Make an Impact: Choose Your Own Fitness Adventure

Whether you’re embracing cardio for the first time, looking to mix up your marathon training schedule, or ditching the pavement for a softer landing, an impactful adventure awaits you.

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We know how to leverage our outdoor amenities and it shows: This past May, Minneapolis and St. Paul topped the list of the “50 Fittest Cities,” according to the American College of Sports Medicine and Anthem Foundation. The metro area scored high on metrics like low rates of asthma, obesity, and smoking, and for its higher-than-average percentage of residents who bike or walk to work. It goes to show that our fitness scene is as vast as our number-one urban park system; from the bike trails to barre class, paddleboarding to CrossFit, there’s something for every age and ability to choose from. 

So with all of this variety, how can you be sure you’re picking the right form of exercise? Knowing the characteristics of high- to low-impact exercise and its implications on the joints can help you determine how—and where—you should be sweating it out. 

High Impact

Feel the Adrenaline + Build Up Your Bones

Over the years, “high impact” has become something of a dirty word, entangled with images of blown knees and inflamed shins. It’s not as tough as its perception implies, so long as you’re working with a solid base of joint control, core stability, and a clean injury track record.   

“People of all ages and backgrounds are totally appropriate to participate in high-impact exercise,” says Hilary Dolan, PT, DPT, TRIA Orthopaedic Center. “Those who do well are the ones who consciously listen to their bodies and stay consistent with the progressive loading of their joints and ligaments.”

High-impact exercise can be best defined as activities where both feet regularly lose contact with the ground. Most synonymous with running, these workouts involve explosive movements—as is the case with jumping, hopping, and plyometrics, and sports like soccer, basketball, and tennis.  

“We used to believe that higher-impact activities were a risk factor for developing arthritis or bone injury, especially in older adults,” says Dr. Robby Bershow, medical director for sports medicine with Sports and Orthopaedic Specialists of Allina Health. “The majority of recent studies, however, seem to indicate there is no increased risk for aging athletes participating in impact activities within reason.”

Contrary to popular belief, there’s a growing body of evidence pointing to runners with a lower incidence of knee osteoarthritis compared to their non-running counterparts. 

In a study published in the June 2017 issue of the Journal of Orthopaedic & Sports Physical Therapy, researchers selected 17 studies with a total of 114,829 people and looked at competitive runners, recreational runners, and non-runners. They found that 3.5 percent of recreational runners developed hip and/or knee arthritis, compared to 10.2 percent of non-runners and 13.3 percent of competitive runners. 

That said, individuals without the requisite strength and endurance to correctly perform activities like running are at greater risk of injury, says Bershow. 

“If you have never exercised and go out to do four hours of box jumps, you’re much more likely to sustain an injury because you’re not going to be able to protect your body by using your muscles to control your landing.” 

When we’re moving, impact forces much greater than our own body weight act on the joints. Meaning the more that we weigh, the greater the load our joints bear during high-impact moves. 

“Some studies show anywhere from three to seven times of your body weight is transmitted as a loading force through your legs and your spine when running,” says Dr. Ed Laskowski, co-director of the Mayo Clinic Sports Medicine and professor in the Department of Physical Medicine and Rehabilitation.  

If you’re new to weight-bearing exercises, avoid the training trifecta of doing too much, too soon, too fast. On a training plan and new to running? Increase your mileage by no more than 10 percent every week. Can’t push through your jump rope warm-up? The simple act of walking is a good bone-loading activity, says Laskowski.

“Walking on a regular basis is a great way to maintain bone health,” he says. “If your joints are in otherwise good health and you have a good strength foundation, studies have shown that introducing some higher-impact activity can help even more to maintain bone density.” 

“People of all ages and backgrounds are totally appropriate to participate in high-impact exercise. Those who do well are the ones who consciously listen to their bodies and stay consistent with the progressive loading of their joints and ligaments.”  

—Hilary Dolan, PT, DPT, TRIA Orthopaedic Center 

Where to train: 

Cardio Burn at STEELE Fitness (steelefitness.com); the Twin Cities Running Experiment (meetup.com/theTCRE); Kangoo Power at High Five Fit (highfivefit.com)

Pick a lane:

Twin Cities Rugged Maniac (Sept. 16) ruggedmaniac.com/events/twincities

Fulton Brewery Halloween Beer Run (Oct. 28) 5Kbreweryrunningseries.com

Turkey Trot (Nov. 23) 6K, 10K turkeytrotsaintpaul.com

Moustache Run (Nov. 25) 5K, 10K, 13.1K moustacherun.com 

Medium Impact

Maximize Your Workout + Save Time 

While high- and low-impact exercise are the umbrella terms that most workouts fall under, there’s a subcategory of aerobics that isn’t talked about as much but can be found at your neighborhood boutique fitness studio: medium-impact exercise.

“We know plyometrics are high impact and low impact is smooth movement like swimming or the elliptical,” says Amy S. Beacom, MD, sports medicine physician at Summit Orthopedics. “But if we’re talking about medium impact, it’s going be a little bit in between all of that, like short bursts of jumping or anything involving some plyometrics.”

Medium impact blends high- and low-impact exercise and incorporates large ranges of motion. Think: yoga with weights, barre class, martial arts, or cardio kickboxing. 

“There’s this whole mentality behind these fusion classes popping up,” adds Beacom. “It’s like, ‘Let’s get stronger together and let’s have this great music to push us along because we’re on this journey together.’” 

Most gyms and fitness studios offer classes touted as “low” or “high” impact, but it’s become increasingly common to see them labeled as “high-low.” These exercises provide equal parts maximum workout intensity and minimum injury risk. 

“People take these classes because they’re short on time and they can hit six different body parts within the hour,” says Beacom. “Even long-term runners will take a class because they’re too sore for that third run, and while it may not necessarily scratch their running itch, it gets the heart rate up.”

Attempting a class that is too advanced, however, may open the door for injury. 

“People come to these classes because they want to be coached, but your coach doesn’t know the individual limitations of each one of their participants,” cautions Beacom. “If you’re doing something that requires a lot of agility and you’ve never done it before, make sure you are patient with yourself and have good form.”

Can’t hold the plank for 60 seconds? Modify it! Injury prevention is about trusting your gut. If something doesn’t feel right, don’t force it. And always be sure to consult your primary physician before trying any exercise routine. 

“There are a wealth of resources to help you with progression of exercise, nutrition, hydration, mental strategies, and training principles to prevent injury,” says Laskowski. “Exercise communities can provide the support, accountability, and encouragement that will help get and keep people moving.”

“People take these classes because they’re short on time and they can hit six different body parts within the hour.”

—Amy S. Beacom, MD, Sports Medicine Physician at Summit Orthopedics

Where to train: 

Orangetheory (orangetheoryfitness.com); CrossFit (crossfit.com); TITLE Boxing Club (titleboxingclub.com) 

Pick a lane:

NorthShore Inline Marathon (Sept. 16) northshoreinline.com 

Minneapolis Bike Tour (Sept. 17) minneapolisparks.org  

One Last Tri (Sept. 17) trifitnesswbl.com/olt 

Luminary Loppet (Jan. 27, 2018) loppet.org/luminary-loppet

Low Impact

Start Your Fitness Journey or Give Your Body a Break 

High-impact exercise gets all the glory when it comes to torching calories and burning fat. But despite what its name suggests, low-impact exercise doesn’t have to mean lower results. 

“Oftentimes, people think that they have to perform high-impact exercise to gain optimal training benefit and calorie burning,” says Laskowski. “But intervals on the bike or the elliptical machine all provide excellent aerobic exercise and cardiovascular benefit while minimizing stress on your joints.”

By definition, low impact  is when at least one foot stays in contact with the ground at all times. While minimizing the wear and tear on joints, it has the ability to produce a total body workout. Case in point: Tour de France.

“Lower impact does not equate to low intensity,” says Dr. Owen O’Neill, orthopedic surgeon and medical director of the EXCEL Program at Twin Cities Orthopedics. “You can have the same exertional workout and same calorie burn with a low-impact, high-intensity workout. The Peloton spin bike is a great example: Once you get off a spinning workout, you’re drenched!”  

The benefits of low-impact exercise run far and wide: It helps build core strength, muscle endurance, and balance, to name a few. 

“Three of the best [low-impact] exercises that can be done safely to build core muscle strength and prevent injury are planks, hanging leg raises, and reverse crunches,” says Dr. Stefano M. Sinicropi, orthopedic  spine surgeon at Midwest Spine & Brain Institute. 

Even if you’re a marathoner, it’s good practice to give those knees a break every once in a while.

“Patients that like to run will continue to run because it’s efficient and they can get a reasonably good workout in a short period of time,” continues O’Neill. “But in looking at caloric burn, let’s say you’re walking four miles per hour on a treadmill at a 10-degree incline, you’re getting the same cardiac workout with much less impact on your joints.” It’s a win-win. 

“Mixing up your workouts can also keep things from getting stale with your exercise routine,” says Bershow. “Spending some time in the pool, at yoga, or with some weights tends to promote the best whole-body health.” 

“Everyone has a different pathology and limitations,” adds Dr. Nima Adimi, medical director at MAPS Medical Pain Clinics, Chaska. “I always tell people to start out low because you can always go higher.”

Where to train: 

Aqua Zumba at YMCA (ymcamn.org); Barre Bliss (barrebliss.com); CycleBar (cyclebar.com) 

Pick a lane:

Walk to End Alzheimer’s (Sept. 9) act.alz.org

Mississippi River Day Canoe Trip (Sept. 23, Sept. 30, Oct. 7) wildernessinquiry.com   

Brown’s Creek Guided Night“Flashlight” Walk (Oct. 28) nstt.org    

Becoming an Outdoors Woman–Minnesota River Nature Hike (Dec. 9) dnr.state.mn.us

Advances in Pain Management 

Joint pain: It burns, it aches, it stiffens, and it’s an unfortunate part of daily life for many. Fortunately, modern medical advancements have opened the door to more treatment options.

Regenerative Medicine

“A person can take advantage of their body’s ability to heal itself by using healthy adult stem cells that can be found throughout the body,” says Dr. Constantin Starchook, medical director of Twin Cities Pain & Regenerative Medicine. “Research has shown that it is possible to use adult stem cells to effectively regenerate tissue in the body.”

According to Starchook, stem cells are most commonly used for treatment of the shoulder, hip, foot and ankle, elbow, hand and wrist, and spine degeneration.

“Active Minnesotans are now able to return to activity more quickly with greatly decreased pain and improved mobility,” says Starchook.

Neurostimulation Therapy

“There is an overall trend across the country toward reducing over-reliance on opioid medications and an emphasis on other pain management tools, such as neurostimulation,” says Dr. Sherri Haas, physician at Twin Cities Pain Clinic. 

Neurostimulation is the practice of applying stimulation to nerves that have been identified as sending strong, frequent pain signals. A small device implanted near the spine generates a frequency that the patient may not perceive but works on the nervous system to reduce the pain, says Haas. In other words, it outsmarts your pain. “I had a patient who was previously active sustain an Achilles tendon injury and, despite several foot surgeries, was not able to bear weight without significant pain,” Haas shares. “This patient underwent a neurostimulation trial and within minutes was able to jump up and down. The patient was seen back in the clinic for implantation and has not needed to come back since.”