Although fall-related injuries aren’t talked about as frequently as smoking or obesity-related illnesses, they are at epidemic proportions. In the US alone, almost 1 in 3 adults over 65 years old falls each year. Of these older adults who fall, 37.5% report sustaining an injury in the fall.* And most tragically, many of these injuries, such as a head trauma or hip fracture become fatal. In fact, if deaths from falls continue to increase at the same rate, the U.S. can expect 59,000 deaths because of a fall in 2030.**

Yet, it’s not just older adults who get hurt when falling down. Pause and think for a second. There is a good chance you know someone who broke a wrist or twisted an ankle when crashing to the ground. Maybe you’ve suffered your own fall-related battery?

It’s time that we stop talking about falls mainly from a preventative point of view. Not all falls are avoidable. Instead, let’s change the discussion to how to minimize injury when the inevitable happens.

Listed below are seven ways to help you avoid an injury during a fall. These are hard won insights, born from martial artists, skateboarders, and parkour athletes. These individuals routinely drop to the ground, and yet they get up again and again without injury. How they fall and interact with the ground is a curious feat, and a great starting point to the topic of injury prevention.

Be aware of your environment

Athletes who fall down frequently have a heightened awareness of the space around them. Why? Because if you know that a fall is inevitable, you want to drop in such a way that you avoid hitting an unforgiving surface. Slamming your head on a cinderblock is much less pleasant then landing in a soft bush. Likewise, the concrete sidewalk is a much less welcoming landing pad than the patch of grass off to your side.

By scanning the environment and being aware of the world around you, you are better prepared to steer your fall away from danger. Now, you might not always have much leeway to direct your fall, but it is a good aspiration to have.

Incidentally, if you are reading this on your smartphone while you’re walking down the street: Please put your device down. As with texting and driving, distracted walking makes you much more likely to careen into danger.

Don’t freeze!

A common theme in self-defense seminars, is that if you freeze you die. If someone is intent on causing you bodily harm and you don’t respond accordingly, well, harm happens. The same thing applies during a fall.

If you have ever been to a self-defense course, recall how you practiced deflecting and responding to an attacker. You practiced your blocks and strikes over and over again to build your muscle memory. The repetition strengthened your neural pathways to make sure that you would not freeze in the face of danger.

In a similar way, martial artists, skaters, and parkour athletes train themselves to recognize and respond to a fall as quickly as possible. The faster you can recognize that you are going down, the faster you can respond and avoid injury.

Close your eyes for a moment. Imagine that you were ten feet above the ground, walking across the narrow metal beam of a playground swing set. Don’t bother yourself with how you got there – just play along here.

You take one step, a second step, and on the third step you lose your footing. You are starting to FALL.

In this moment, you have two options. Option A: you can do nothing and let the ground rush towards you, as you brace for impact. Or, option B: you scramble and claw to grab the metal beam so that you can drop in a more controlled manner.

Let go and do nothing. Or, react and take control. Those are your options.

Which one do you think has a better chance of avoiding injury?

However improbable that scenario might seem, the same thing applies every time you fall on flat ground. Do nothing. Or, respond and take action.

If you are wondering what type of response and action to take, keep reading. Athletes who fall down a lot cultivate a style of falling that helps keep them from getting hurt. Copy their style and you too can fall without injury.

Avoid straight lines

During a fall, your straight limbs might as well be broken limbs. Don’t believe that? Go watch a few “fail” videos. Striking the ground with outstretched limbs often leads to a broken bone.

Thus, athletes who fall down a lot try to make impact with rounded limbs. They stay loose and lightly flexed across their major joints. From the spine, legs, and arms, their major body segments form into relaxed semicircles.

Consider tipping a kitchen chair backward and then letting it drop back onto all four legs. That leads to a pretty rough landing, right?

Now, imagine tipping a rocking chair backward and letting it rock forward. The curved support of the rocker makes for a much softer landing.

Your goal when learning to fall should be to transform yourself from a rigid kitchen chair into a rounded rocking chair. Harness your inner rocking chair

As another example of what it means to avoid straight lines, place your arms out to your side, and then point your hands back toward your waist. Pretend you were demonstrating to someone the shape of your body as if you were wearing a blow-up sumo wrestler suit. Now, flex your spine a little and go loose in your legs crouching toward the ground a few inches.

Once you are in this position, feel what it is like to be in this ball shape. The more ball-like with rounded surfaces you can become during a fall, the better you can avoid injury.

Spread your impact across multiple body segments

It follows from the last point that dropping entirely onto your wrist, hip, or shoulder without spreading out your impact is a recipe for disaster. The solution is to dissipate your contact across multiple body parts. The ideal strategy is to have a light contact with the distal (far) point of your limbs, with greater absorption happening close to your larger joints and torso.

Think of how an airplane comes in for a landing. The pilot doesn’t drop the plane onto the tarmac all at once. First the rear wheels touch down, then the front of the plane eases onto the ground. The analogy isn’t perfect, but that image of spreading out your contact should be helpful.

Stop thinking of your hands and arms as your main shock absorbers. Instead, consider them as insect-like feelers to contact the ground and re-orient your impact. Strike lightly with your hands, then quickly transition up the chain to your forearm, shoulder, and backside.  Even if your arms are out of the picture for some reason, the same sequencing applies elsewhere on your body. If you are dropping onto your bottom, spread the force across your hip, back, and shoulder.

Stay away from your bony bits

After training yourself to spread out your impact and avoid straight limb-lines, the next thing to work on is avoiding hitting the bony parts of your body. In the medical world, we call these your bony prominences and you have them wherever your bones extend close to the surface of your skin.

Starting from the ground up, here are the main bony prominences to avoid during a fall:

• The side of your ankle (lateral malleolous)
• Your kneecap (patella)
• The side of your hip (greater trochanter)
• The bones of your pelvis, tailbone, and sacrum
• The bony extensions of your vertebrae (spinous processes)
• Your shoulder blade (scapula) and the tip of your shoulder (acromion process)
• Your elbow (olecranon process) and the small bones of your wrist and hand
• And of course, the biggest bony prominence of all: YOUR HEAD!

Training yourself to avoid impact with these bony landmarks takes some practice, but it’s worth it. After 17 years as a physical therapist, I know of numerous cases where a fall onto an elbow or knee led to a fracture. Since they are so close to the surface of your body, these prominences are not well protected and cannot take much impact.

So, how do avoid hitting these tender points? Part of it comes down to spatial awareness and knowing how to tuck your body to provide them with extra protection. The other part revolves on training yourself to avoid falling along the cardinal motions – forward, backward, or sideways. Instead of dropping along these four directions you should become familiar with diagonal paths, 30 to 45-degrees off your main axis. Falling along these diagonal paths provides some protection to your bony parts, and it also uses your body’s padding more effectively.

Wear your muscle as padding

During a fall, the big muscle groups of your body can act as a coat of armor to help keep you safe. By learning how fall in a way that maximizes impact along these muscle groups, your contact with the ground becomes much less disastrous.

In your lower body, we are mainly talking about using your glutes as padding. This means falling along a diagonal path that brings your impact onto one cheek at a time. Of course, this is really only beneficial if you can orient yourself so that your backside strikes the ground first.

Luckily, your upper body is a bit better armored for impact. You have the large muscle wad of your forearm that can help dissipate force. Even your triceps and deltoids can be used to your advantage during fall. Similarly, the wide breadth of your lats (latissimus dorsi) can provide key protection to your trunk.

What should you do if you don’t have that much muscular padding? Consider it one more reason to develop and stick to a strength training regimen. Aging naturally results in the loss of muscle mass over the years, thus you need to be extra diligent to maintain and build muscle as you get older.

Use a roll when appropriate

Lastly, there are certain times when rolling across the ground is the best solution to avoiding a fall-related injury. Over the years, I have fallen and rolled across concrete multiple times without getting hurt. It has happened when skating at the skatepark, training parkour, and even running my dog on a leash. Without the rolls, I’m convinced that either of the falls could have resulted in a trip to the hospital.

Mind you, these were legit, hard falls on concrete with speed involved. Using a roll is so effective, that each time I popped up to my feet with a look of bewilderment:  How I was I not hurt?!

Note though, that the type of roll you do is of huge importance. We aren’t talking about an over-the-neck gymnastics roll. It’s closer to a martial artist’s shoulder roll, but with some slight tweaks. Parkour athletes have perfected this roll for the real world, since they regularly train without the pads or crash mats.

It’s not within the scope of this piece to go into the details of a parkour roll here. Instead, please go meet with a local parkour coach to learn how. If you live in a major US city, the chances are high that there is a parkour gym awaiting your visit.

The main thing is to know that rolling is a movement skill that everyone should to master. Maybe you will need it someday, maybe not. Either way, it is best to be prepared.

Conclusion

Falling down IS a part of life. It’s time health care workers and the public health community recognize that not every fall can be prevented. As someone who wants to stay healthy and whole, make it your mission to learn how to fall without getting hurt. Furthermore, please help spread the knowledge to your loved ones, neighbors, and colleagues.

If you want to learn more about the falling techniques used by parkour athletes, you are in luck. ParkourEDU recently released an online course titled the Art of Falling. This is the first time I have put an affiliate product on the website, and it is because this team puts out such high-caliber material. Amos, the course instructor, is a wonderful coach and a riot to watch. You should check it out.

DISCLAIMER | word to the wise: Please don’t start throwing yourself on the ground willy-nilly because of this article. It’s not a substitute for one-on-one instruction. A good teacher will use appropriate padding and will make other adjustments to minimize your impact. Likewise, people with certain bone disorders, blood disorders, on certain meds, or with other health concerns should definitely talk with their doctor before beginning this type of training.

*CDC Morbidity and Mortality Weekly Report: Falls and Fall Injuries Among Adults Aged ≥65 Years — United States, 2014

**CDC Morbidity and Mortality Weekly Report: Deaths from Falls Among Persons Aged >= 65 years – United States 2007- 2016

Do you have a great story to share about falling down or injury prevention? Please leave a comment below.

Ryan Ford and I published Parkour Strength Training at the beginning of 2016 to ignite a conversation about what it takes to be lifelong practitioner of our sport. Drawing on Ryan’s coaching career, the book discussed the strength, mobility, and joint preparation needed to keep an athlete injury-free.

Yet, besides that writing, there is little published on injury prevention for our community. Finding academic information about parkour injuries, rates, risk factors, or how they occurred is a practice in futility. A study came out of Brazil in 2014, but only 91 individuals were sampled. The conclusions were that age and the duration of a training session were the main variables associated with injuries. It also concluded that more studies were required to develop a more comprehensive prevention strategy.

To that end, perhaps you heard about the survey conducted by Dr. Lafe Harris and myself this past summer. The questionnaire was issued IRB approval and we had a turnout of over 1700 consenting respondents.

From height and weight, number of years training, sex, and prior fitness level, we collected a massive amount of information. Cleaning and organizing the data has taken some time, but we are now in the process of submitting it for academic review. Because the results are still unpublished, we are limited in how much we can disclose at this point.

Nonetheless, we are eager get the results out to everyone as soon as possible. The bullet points below offer a quick summary of our findings. Understand that this is a superficial overview, with more details to follow upon publication.

Survey Summary

• The vast majority of respondents were men, under the age of 35.
• Almost 4/5 of them had an injury that kept them from training parkour in the past year.
• Most injuries resolved in less than 2 weeks, with a much smaller fraction causing impairment that lasted over 6 weeks.
• The injuries were more likely to be sustained while outside or training alone, than indoors or with a group.
• The ankle, knee, and foot were the body regions most frequently injured.
• Sprains/strains and contusion/bruises accounted for the majority of recorded injuries.
• A sprain/strain/tear of the ankle (including the Achilles) was the most common reported injury by individual response count.
• The foot, wrist, and ankle were the 1^st, 2^nd, and 3^rd most common regions to experience a fracture.
• The knee was the most commonly reported bruised/contused body part.
• Landing was the most frequently recorded cause of injuries, followed by falling, and impact with an obstacle.
• Over 1/3 of respondents said that they have experienced a non-traumatic injury, such as a tendonitis or similar syndrome.
• The knee was the most common joint to suffer from a non-acute injury.

Points to Remember

Whether you are a solo practitioner or the coach of many athletes, a few take-homes should jump out:

1. The environment and setting where you practice is important. Training outside or alone presents more risks than indoors or with a group.
2. Landing, falling, and passing obstacles with grace are essential skills. High loads and harsh impacts don’t make for a happy body
3. Parkour athletes need better methods to protect their ankles and Achilles from injury.
4. Like every sport, parkour has its own collection of cumulative and overuse injuries. Prehab work must be part any strength and conditioning program, especially for your knees.

As we dig deeper into the data, new insights are bound surface. Slicing the sample according to age, gender, and experience, should provide a deeper level of understanding.

One theme that stood out was that many people said parkour actually helped them avoid injuries. That is a pretty cool, don’t you think?

Dr. Harris and I are interested to hear your thoughts about this topic. What additional research questions would you like to see addressed? Are our findings congruent with your own experience?

Finally, if you would like to be notified once the official results are published, please add your name to the email list here.

Thanks to Kelly Starrett, everyone knows that if you aren’t strong AND supple, then you’re as good as broken.

In fact, meeting someone who doesn’t work on their mobility nowadays, is about as rare as skateboarder landing a 360 flip on the first try. It doesn’t happen.

Yet, I ask you, how many of you can say that you have a daily agility practice?

Unless you’re a circus acrobat, I’ll venture that you aren’t working on agility every day.

That’s too bad.

The more agile you are, the better athlete you are. More importantly, the more agile you are, the better you can avoid injury.

The importance of a daily agility practice

If you follow me on Twitter or Instagram you know that I love skateboarding. What many of you might not know, is that I turned 39 this week. The risks associated with skateboarding are always top of mind.

Last year I saw a buddy snap his ankle at a skatepark. He slipped on a backside tail slide, and came down on his foot like a limp lawn dart. Pop went his fibula.

Witnessing that was a wake-up call. It was such as simple accident. The more I thought about it, the more I came to think of how important it is to be light on your feet, not just in skateboarding, but all the time.

Stumbles, trips, and missteps happen to all of us. They happen while walking down the sidewalk. They happen in grocery stores, museums, and movie theaters. They happen in the most mundane moments, and in the heat of competition.

If you don’t train yourself to be nimble, then sorry, your movement practice isn’t complete.

Agility isn’t just the hallmark of a good athlete. It’s more than that. Being light on your feet is a crucial life skill.

Falls account for the majority of injury-related deaths in older adults. Think about that for a moment. Working on your agility could save your life someday!

What does an agility practice look like?

First of all, there is no need to make it complicated. Having a daily agility practice can be as simple as working on rapid footwork and simple balance drills. You don’t even have to cut into your normal workout time.

Here are a couple of guidelines:

• Agility work can and should be part of your warm-up activities, especially before sports.
• Practice hopping in and out of different positions, as if you were recovering from losing your balance. Hop forward, sideways, backwards. Go from two feet to one foot, and vice versa.
• Be graceful! Keep excess arm and trunk motion to a minimum
• Use targets on the ground to help refine your feet-eye coordination. If you’ve ever walked down the street, trying not to step on cracks in the sidewalk, then you know what I mean. The more aware of where your feet are, the more agile you become.

For those of you looking for more of a challenge, up the ante by introducing a small obstacle, like a thin block of wood or a piece of PVC pipe. Can you hop over it without getting your feet tangled?

Agility work is meant to test your coordination, and spatial awareness. The rope ladders and tire runs used by strength and conditioning coaches are great examples. Exercises where you quickly switch directions when running between cones is another favorite for team sports.

For another test of your agility, see if you can quickly hop onto and off of a small obstacle. It could be a low step or even the one of the ground rail trainers used in parkour. Can you land softly, stabilize, and then pop off again? What about jumping completely over the barrier and then back again? How about swapping your feet atop the obstacle? Imagine the surface was covered in sticky glue. Could you be so light on your feet that you would not get stuck?

Notice however that none of this resembles plyometric training. None of the jumping or hopping is anywhere near max effort. We’re talking about very small movements.

Keep your vertical and horizontal displacement to a minimum. Likewise, you shouldn’t be making any sound upon impact. Turn your ninja dial to 110%, and be as quiet as possible.

An example agility series to try right now

The following drill is the agility series that I use every time before I go skateboarding. I use it to warm-up my ankles as well as heighten my coordination. Put down your phone, tablet, or whatever device you are reading this on, and give it a spin:

1. Double leg ankle hops
2. Single leg ankle hops
3. Alternating ankle hops
4. Forward/backward hops
5. Lateral hops
6. 4-square hops

That is pretty straightforward, right? All together, it shouldn’t take more than a two minutes to do five to 10 reps of each exercise.

Like I said, that is the little flow that I use before skateboarding. A more thorough daily agility practice could include some of the elements mentioned earlier.

The point is to start incorporating rapid footwork and small balance challenges into your regular exercise programming. Even adding multidirectional hops while jumping rope can have a positive effect on your agility.

The more you practice these agility skills, the easier they become. Start small, and gradually increase the complexity.

If you already have a daily agility practice, what are some of your favorite drills?

I’m always looking for fresh ideas, so please leave a comment below!

*Disclaimer: This article is for information purposes only, and is not a substitute for medical care. Talk with your healthcare provider before beginning this or any other exercise routine. 

I trained there for a few months, while grinding through my physical therapy pre-reqs in Albuquerque. I LOVED stress-release of those workouts. The sparring boosted my confidence, and it was one of the few times in my life when I could boast of a chiseled six-pack.

Having stacked abs was a cool side effect from all of the crunches, the intense cardio, and the limited diet of a college student. Yet, that was not the reason why we finished our training with such a gawd-awful amount of calisthenics.

By toughening our trunks, we were conditioning ourselves to take blows without getting hurt. Internal organs dislike blunt trauma. Our ripped abs became the shield that let us spar without injury.

The benefits of additional muscle mass are well established within the health and fitness world. More muscle yields more brute strength. It allows for better power generation and postural support. And, of course, it also helps boosts your metabolism to promote fat loss.

However, less often discussed, is how muscle can act as protection for the more delicate parts of your skeleton and organs.

Martial artists pay heavy attention to strengthening their midsections, but every athlete can use the idea of muscle as protection. Skateboarding, trail running, and parkour are some of my favorite pastimes. Needless to say, I am a little too familiar with falling down. And, in case you have not taken a spill in a while, let me remind you that it hurts. Multiply that tenfold if you strike a bony part of your body on the ground.

If you are an athlete that crashes to the ground with any frequency, listen up.

Putting more muscle on your body can make your falls less painful.

In PT school, we were taught that bed bound patients and others with limited mobility were at risk for skin breakdown wherever a bone is close to your skin. Because of the limited padding, skeletal prominences are more likely to develop pressure sores than other, fleshier areas. Those bony landmarks are also the parts of your body that hurt the most when they strike anything hard. Think of hammering your elbow into a doorframe or tagging your knee against a car door.

Strike a muscular part of your body against something solid, you can generally shake it off without injury. You might have a bruise and some brief discomfort, but it is nothing like the howling pain of hitting a bony body part.

Everyone knows to protect your skull during a fall or a roll. Other parts of your skeleton that need protection include your:

• Lateral malleolous – the outer part of your ankle
• Patella – your kneecap
• Greater trochanter – the bony prominence of your lateral hip
• Olecranon process – the tip of your elbow
• Acromion process – the tip of you shoulder
• Spine of scapular – the ridge of your shoulder blade
• Spinous processes – the tips of your vertebrae
• Coccyx, sacrum, and iliac crest – the bones of your pelvis

In terms of injury prevention, your first line of defense during a fall is learning to strike the ground in a way that you do not hit these landmarks. Improving your kinesthetic awareness and proprioception are useful. Learning to break-fall and roll with good technique are also essential.

After that, your next line of defense is simple: Put more muscle on your body!

Increasing your muscle bulk provides cushioning against any unplanned-for-impact. It is like strapping pillows to your body. The extra girth makes it harder hit your more sensitive parts.

There is no need to bulk up like a sumo wrestler or strongman competitor. All you need to do is focus on a few key muscle groups.

Which muscle groups should you focus on? Target these three:

• Shoulders
• Back
• Butt

Does this mean you should neglect the rest of your body? Of course not.

Strong calves, quads, pecs, and biceps, all contribute to better athletic performance. But, compared to the three groups listed above, they are much less likely to help cushion your falls.

If you need proof, try out this quick test. Go stand in a grassy field and let yourself crumple to the ground.

I am going to venture that you did not drop to your knees, and then roll onto your thighs and belly like a deranged rocking horse.

You probably went slack through your lower body, started tipping sideways, and then dropped onto a butt cheek. From there you likely rolled sideways onto your back and shoulder.

Maybe you also extended an arm to take some impact.

The broader the area that you make contact with, the less force any single area takes. Having more surface area in contact with the ground, makes for a less painful, and less damaging landing.

By the way, your forearms and triceps are two smaller muscle groups that could easily fit within the muscle-as-padding paradigm. Bulk those puppies up and you basically add two more bumpers to your body’s frame.

Now, imagine for that some reason you were stripped of 90% of you muscle mass. Consider what it would feel like to crumple to the ground via the same sequence.

What would it feel like to do it on the sculpted concrete of a skatepark?

That would be a world of hurt, would it not?

A muscular butt, back, and shoulders are protection for your skeleton.

Fortunately, the way to build these muscles is simple.

Multi-joint upper body pushing and pulling exercises, along with compound lower body movements are the key to athletic development. They are also the key to building muscle as padding.

It does not need to be complicated. These are some multi-joint exercises that can help pad your body:

• Dips, push-ups, and shoulder presses
• Pull-ups, chin-ups, and inverted rows
• Squats, deadlifts, lunges, and step-ups

When your goal is to add muscle as padding, you need to be sure to use a repetition scheme that favors muscle hypertrophy. You want to actually grow the size of your muscles, not just get stronger. Pure strength is achieved at high load and lower repetitions, but that is not what you are shooting for. Instead, target a higher volume of sets and reps at a slightly lighter load. You are trying to provide a stimulus that tells your body:

Hey, let’s add some bulk to these specific muscles.

Once you have built a level of  padding that you are happy with, go ahead return to a workout structure that benefits your sport-of-choice. Depending on what you do, that could mean more endurance, more power, or some hybrid of the two.

Gravity snags everyone sooner or later. Whether you trip on a root, slip in the mud, or bail on trick, it is just a matter of time before you go down. You can either take it like a warrior, and walk away unscathed. Or, you can lie writhing in pain.

A well-developed butt, back, and shoulders, can act as cushioning for your crash landings. Be proactive. Build your padding, and play as hard as you want.

* * *

Are you athlete with lots of falls over your lifetime? I would love to hear from you. What strategies do you use to stay injury-free?

Please leave a comment below.

Twenty years later, I’m a stronger and more mature athlete, yet I still get goosebumps remembering that noise. However, instead of worrying about another random fracture, I’m mainly conscious of not snapping my Achilles tendon.

You see, if you’ve been doing parkour for a number of years, then there is a fair chance you’ve heard of someone who has popped an Achilles while training. While it’s not an epidemic, it’s definitely a noteworthy occurrence. I’m aware of least three high-level parkour coaches have succumbed to the injury. A competitor tore his Achilles while running the Warped Wall on American Ninja Warrior. And although it’s not directly parkour-related, the CrossFit scene has had a rash of Achilles tears in their community.

An Achilles rupture is debilitating injury. Whether or not it is treated surgically or with splinting, you are looking at multiple weeks of immobility. If your goal is to have an uninterrupted, lifelong training career, protecting your Achilles must be a priority.

Every sport has its unique traumatic injuries. Skateboarders fracture their ankles and wrists. Cyclists break their collarbones. And soccer players tear their ACLs in an unfortunate sacrifice to their sport.

To prevent Achilles ruptures from becoming a right of passage for parkour athletes, this is the critical information you need to know:

WHAT IS THE ACHILLES?

Your Achilles tendon is the thick bundle of tissue that connects your calf muscle to your heel bone, the calcaneous. When you fire your calf, the Achilles tendon pulls on your calcaneous to plantarflex your foot, i.e. point it away from your torso. Conversely, when your ankle dorsiflexes—bringing your foot toward your face—the Achilles tendon and the calf muscle become stretched.

Most injuries to the Achilles occur with an eccentric load or an explosive plyometric contraction.¹ This means that you need to be careful when your calf counteracts the dorsiflexion of your foot or when the ankle rebounds into plantarflexion. When does this occur? Imagine dropping onto the balls of your feet and then letting your heels slap down. That represents an eccentric load to your Achilles. Now imagine doing box jumps for time, bouncing from the floor to the box as fast as possible. That represents an explosive plyometric contraction. Consider how those mechanics relate to the wide array of parkour movement. Precision jumps, wall runs, plyo broad jumps, tictacs, bounding—any activity that requires heavy loading of your forefoot places your Achilles at risk.

Vinny Fiacco is the general manager and one of the coaches at APEX Movement Denver. He tore his Achilles back in 2014 when doing a wall run. The injury happened on a Monday, but it’s important to note that he had participated in a force-measuring experiment the previous Thursday. He had done about 6 max effort wall runs during the study, and he remembers that his Achilles felt super sore on Friday. He took 3 days off and then returned to the gym on Monday. After warming-up and training without any difficulty, he took a break. Upon returning, this is what he recalls:

I went back into the gym, thinking I was still going to be warm, but I guess I was cold. And the second I tried this wall run I heard a loud snap and that was it. It was very loud. I even have a video of me, filming probably 30 feet away, and you hear the pop pretty loud. Someone thought I hit my knee into the wall.

I landed on my other leg, got to the ground, and I was like what happened? I looked at my Achilles, and saw that the skin was just jelly and the tension was all gone.

WHAT ARE THE RISK FACTORS?

It’s well known that sports with repetitive, abrupt jumping and sprinting have higher rates of Achilles ruptures.² On a recent cross-Atlantic flight, I talked with a college-level track athlete with a 6-inch vertical scar ascending from his heel. He popped his Achilles running cone drills on his third day back after summer vacation. He ended up missing the entire season, but because it happened during a scheduled practice, the university paid for his surgery.

The injury can also happen from an unfortunate misstep or a fall. In physical therapy school, I worked with an older gentleman who blew his Achilles stepping off a boulder while hiking. Thank goodness he wasn’t too deep in the wilderness. He was able to hobble back to the trailhead, albeit much slower than he would have liked.

Many people will report that they felt a blow to their heel at the time of injury.² The snapping of the tendon is so powerful that it can feel like someone kicked you in the back of your leg. The track athlete I spoke with said he thought a teammate had punted him from behind.

Besides the type of physical activity that you do, the literature identifies additional risk factors for an Achilles rupture. One of them is your age. People in their 30s and 40s have higher rates of heel cord injuries than younger athletes.¹ Your connective tissues gradually become less elastic as you age. You also typically aren’t running wild outdoors, strengthening your joints as much as you did in your childhood and teen years.

The other main risk factor is a history of Achilles tendinopathy.¹ A tendinopathy is a painful disorder of a tendon that is related to a failed healing response to an injury, traumatic or cumulative. Jumper’s knee is an example of a tendinopathy of your patellar tendon, but along with the Achilles, there are many body regions that can be involved.

When a tendinopathy is present, the involved tissue is restructured so that it becomes weaker and more likely to fail. The collagen fibers become less tightly bundled and less organized than in a healthy tendon. Additionally, tendons have 7.5 times less oxygen consumption than skeletal muscle, meaning that their healing and strength gains take longer than muscle tissue.³ Consequently, whenever you’re aware of some discomfort in a tendon, you need to put your brakes on and let it heal.

I’ve got some tendinopathy going on in my right Achilles after stepping in a pothole during a run last summer. I know that it places that leg at a higher risk for injury, thus I’m way more cautious about warming-up and calling it quits if the pain increases. Vinnie’s report of his Achilles being sore just a few days before his tear, is definitely in-line with what is known regarding the etiology of ruptures.

HOW CAN A TEAR BE PREVENTED?

The most important aspect to preventing an Achilles tear involves having a solid understanding of the mechanism of injury. Knowing how a tear happens, prepares you to avoid one. Here are the key points to remember:

• Use caution with heavy eccentric and plyometric movements. Besides sprinting, jumping, and dropping, many other lower body dominant parkour skills put you at-risk. The data for parkour-related Achilles tears are sparse, but I suspect that wall runs and similar forefoot-loaded movements are the worst offenders. Eccentric and plyometric contractions generate higher tension than concentric muscle action only. To protect your tendons, you need to be gentle in how you introduce this type of skill into your training. Add wall runs and other similar movements into your repertoire slowly, gradually increasing the height and speed involved. Whenever there is a major bump in the intensity or volume of your training load, know that your connective tissues might not have had time to catch-up, and an injury might not be too far behind. I know it’s hard, but you need to slow down and be methodical in your progressions.

• Pay attention to your technique. Striking the ball of your foot into a firm surface with a floppy ankle is a recipe for over-stretching and tearing your Achilles. Make it a practice to stay “active” in your ankle, meaning that your foot is plantarflexed and ready for impact. By actively expecting a specific load, you are better prepped to counteract the force. If you’ve ever done any trail running, recall how vigilant you become to avoid rolling your ankles on a root or a loose rock. The same thing applies to parkour. The more conscientious you become of your Achilles, the better you can protect it.

After understanding the mechanism of injury, the next step in prevention involves being aware of the relevant risk factors. The most important concepts are:

• The older you are, the greater the risk. People in their fourth and fifth decades of life experience higher rates of Achilles ruptures than younger athletes. As you approach middle age, or even your late 20s, be much more mindful of your training.

• Don’t ignore heel cord pain. The degenerative changes that are associated with a tendinopathy increase the risk of tissue failure during high loads. If you have discomfort in your Achilles tendon, consider it a warning sign that you need to be extra cautious. Seek medical attention and rehab the tendon back to full integrity.

When asked to identify what he might have done to prevent his injury, Vinnie put it succinctly:

More rest. I thought I was doing a good job of listening to my body, thinking 3 days off was enough rest. I know that the Achilles, and other tendons and ligaments, take way longer to heal. It’s not a muscle. So, I should have given it more rest, warmed-up more, and not gone into the gym cold. I was 29 at the time, and you can’t pull that anymore.

BUILDING BOMBPROOF ACHILLES

So far we’ve taken a defense approach to injury prevention. To complete our discussion about Achilles tears, let’s finish on a proactive note. Just as you hopefully already work on hanging shrugs as prehab for your shoulders, it’s time to strengthen the connective tissues of your calves.

Assuming that you already have good ankle mobility and strength, there is one main Achilles-targeted exercise that I recommend adding to your routine. As a descriptive term, I’ll call it an elevated calf raise. You might already know it as a heel drop. The idea is to stand on the edge of a stair, rise onto your tiptoes, and then let your heels lower below the lip of the stair. For the exercise to be safe you need to start slowly and ease into your full range of motion. Be respectful of your body. Don’t slam your heels downward and expect everything to be fine.

By emphasizing the eccentric component, heel drops strengthen your Achilles in the position where strength is most needed. Yet, the dose makes the poison. If you lower with too much force you are gambling with getting hurt. Start slowly!

Once you are comfortable doing heel drops while perched on two feet, transition to a single leg. Hold onto a rail or post for balance. Also try varying how you stand—between a bent knee and a fully extended knee—to work the different layers of your tissue. Add a greater descent velocity and a rebound back to the top position as the final elements.

Remember what I said about oxygen consumption and tendon health. For this exercise to have an effect on your tendon strength, you to need to think long term and accumulate a huge number of repetitions. As long as you are pain free, and muscle fatigue isn’t spilling over into your athletic performance, try squeezing in a few dozen reps throughout your day. Crank out a few sets on a curb while waiting for the bus. Pump out a couple more whenever you pass a flight of stairs. As always, be smart and build up to how many reps you do. Introducing a high volume of any exercise without a gradual ramping period is sure way to irritate your tissues.

Heel drops are my preferred method to strengthen the Achilles, but in the name of a well-rounded prehab program, consider these supplemental exercises:

• Ankle hops Bounce up and down on the balls of your feet, while keeping your knees essentially straight. Focus on your calves, and minimize any upper leg effort.
• Jump rope The repetitive loading of jumping rope is perfect for building bombproof Achilles. Try to be as silent as possible, and mix things up with single leg jumps, skipping, and alternating step patterns.
• Jogging If it isn’t already part of your fitness regimen, push yourself to take a couple of runs through your neighborhood each month. Like jumping rope, the cyclical nature of jogging is beneficial for Achilles health. Start with short distances, and be light on your feet, aiming for a mid to forefoot strike if possible.

CONCLUSION

I don’t mean to be an alarmist. Your Achilles tendon is a remarkable structure, and it’s built to withstand tremendous load cycles. Yet, like any other biological tissue, failure is always a possibility. As a parkour athlete, many of your regular movements put you at-risk for an Achilles injury. By being aware of the risk factors and understanding how an injury occurs, you can take measures to thwart an accident. Likewise, by adding a few prehab exercises into your routine, you’ll be better prepared to avoid disaster.

If you found this article useful, please help spread the word to other athletes. I’ve had my share of orthopedic mishaps over the years, and one of my top priorities is to help others stay injury-free. Finally, I encourage you to leave a comment below. The more we learn about parkour injuries, the more effective we become at prevention.

This article is not intended to diagnose or treat any medical condition. If you are injured, speak with a licensed health care professional for guidance.

¹ Gregory William Hess, MS, ATC/L, CSCS, Achilles Tendon Rupture: A Review of Etiology, Population, Anatomy, Risk Factors, and Injury Prevention. Foot & Ankle Specialist, Feb 2010, vol 3, no 1 29-32

² Dr Dishan Singh, Acute Achilles Tendon Rupture, British Medical Journal, 2015;351:h4722

³ Pankaj Sharma and Nicola Maffulli. Tendon Injury and Tendinopathy: Healing and Repair J. Bone Joint Surg. Am. 87:187-202, 2005.

Injuries often seem unavoidable. Yet, when you know what the most common types of injuries are in your sport, you have the power to adjust your risk-taking accordingly.

It was from that mindset that I wanted to create a survey to explore the types of injuries that parkour athletes face.

As of today, 239 people have submitted their responses to the Survey Monkey link I put out on social media.  (I’m grateful to American Parkour, Ryan Ford, Revolution Parkour, and the Portland Parkour Facebook community for helping to spread the word!)

I had a lot of feedback about the design of the survey, with emphasis on the fact that you should have been able to select more than one answer, and that some options weren’t even listed. Chalk it up to my  inexperience with survey design. Given the opportunity to redo it, I would have enabled multiple selections and allowed free text for some of the questions

Here is summary of the responses for each of the 10 questions, followed up with a bit of analysis at the end:

1. Have you experienced a parkour-related injury in the past 12 months?

YES: 85.5 %

NO: 14.5%

2. How would you describe the injury?

Traumatic (resulting from a specific accident/fall, etc.): 74.2%

Cumulative (chronic, developing over time): 25.8%

3. What body part was injured?

Head, neck or upper back: 5.7%

Shoulder: 6.8%

Elbow, wrist or hand: 18.2%

Low back: 6.3%

Hip or pelvis: 3.6%

Knee: 20.8%

Ankle or foot: 38.5%

4. What was the nature of the injury?

Joint sprain: 23.2%

Muscle strain or tear: 19.1%

Fracture: 5.7% (11 people)

Dislocation: 2.6%

Tendonitis or bursitis: 9.8%

Nerve injury: 2.1%

Contusion or bruise: 24.2%

Other: 13.4%

5. What level of medical intervention was required?

None: 72.5%

Emergency Department: 4.7%

Surgery: 1.6% (3 people)

Physical therapy: 10.9%

Chiropractic: 6.2%

Multiple: 4.1%

6. If the injury was traumatic, how did it occur?

While running/sprinting: 2.9%

Fall (during precision jump or vault): 35.8%

Dropping from a height: 16.2%

On bars (lache, brachiating): 3.5%

Performing acrobatics or freerunning: 23.1%

While strength training: 4.6%

Other: 13.9%

7. In your opinion, what could have prevented the injury?

Improved technique: 31.3%

More training: 10.9%

No hesitation: 6.3%

Better strength: 7.8%

More flexibility: 8.3%

Better spatial awareness: 17.7%

Freak accident: 17.7%

8. How have you had to modify your training since the injury?

Not currently training (still recovering): 8.3%

Use of a brace or strap: 10.4%

Shorter training episodes: 1.6%

Less intense movements: 10.9%

Cautious of the injury: 31.1%

Feeling fine (no modification to routine): 37.8%

9. What “tools” have you used to recover?

Pain killers: 5.2%

Icing: 12.5%

Rest: 31.3%

Compression (ace wrap, sleeves): 9.9%

Mobility drills: 7.3%

Stretching: 20.3%

Targeted strength training: 13.5%

10. How would you grade your knowledge of injury prevention and recovery, as it relates to parkour?

Excellent: 12.8%

Very good: 33.5%

Good: 36.9%

Fair: 13.8%

Poor: 3.0%

My Commentary

• Over 85% of respondents reported a parkour-related injury in the past year!  That’s a huge number, and perhaps related to selection bias, meaning that people with an injury were more likely to take the survey than the non-injured. Either way, it should draw attention to the fact that injuries abound in parkour, and we should be mindful of how to avoid getting hurt.
• The majority of injuries were traumatic, involved the leg (knee, ankle, feet), and resulted from a fall or dropping from a height. Not much of a surprise here. Any time high velocity is involved, the risk of tissue damage is greater during an accident. Falls or dropping from a height, by definition involve the acceleration due to gravity, thus they can result in significant tissue disruption, like the sprains, strains and contusions, which were the most frequently reported injuries. This reinforces the need to practice the art of falling, and limit your height drops. I recommend following Amos Rendao’s YouTube channel Parkour Ukemi, for advice on falling and rolling techniques.
• 13% of injury types were described as “other.”  My guess is that people in the “other” category suffered from cuts/lacerations and concussions, but I’d love to hear your feedback in the comments.
• Over 75% of the injuries reported could have been prevented with: improved technique, more training, increased strength, better flexibility, and heightened spatial awareness. This is a really important take-home message. All of the conditioning and training that you do can have a large impact on whether or not you get hurt. It emphasizes the need to dedicate time to strength training, balance work, stretching, and practicing the basic movements as part of your weekly routine. Dedicate too much time to learning new skills and you place yourself at greater risk of injury, than if you had a more balanced training regimen. 
• 15% of respondents noted only “fair” or “poor” awareness of injury prevention and recovery techniques. If you find yourself in this category, it’s essential that you take steps to search out instructors or mentors to help you learn how to avoid getting hurt. By being proactive in your approach to prevention, I’m confident that you can decrease your risk of parkour injuries.

Thanks again to everyone who participated in the survey.

Please leave your comments below.

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