Health

Hurdles’ Hidden Hazards – Abigail Levene

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Abigail Levene

The Steeplechase track and field event poses serious health risks to even the healthiest runners, new research suggests.

University of Colorado seniors Emma Coburn and Shalaya Kipp moments after qualifying for the 2012 Olympic Games.

Author note: this piece was written in the fall of 2013.

Emma Coburn seemed invincible. The Olympian and national champion ran with textbook form. She had no muscle weaknesses. Her bone density remained rock-solid. Her blood chemistry shot off the charts. And winning felt easy. She triumphed in every race she entered this spring. The fastest steeplechaser in the country, her ticket to the World Championships in Sochi, Russia, was practically punched. Until her body shattered.

During the preliminary round of the NCAA Championship, slight muscle soreness exploded into excruciating back pain. After capturing the collegiate national title two days later, an MRI confirmed the worst: her sacrum was broken. “I had never even missed a practice due to injury,” Coburn said. “All of a sudden, my season was over.”

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What is most shocking about Coburn’s case is how commonplace it is within the steeplechase community. Athletes must run nearly two miles, leap over 28 hurdles, and clamber over seven water barriers, unparalleled demands that attract the sturdiest, strongest runners. Yet an unusually large number of elite steeplechasers suffer from serious injury, experts claim.

Even more alarmingly, these injuries fly under the radar. Scientists and physicians publish prolifically on conventional running — the medical database PubMed contains well over 1,200 studies on running injuries. But no one has studied steeplechase, until now. Shalaya Kipp, integrative physiology researcher and Coburn’s collegiate and Olympic steeplechase teammate, examines the forces involved in jumping over steeplechase barriers and water jumps. Her findings could revolutionize the way athletes, coaches, medical personnel, and track and field officials approach the event.

“My findings suggest that we are approaching the steeplechase irrationally,” Kipp said. “We are not acknowledging the fact that training for and racing the steeplechase is incredibly taxing on the body. And this is actually kind of a unique situation in track and field.”

Steeplechase stress fractures: a silent strain

Pounding the pavement breaks down muscle and bone, forcing the body to constantly rebuild itself. Sometimes when breakdown trumps repair, a bone swells and eventually cracks. The surrounding area of the body stops working — “dead leg,” in runner-speak. A runner’s worst nightmare, these injuries require at least two months of downtime to heal.

Stress fractures pervade the running world. The numbers remain nebulous, but the American College of Sports Medicine estimates that these injuries plague between 13 and 52 percent of runners. Three out of every five track athletes have a history of at least one prior stress fracture. But sacral stress fractures like Coburn’s remain exceptionally rare. Doctors record them so uncommonly that their estimated incidence remains statistically insignificant.

“Stress fractures in runners typically involve lower extremities, like the feet and legs,” said sports physician Stephen Poddar, one of Coburn’s physicians at the University of Colorado. “Running impacts these areas of the body the body the most, so it makes sense. Sacral stress fractures are almost unheard of.”

The sacrum sits between the base of the spine and the back of the pelvis, like a large, triangular wedge between the two hip bones. While conventional running stresses the legs, and even the pelvis and spine, the sacrum generally remains fairly cushioned by surrounding muscles and bones, Poddar explained.

As Coburn’s case illustrates, the silence of sacral stress fractures in sports medicine is bad news for steeplechasers. When the early warning signs of this stress injury begin to materialize, athletes, coaches and doctors generally write it off as something else.

“At first, I thought my problem was muscular,” Coburn said. “I thought it was just glute tightness. “It grew sore on a Saturday. By the following Saturday, after nationals, I was crawling in pain. I couldn’t walk.”

Sacral stress fractures do not enter most athletes, coaches, and doctors’ radar. This problem is magnified by the fact that most steeplechasers are not considered to be at high stress fracture risk in the first place.

Several clear warning signs collectively labeled the ‘female athlete triad’ characterize high-risk female runners: excessive leanness, menstrual dysfunction, and weak bones. When the female body does not receive enough energy from food and fat reserves, it enters survival mode and stops producing enough of the hormone estrogen for menstruation to occur. Estrogen is vital to bone health; without enough of it, bones do not properly rebuild themselves and begin to crumble away.

This paradigm proves to be a problem for steeplechasers. As experts and athletes are beginning to realize, being “healthy” does not prevent injuries.

“When I found out I had a stress fracture in my sacrum, my coaches and I were shocked,” Coburn said. “I’m healthy. My bone density is excellent, and I have body fat. I’m not super slender to the point where my body is eating itself. And my weight is consistent — for the past five years, I have weighed within three pounds.”

Even experts were baffled.

“When I saw a doctor at the Olympic Training Center after I got hurt, he was hoping to find some big muscle imbalance that would explain it,” Coburn said. “But I didn’t have one. No one could figure out why I had gotten injured.”

Marriage of science and sport

Kipp is determined to solve Coburn’s puzzle by revolutionizing the paradigm of the steeplechase, one study at a time. Kipp was Coburn’s teammate at the University of Colorado for four years. And if training together, travelling together, and racing together were not enough, they also served as two of the three American women in the steeplechase at the London Olympics.

For Kipp, athletics, school, and life run together. Simon, the skeleton in her apartment, currently serves as her Christmas tree, draped in evergreen branches and bright lights with a star atop his head.

“But Simon’s purpose 11 months out of the year is being an anatomical model for school and running,” Kipp clarified.

When Rodger Kram, her boss at the University of Colorado’s Locomotion Laboratory, suggested that she study the impacts of steeplechase on the body last spring, Kipp leapt at the challenge. She built her own steeplechase barrier complete with force platforms. She refers to it as “my barrier,” and grows giddy over the prospect of painting it. Her research seems to be an extension of herself.

Kipp examines how the ground reaction forces involved in takeoff and landing from steeplechase hurdles and water barriers place the body at risk of injury.

“For example, when you jump off the barrier into the water pit, you land with a certain amount of force,” Kipp said. “The ground then exerts that amount of force back onto the body. That force radiates in certain ways through the body, and the body has to try and handle it.”

Kipp’s research reinforces the advantages of — really, the need for — a thorough understanding of the sport itself in sports science. You can’t successfully study a sport like the steeplechase without doing it yourself.

“As a steeplechaser, I have intuition about the sport that non-steeplechasers wouldn’t,” Kipp explained. “For example, your toe rolls over the barrier; you don’t just step flat on top of it. This detail might seem trivial, but it drastically alters the biomechanics of jumping over the barrier, and thus the forces involved and the subsequent impact on the body.”

“There are so many styles of hurdling,” Kipp continued. “And I have the eye for good hurdling. Since we are studying the biomechanics of good steeplechasers versus not as good ones, it is imperative that we can differentiate between the two. I don’t think I would be able to do this research if I wasn’t a steeplechaser, actually.”

While Kipp continues to delve deeper into her study, the results so far have been shocking, she says. Kipp discovered that the forces involved in landing into the water pit are about 12 times that of the runner’s body weight. Normal running, by comparison, amounts to only three or four times normal body weight. The forces are higher for elite steeplers than novice ones. And most of the forces radiate into the lower back, helping to explain Coburn’s seemingly bizarre injury and why similar sacral injuries — almost unheard of in distance running — occur so commonly within the elite steeplechase community.

The biomechanical forces involved in steeplechasing are incredibly complex. Innumerable variables enter into the equation, and each can wildly influence ground force severity and location within the body. But one of Kipp’s findings so far is of little surprise — but considerable help — to Coburn: running the steeplechase slowly increases ground force stress on body, and places even greater strain on the lower back. To most people, this finding may seem counterintuitive: how can running slower be harder for the body to handle? It’s all about the trajectory.

“When elite steeplechasers race hard, they launch themselves off the water barrier,” Kipp said. “The trajectory is mostly forward. But when they slow down, the trajectory changes. It becomes more straight up and plop down, which drastically elevates the impact on the spine and bones.”

Steeplechasing thus mirrors sports like ski jumping, in which flying high into the air and straight back to earth proves far more painful than shooting out and slowly floating down.

But up and down is exactly what Coburn did, over and over, last spring. As a collegiate athlete, Coburn planned on racing two seasons: the NCAA one in the spring, and the professional one in the summer. Most elite steeplechasers are out of college and can limit the number of steeplechases they enter to four or five a year. The demands of the NCAA season forced Coburn to race four steeplechases in just six weeks. With her sights set beyond the collegiate championship, Coburn and her coaches decided she should run these races “slowly” to rest her legs.

“You think after racing a slow steeple, ‘well I don’t feel that wiped out,” Coburn said. “But it’s still a toll on your body. And in some ways it’s even worse, because you don’t realize it.”

“In hindsight, I would have done that differently,” Coburn continued. “I think there is a sweet spot between killing yourself aerobically and still maintaining a decent trajectory. Instead of cruising at 10 minute pace, I should drop it down to 9:40.”

While running “slowly” is a dangerous for elites, it is the savior of slower steeplechasers, Kipp’s research indicates.

“Not as good steeplers just kind of have to clamber over the barrier, no matter how fast they’re going,” Kipp said. “Their trajectory is a lot lower. And as a result, so is the impact.”

Moving forward

Kipp’s findings can directly influence the way athletes, coaches, and medical personnel approach the steeplechase to help prevent more cases like Coburn’s.

“My research indicates that we need to limit the amount of barrier work that steeplers do in practice, and also limit the number of steeplechases they enter in a season,” Kipp said.

According to Coburn, last season her coaches instructed her to practice jumping over hurdles and water jumps several times a week.

“I felt great, and I was completing the best workouts of my life. My bones and muscles weren’t hurting. But before every workout, we would do lots of hurdle drills and hurdle flights, and we would do entire workouts in spikes. That is something I will definitely do differently this year — a lot fewer water jumps and hurdle practice. Your body can only handle so much.”

In addition to tempering training, Kipp argues that steeplechasers require different musculature and different strength, conditioning, and flexibility workouts then normal runners.

“Steeplers need to be doing more lower back work, for one thing,” Kipp said. “Also certain body types may be better suited to the sport. So when coaches are selecting whom they want to train for the event that should be an important criterion.”

Kipp’s work also unearths deeper, more intractable issues with the way society views and treats the event. In the track and field world, people consider the steeplechase a middle-distance event. But in terms of the race’s toll on the body, it’s not.

“The way we view and race the steeplechase inherently places athletes at risk,” Kipp said. “For example, the 10-kilometer track race only has one round at championship meets like the Olympics. Track officials deemed the race too tiring and too taxing on the body for runners to race more than once. The steeplechase, in contrast, has a preliminary, semi-final, and final round, mirroring middle distance events like the mile. In the mile, a day or two of rest in between each round proves sufficient for the body to recover. This is not the case with the steeplechase.”

“Racing the steeple is really as demanding as racing a 10k,” Kipp continued. “The science and the sport don’t match up.”

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