicine and Science.

    He also has a passion for travel and Expedition Medicine, which has seen him accompany medical, scientific and charity expeditions all around the world. He also has vast experience in treating musculoskeletal injuries from children and adolescents to veteran exercisers, both male and female.

    Dr Seth also has positions in leading Sport Medicine organisations, including the non-executive board for the UK’s largest Sports Medicine charity, BASEM and Past President for the Royal Society of Medicine. 

    A day in the working life of Dr Seth involves consulting his patients in clinic, performing diagnostics and ultrasound guided injections. He also regularly lectures and tutors students and presents at sports medicine conferences internationally. He also spends part of the working week at the National Tennis Centre, LTA, supporting British Tennis players.

    Outside of work, Dr Seth enjoys playing club tennis, triathlon, golf, running and skiing (but will give any sport a go!). He enjoys keeping fit and active and good quality family time with his wife and three children.