Is Extreme Fitness Really That Extreme?

There is an ongoing debate about whether some types of exercise push people too far. So-called “extreme” fitness activities—from CrossFit to marathons to adventure runs like Tough Mudder and Spartan Race—have been blamed for incidents in which participants suffered illness, injury, or even death. But nearly every kind of physical movement carries some risk of injury. Are these vigorous activities any more dangerous than other forms of exercise?

Marissa Zeitinger says she never had a passion for working out until she tried CrossFit, a regimen that combines powerlifting with high-intensity interval training. Less than a year since she started, the slim New Yorker has suffered injuries to three major areas of her body: her upper back, hips, and Achilles tendon. But she doesn’t blame CrossFit.

“I tried to lift too much weight, too fast,” Zeitinger explains, noting that her coaches never pushed her beyond her limits. She lays the blame entirely on her own shoulders. “Now I’ve learned to listen to my body.”

That change in attitude—learning to be mindful of one’s body—may make all the difference when it comes to staying safe while engaging in vigorous fitness activities.

“When we think of things like CrossFit, marathons, and adventure racing—they are all self-paced,” says Aaron Jones, P.T., M.P.T., a certified physical therapist who has treated a broad spectrum of clients for injuries related to such activities. “It is a real mental game that pushes how hard people go.”

Jones notes that many fitness activities labeled as extreme may actually be safer than most sports because participants can set their own pace. The injuries he treats from team sports generally tend to be worse.

“The forces that cause injuries in sports are high velocity,” Jones explains, adding that activities like football and skiing carry risks for spinal cord injuries, concussions, and death. By comparison, he considers CrossFit and marathon running to be relatively safe—and much safer than sitting around doing nothing.

“Even when I worked in a clinic right under a CrossFit studio, I saw more injuries—particularly necks and backs—from people leading a sedentary lifestyle,” says Jones, who now works at NYSportsMed, a highly regarded one-stop-shop for sports medicine and physical therapy. He used to joke that CrossFit was great for business, but adds, “the irony is that I’ve seen way more injuries from people sitting in offices all day.”

Exercise-related injuries are nothing new, but there’s been a wave of recent research highlighting the dangers of sedentary living. Multiple studies have shown that long periods of sitting increase the risk of death from all causes. Conversely, there’s no doubt that high-intensity exercise is linked to better health and a lower risk of developing serious health conditions like heart disease and diabetes. A small 2013 study confirmed that CrossFit also offers measurable health benefits, while a later study noted that most injuries from the workout program were fairly mild.

One thing is certain: being mindful of your body’s limits should be your first priority. To reduce the risk of getting hurt, Jones suggests participants ease into any new activity. “Don’t do too much too soon,” he advises.

If you feel the beginnings of an injury, Jones emphasizes that it’s important not to wait too long before seeking professional care. If the sensation isn’t gone in three days, if it returns two or three weeks in a row, or if it hurts enough to prevent you from doing a particular movement, Jones suggests getting it checked out.

It’s a lesson that Zeitinger, who spent months going to physical therapy for her injuries, had to learn the hard way. “CrossFit made me learn self-care,” she says, admitting that there were times when she was so frustrated with her injuries that she nearly quit. “But I just said to myself, I love it, so why am I going to let this keep me down? It gives you a feeling of strength to overcome these obstacles.”

Zeitinger now trains four to five days a week and has made adjustments to protect her body from further injury. “I focus more on technique than I did before and I do not push myself to the point where something doesn’t feel right,” Zeitinger says. “I also take fish oil, which is a natural anti-inflammatory.”

Fitness lovers often try supplements and special diets to help ward off injury-causing fatigue. Although eating a healthy, balanced diet is the best way to support your body, there’s some evidence that certain nutritional approaches may also be helpful. For example:

Omega-3 supplements
Research confirms that supplements containing omega-3 fatty acids have anti-inflammatory properties and some small studies suggest it may help reduce inflammation after exercise. It may also help exercisers reduce body fat.

The Paleo Diet
CrossFitters love to tout the benefits of eating “paleo,” a diet that focuses on meats, vegetables, fruit, and nuts, but excludes grains, dairy, and refined sugar. While there’s no evidence that the diet boosts athletic performance, small studies suggest it may improve risk factors for heart disease and type 2 diabetes, such as blood pressure and glucose tolerance.

Vitamins and minerals
There’s little evidence that exercise depletes your body of vitamins and minerals, unless you are following a restricted diet—but being deficient in key nutrients like iron, B vitamins, and vitamin D can affect your athletic performance. If you’re concerned, there are tests to screen for deficiencies. Taking extra vitamins and minerals when you don’t need them may be harmful, so be sure to talk to your doctor first.

There’s no supplement or diet that will erase the risks that come with vigorous physical activity, but neither is it safe to lead a sedentary lifestyle. High-intensity fitness offers significant physical benefits—from a lower risk of some serious health conditions to a potentially longer life. These benefits may be worth the low-to-moderate level of risk involved in these activities. The key is to stay aware of your body and mindful of its limits. Finding a happy medium between an intense workout and respecting your boundaries can help you optimize your health, while reducing the chance of injury.

Illustration by Addison Eaton