Extreme-ly Stressful Sports

Maybe one of your New Year’s resolutions has led you to enroll in an intense new extreme workout program — one that promises to leave you physically ripped and uber-committed to self-improvement.

A few quick tips: Don’t jump into extreme exercise programs. You can get hurt, really hurt. Also, look for clues as to a program’s suitability for your unique fitness level and personality type. If your workout’s unofficial mascot is a vomiting clown (meet Pukie the Clown, from CrossFit), maybe that’s a sign you need a more reasonable workout program.

“I get very tired of talking to acquaintances who are doing CrossFit, which I see as kind of a cult, really,” said a Boston 30-year-old social services professional. “They love throwing around terms like burpee, deadlift, reps and squats, assuming we are all excited by those things. It’s exhausting even talking to them.”

Extreme workout programs like P90X, Insanity, and Tough Mudder – a 10-12-mile obstacle course race that includes carrying logs, clambering over a “beached whale” inflatable, and sometimes manipulating fire and electrical wires — are extremely popular in the U.S. P90X has DVD sales earnings of about $250 million as of 2012, said CNBC.

CrossFit, perhaps the most popular of the extreme workout programs, said in spring 2014 it had reached 10,000 affiliates worldwide.

No matter their popularity, fitness and medical professionals have become increasingly concerned about the steady stream of injuries coming from CrossFit programs.

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One weightlifting trainer was aghast at the workout schedule for one day of a CrossFit competition.

“I thought it was an ‘Onion’ article,” Rachel Crass told ESPN.com after hearing about competitors running while carrying 70-pound kettlebells.

CrossFit is a mix of gymnastics, powerlifting and calisthenics, distilled into short, intense bursts of exercise in a WOD (workout of the day). First tested on firemen and first responders, the regimen intends to prepare participants for every possible situation, but is increasingly attempted by weekend warriors, as well as those who are not nearly fit enough to dive into intense training regimens.

“We see a lot of back and hip injuries,” said Allison Stringer, regional clinical director of ProEx Physical Therapy in Woburn, Massachusetts, and a certified physical therapist. “We see people involved in extreme sports participate in a very high volume of training combined with a very heavy weight — say deadlifting. This can create any number of problems.

“There is the workout concept of ‘peaking,’” Stringer added, “and an athlete is supposed to build physical strength and ability at a steady pace, then ‘peak’ with their workout. With extreme workouts, you are asking your body to be at ‘peak’ ability 100 percent of the time, which strains the body in an unhealthy way.”

Related: Stairway to Longevity

Johns Hopkins Medicine’s Department of Orthopedic sSurgery shares some signs of overstress in an athlete’s body. These include muscle swelling and extreme soreness, as well as irritated tendons from too much stress too rapidly, including patellar (kneecap) tendonitis. In cases of too much stress on bones (such as running too far too fast), the bones “remodel” themselves incorrectly, adding bone to existing bone and causing pain and even bone failure.

Cartilage damage is also worrisome in extreme sports. Cartilage is the slippery white tissue on the ends of bones that allow the bones to glide smoothly over one another. Wear and tear as we age is common, but when too much stress and pressure is applied to the cartilage too quickly, pain and fluid build-up may result. Functional problems may also occur if the joint and cartilage aren’t rested. The pain level can be very high.

“It’s sad when you see a mom with young kids come in and have a herniated disc from extreme exercise,” Stringer said. “That injury is going to impact her daily, impact her quality of life.”

Even more dangerously, a condition called rhabdomyolysis can occur during an extreme workout. It is rare, but damaged muscles can break down and their protein then enters the bloodstream. Nausea can be a symptom.

Is it worth the risk of muscle, bone or joint damage, rhabdomyolysis or even death, to get that perfect body?

It’s actually pretty easy to get in shape properly, Stringer said.

“Participate in extreme workouts only if your body is up for it. Spend that important time really getting your body prepared, and you will eventually get into terrific shape. Build up to what you want to achieve, safely and gradually, and you will also really enjoy the process,” she said.

This is the first in a three-part look at our health as we age and how to best manage the impact of sports on our bodies.