Lower Extremity Stiffness: Considerations for Testing, Performance Enhancement, and Injury Risk.

Brazier, J, Maloney, S, Bishop, C, Read, PJ, and Turner, AN. Lower extremity stiffness: considerations for testing, performance enhancement, and injury risk. J Strength Cond Res 33(4): 1156-1166, 2019-Force-deformation characteristics of the lower limb have been associated with athletic performance and may modulate the risk of injury. Despite these known associations, measurements of lower extremity stiffness are not commonly administered by strength and conditioning coaches. This review provides an overview of the available literature pertaining to the effects of lower extremity stiffness on physical performance and injury risk. Practical methods of monitoring and training stiffness are also discussed. The cumulative body of evidence indicates that increases in lower extremity stiffness are associated with heightened performance in athletic tasks such as hopping, jumping, throwing, endurance running, sprinting, and changing direction. Relationships with injury are less conclusive because both excessive and insufficient limb stiffness have been postulated to increase risk. Thus, the "optimal" level of stiffness seems to be dependent on the anthropometry and physical capabilities of the athlete, in addition to sport-specific activity demands. Training interventions can positively enhance lower extremity stiffness, including isometric, eccentric, and isotonic strength training and plyometrics. Complex training also seems to provide a potent stimulus and may be more effective than the use of singular training modes. For plyometric activities, it is recommended that coaches use a developmental sequence of exercises with increasing eccentric demand to provide an appropriate stimulus based on the training age and technical competency of the athlete.