HIIT It?

A recent article discussed high intensity interval training (“HIIT”) and the risks associated with that form of training:

The Houston area is home to a lot of extreme competitions including marathons, obstacle courses and triathlons. To get into shape for these events, many people opt for trendy high intensity interval training — or HIIT — programs to reach their fitness goals. However, the “go hard or go home” style of this extreme exercise has developed a reputation for serious injury.

At the core of this extreme exercise are high impact moves completed over short periods of time (sometimes without breaks) that are designed to push devotees to the limit. Many do it for the adrenaline rush. Others do it because it pays off quickly.

…Yet, it is the high-speed, high-impact, “give it all you’ve got” style of this interval training that many doctors say lead to serious and sometime repeated injury.

“This is an explosive type of exercise workout that they’re doing — very high intensity, whether it be with weights or cardio,” said Dr. John Higgins, a sports cardiologist with UTHealth and Harris Health System. “They’re getting a lot epinephrine and adrenaline, and sometimes they may not feel that they’re getting injured during the actual exercise event,” Higgins said.

Background

I was first introduced to HIIT over three years ago, known as fartlek training, while training for a half marathon.  I then moved towards other HIIT workouts (i.e. bodyweight circuits, sprints) as I pulled back on running volume and moved more towards resistance training and calisthenics. While I’ve spent the last six to seven months training in a traditional bodybuilding style, HIIT workouts are included in the programming.  I speak from experience, I’ve practiced this type of exercise and it’s great for your body, even tho I have high arched feet problems I got high instep shoes for when I do this type of exercise so I don’t harm myself .

In a recent comment (here), Kazzy describes a key appeal to HIIT workouts:

One of the things I really like about the approach he taught me is that I spend a lot less time sitting around between sets. I recognize that the rest between sets is integral to the workout but when you only have 40 minutes to hit the gym (and that includes getting inside, getting changed, and getting back out the door), spending 15 of those minutes not moving didn’t feel like the best use of my time. When I’m up to it, I can go balls out for about 30-35 of those minutes and then recover on the train ride home.

Lot of work. Short time.  People happy. The other appeal is the results they can deliver. According to https://roids.co/buy-legal-anabolic-steroids-online/, the internet is full of before-and-after transformation pictures of people that have done P-90x, Insanity, CrossFit, boot camps and other programs, with many getting those results in weeks.  While the results seem to validate the effectiveness of the programs, especially to the die-hards, further examination is required because the results are a significant contributor to the elevated risk of injury, especially with respect to overuse injuries, the focus of this post.1

The Issue

In order to begin, two pieces of information are needed.  The first is the SAID principle, which dictates that the body adapts to specific demands imposed on it.  In other words, you get better at doing something the more you do it.  The second piece of information is that more than anything else, these kinds of workouts are bringing sedentary individuals, accessories and other equipment into fitness.  The before/after pictures I mention show just that.  It’s also safe to assume that many of these individuals have tried other forms of exercise, usually in a commercial gym, and failed miserably, hated it, quit, etc.

Mix these two variables together and this is what happens: a sedentary individual is going to get exposed to a lot of stress through hard exercise.  Being out of shape, the body is going to feel tremendous amounts of stress at a very low work capacity.  Over time, the body adapts to the stress.  Work capacity increases.  Strength increases.  Body composition improves (especially if diet is accounted for as well).  Given the fact that these workouts are usually done in a social environment, people respond favorably to that and push harder than they have otherwise.  Give it enough time, and those formerly sedentary people are very fit. Many of them may very well be in the best shape of their lives.  They’ve achieved goals that they may not have thought possible.  That hard work equates to results gets ingrained in the mindset, and with the desire for results mixed with the confidence gained from doing hard workouts, it can and does foster a go-hard-or-go-home mentality towards exercise.

Uh Oh

This can become a problem because the body can push back. Consider the stress-performance curve (via Breaking Muscle)

stress-performance-curve

Sedentary individuals starting exercise are on the left side.  They’ll shift to the right along as their fitness levels improve and their bodies remain capable of recovering from the stress. Having reached fitness levels they’ve never reached before and improving every time they go at it, they keep going.  When they do, they may find themselves having a few “bad” workouts where performance wasn’t as good as it has been.  At this point, they’re going into the territory of a performance decline.  How are the people that have spent the last several months or so going beyond their limits with an intense mindset towards exercise going to react to a performance decline?

Chances are they go harder.  That’s what they’ve done to get to where they are so why change?  If they haven’t sustained an injury by then and feel good doing what they’re doing, they may neither recognize nor think about the risks.  If they’re feeling good, they’ll think they have  Therefore, already past the point of the body’s capacity to recover from the stress, they double down with more and push themselves further and further.  Add more stress to a diminished capacity to recover and bad things can and do happen.  Welcome to the General Adaptation Syndrome in action.

This isn’t unique to HIIT, as it can happen to anyone when the training stress exceeds the body’s capacity to recover from it.  However, unlike other exercise modalities, the combination between the high intensity and volume in addition to the frequency people do the workouts creates a very troublesome combination, a combination best avoided through the use of proper programming that takes into account the individual’s fitness level, proper exercise selecton and proper rest periods.

Despite the cautionary tale, my purpose here is to educate.  HIIT workouts are part of my training program, usually one to three times a week depending on cycle.  The workouts range between 10 to 20 minutes and if you want to use a weightlifting belt then follow this purchasing guide.  They’re optional. I do them because I choose to.  For the most part, they involve a single exercise (i.e. bike sprints, kettlebell swings) done in short bursts with programmed rest periods as opposed to doing as many reps/rounds as possible in a given time period or a fixed amount of work as quickly as possible.

Should people do HIIT?  I’ll put it this way: no one has to do HIIT.  I like HIIT, but recognize its limits.  Yes, the workouts are challenging and fun and people can see results quickly, but for people that have fat loss or general fitness goals in mind and either can’t do or don’t want to do HIIT workouts, steady state-cardio will do the job just fine.  Hard exercise is not the same as smart exercise, and with HIIT, the risk of blurring that distinction is pretty high.  Whether or not the benefits outweigh the risks I’ll leave up to readers to decide and discuss in the comments section below.

Image Credit: here (via New York Public Library)Notes:

  1. For the purpose of this post, I have deliberately ignored acute injury risk. []

Staff Writer

Dave Regio is a part-time blogger that writes about whatever interests him at that particular point in time. When he is not writing, which is most of the time, he is either gently reminding people of the OT commenting policy or working in the commercial real estate business, primarily in healthcare real estate with a capital markets focus.

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29 thoughts on “HIIT It?

  1. HIIT workouts are standard in marathon and distance cross country ski race training. You always want to have some hard intervals verging on sprinting. However it is consider the standard that most endurance distance training is done at low intensity with some hard work mixed in. This is often done at an 80/20 ratio or something like that. I get that a lot of people don’t want to do all the low intensity stuff and you can get in shape without it. Especially if you aren’t training for an endurance event. I tend to think people do far to much HIIT if they think it is a quick fix or they are starting from sedentary.

    I’d agree you don’t’ have to do HIIT but it is good stuff if your body can handle it and done in moderation.

    Glad you started this feature. Should be fun discussions and we all have stuff to learn from different discipline.

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    • I used fartleks for about six weeks in my half marathon training. It was in the strength phase and after I spent 8 weeks base building. By the last workout, it was long enough that between the intervals, running, cooldown, etc, I had logged 9 miles.

      If I recall, I only did one a week so the 80/20 seems right to me.

      If you have any suggestions for ideas, topics, things you want to know, etc. by all means let me know. As we are a community, I’d rather gear the discussions towards topics that may interest people and draw them into discussions.

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  2. At the tail end of my year throwing iron, we got into Tabata.

    Four minutes of Hell with the only upside being that it was only four minutes. 20 seconds have never taken so long. 8 has never seemed like so large a number to count down from.

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  3. Epinephrine and adrenaline are the same thing. Talking about getting epinephrine and adrenaline rush is like ordering a glass of water and dihydrogen monoxide. Silly.

    Yes, I know it is a block quote and not Dave’s words, but ARRGH. This is not that hard.

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  4. I only began doing HIIT-style workouts after more than a decade of weight training and dramatic improvement in my cardio regimen (including several half-marathons with decreasing times each run). I needed something new and different and met with a very knowledgable trainer and he gave me the HIIT work based on my profile. The first times out, we did ONE exercise and I was spent. Like, curled-up-on-the-ground-ready-to-puke spent. While I had the strength to move the weights and the endurance to run for 2 hours, my body wasn’t trained for this type of workout. So we started small and trained it to. We didn’t go balls out day one. Or day two. Eventually we reached a point where I could go through a full routine with the trainer and then on my own. And even now, I have to listen carefully to my body… “You’re getting tired… your form is breaking down… you’re going to get hurt if you try to go more.”

    I couldn’t imagine an amateur trying these exercises. Not without the guidance of a professional who can ease them along.

    The main reason I went with the trainer was to diversify my workout. And when I work with a trainer, I always ask tons of questions. I want to learn the in’s and out’s so I can apply the lessons elsewhere. “So this routine does tabata core exercises… what else can I do tabata with?” Now, I mix in a variety of exercises in routines to stave off boredom, “keep the body guessing”, and to account for my given needs on a day or to address specific body needs.

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    • My first experience outside of my half marathon training came shortly after I completed the half marathon and started training for a Tough Mudder. Not knowing jack crap about what to do, I downloaded one of the Tough Mudder workouts from the website. I figured I had a good base to work off from the cardio.

      Three exercises in, I attempted two minutes of burpees and 45 seconds in, I wasn’t only done but felt god awful. Workout over. LOL! Like anything else, the more workouts I did the better I got and I got myself to a point where I could handle some pretty high intensity workouts.

      About a year ago, I attempted the CrossFit WOD Cindy – 5 pull ups, 10 push ups and 15 bodyweight squats = 1 round and you have to do as many as possible in 20 minutes. Using strict form pullups, I managed 26 rounds. I don’t know if I can do that today, and frankly couldn’t care less for reasons I may explain in a different post.

      Still, all it takes is one exercise done at the right intensity for the right period of time to put me on my ass when I’m done. One of my favorites for that is plain old sprints. 20 sprints every minute on the minute – run for 15 seconds, rest for 45 (I love the 1:3 ratio). The 15 seconds is pretty much the max time for an all out push and by the time the 45 seconds passes, you’ll be winded as hell but still recovered enough to have the strength to do the sprints.

      I think beginners can do certain forms of HIIT so long as the movements are low skill. For example, take a tabata workout and use push ups, sit ups, body weight squats and mountain climbers. Assuming no pre-existing injuries, those movements can be done by anyone The problem newbies are going to have is that their work capacity will be very low, they’ll tire quickly and not have the recovery capacity to do much past a round or two with any kind of intensity. That’s ok though.

      Diversification is good. No one in their right mind should follow the same routine much past four weeks. Granted, I may follow a program where I keep the bodypart splits consistent but I change up the exercises after a month. I don’t do it to keep my body guessing but rather to make sure I expose the body to different training adaptations. Unfortunately, a lot of proponents of muscle confusion have taken the concept and bastardized it (see Tony Horton). Change things up too much and you don’t subject the muscles to the sort of stress that lead to long term strength or growth gains.

      I’m always up for a workout. I haven’t thought about an event since 2013 but may consider one. I’d do a shorter Spartan Race but being out on a 10-mile Tough Mudder course just doesn’t catch my interest these days.

      Yes, I”m out in NJ quietly toiling away at a local Lifetime Fitness.

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      • Dude, which LT? My lady friend brought me to the one she used to go to… Like a frickin’ resort!

        Anyway, I’m incredibly fortunate in that my body responds very well to working out. At the risk of bragging, I’m a “natural”. When I half-marathon train, I just continually stretch myself, 3-4 runs a week early and 1-2 later. My hardcore runner friends fret at my lack of speed work or thay I’ll go 4-5 days between runs… But it works for me. COULD I do better with a strict regimen? Maybe? But I can run a 1:48 my way and, as a single dad with two young kids, I’ll take it.

        I do need to be mindful that I’m still susceptible to injury, especially as I get older. I’ve worked through some stress fractures in my foot (after races) and an undiagnosed shoulder injury in the past year.

        Eager to see this is an innaugural post and that more are coming. And let’s get that workout and/or Spartan in!

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        • I work out at the one in Berkeley Heights most of the time. It’s stupid expensive but it’s the only place with the hours I need, especially on Fri-Sun. There are plenty of other cheaper gyms but their weekend hours suck beyond belief. I could do everything at a LA Fitness pay pay $100 per month less if I had one close by.

          Planet Fitness? I set off the Lunk Alarm if I get within 100 feet of the entrance.

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          • I’m game. I go to an LT occassionally with my friend. And not just any ol’ LT… the super ginormous one in Westchester. They are truly first rate. Above and beyond but if the hours work for you, by all means!

            The BH one is doable. If you could get up to the one in Montvale, that’d be even easier. Let’s discuss behind the scenes. “Dave Puts Kazzy Through the Ringer” would make for a fun series.

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  5. By the way, we should get together for a workout or two. Or maybe an event (race, obstacle run) if you are into those kinds of things. You are in NJ, if I remember? Maybe Morris County? I’m in Yonkers and work downtown in Manhattan.

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  6. I am so not on this level (I need to stop taking winters off), but this is extremely helpful, as I have been moving from a focus on mid-level exertion (running) to, come to think of it, a very disorganized approach to HIIT. In particular: jumps, body weight squats (combined with jumps), and a few sprints which I intend to become a much bigger part of my workout because of the reinforcement here. (Funny note: I got the jump/squat routine from an Instagram posted by Ellie Goulding, who appears to be a hell of an athlete.)

    In any case, I had no idea this series was in the offing, and I’m very excited about it. I’ll be following avidly.

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    • Michael Drew:
      I am so not on this level (I need to stop taking winters off), but this is extremely helpful, as I have been moving from a focus on mid-level exertion (running) to, come to think of it, a very disorganized approach to HIIT. In particular: jumps, body weight squats (combined with jumps), and a few sprints which I intend to become a much bigger part of my workout because of the reinforcement here. (Funny note: I got the jump/squat routine from an Instagram posted by Ellie Goulding, who appears to be a hell of an athlete.)

      In any case, I had no idea this series was in the offing, and I’m very excited about it. I’ll be following avidly.

      I don’t mind plyometrics as part of conditioning routines so long as they’re done early in a routine and not too many of them are included. I’ve tried doing jumps and switch lunges when fatigued and not only can you barely jump but your form is so bad that the landings themselves are very risky. I’ve heard horror stories about people injuring themselves doing box jumps in a conditioning format (which to me are a monumentally stupid thing to do unless you’re training as a CrossFit athlete). The scraped shins are the least of one’s concerns.

      I had no idea this series was in the making either. It’s definitely off-the-beaten path given the site’s usual topics, but people are interested and it allows me to reach people at a more personal level. I have a six-year old autistic son and I get plenty of stress and challenges from that to get myself stressed out over the number of controversial discussions I see day in and day out. Life’s too short.

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  7. I’m swallowing my deep sense of embarrassment and starting P90X3. I wish I could describe the sort of exhaustion others are are describing, but I can’t. I think I have different limiting factors.

    1. I can’t do enough pull-ups to actually get tired from doing pull-ups. After a few, I have to stop because otherwise my form deteriorates and I will have to take a 3-month break.

    2. There are some otherwise-exhausting leg exercises, but you’re supposed to do them on your toes. I can’t maintain my balance long enough to really kill myself with those.

    3. Some of the exercises have to be done on one leg. I do it without shoes, and invariably the limiting factor becomes the calf of my standing foot, not whatever exercise I’m supposed to be doing. And no matter how hard I work out my calf, I can’t really expend enough effort to feel exhausted.

    Maybe another way to say it is that the workout is simply too difficult for me. Not in the sense Kazzy references of injury, but in not having the ability to do the basic moves required.

    The embarrassment, by the way, is the concept of working out to a DVD. It feels really silly to me, and I even feel silly admitting it pseudo-anonymously on the internet here.

    Edit: P90X3, by the way, is a 30-minute version of P90X.

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    • For one, you want to do some targeted shoulder/biceps training. If you can’t lift your full bodyweight, try half. Do your reps, and you’ll be able to do pullups eventually.

      For two and three, stand on one foot for two minutes. Then switch. (build up to this, it is hard) Repeat for a couple of weeks.

      You Don’t need to be bone weary to have done your body some good. Cardio works your heart, strength stuff is working your muscles (yes, oversimplification, but still).

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      • I can do a few, but that’s about it. The problem I had, which I did physical therapy for, was that my scapulae were winging out. I spent a lot of time trying to bring them back into their proper position and learning to do pullups the proper way with my lats engaged and using my entire back rather than solely my upper back and neck muscles. But if I get fatigued and push through, I’ll start doing that again and get injured again.

        But I am trying a version of what you are suggesting. I have an exercise band that supports a decent amount of my weight so I don’t have to pull as much.

        For 2 and 3, I’m hoping that just by trying to approximate the workout over time, I’ll eventually catch up and be able to actually do it.

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      • Kim: You Don’t need to be bone weary to have done your body some good. Cardio works your heart, strength stuff is working your muscles (yes, oversimplification, but still).

        It’s amazing how many people ignore this.

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        • Yeah, so, a guy I know NEEDS to make his body sore. The sorer the better.

          Any tips? (I know plyometrics is supposed to be good for this…) Looking for stuff available on the cheap, got treadmill and some up-to-25lb freeweights.

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    • When it comes to at-home workouts, the original P90x blew away the conventional wisdom of home workout programs, so badly that I had to remind myself that there was a time when it probably would have been embarrassing to workout to Buns of Steel. That convention has long since passed. I’ve done video-based workouts (albeit in my gym but still), and the Beach Body products and others like it continue to have a strong market presence (hell, I get people trying to recruit me as a Beach Body coach).

      If you can’t do some of the basic moves, either substitute them out or scale it back to something workable. If you’re working through this for the first time and are still having a hard time slogging through, you’re not going to lose out on the benefits of the workouts.

      Remember, someone getting off the couch and doing just about anything to the best effort possible will lead to those short term improvements so if you can’t hop up and down but can do something else, the physical adaptations will be similar.

      How are you doing pull ups? Are you capable of using a table and doing inverted rows? Only a stable table is required. Less of a load yet an equally effective bodyweight exercise.

      I’d recommend assistance bands for pull ups, but if you’re working out at home and not using an anchored pull up bar (i.e. a bar that hooks to a door way), I wouldn’t put an assistance band on it.

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      • Dave: That convention has long since passed

        Damn. I have to feel old for thinking something is not cool?

        It is remarkable how pervasive that stuff has become though. The YMCA here has “insanity” group classes. I wonder if they actually play the videos there.

        Conveniently, the prior owner of our house put a broom handle in one of our basement joists, so I have a nice pullup bar. I hang a band from it for assistance. Good point about doing inverted rows. I should probably be doing some of those anyway. I’m guessing they aren’t in the program only to reduce the equipment requirements.

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        • A good way to increase your pull-up count is to do several small sets throughout the day. The key is not to get anywhere close to fatigue. If you can do three, you might start by doing several sets of one pull-up, or maybe sets of two in the morning and one in the evening, with long periods of rest between sets (like 30+ minutes). This allows you to get lots of training volume in without fatigue.

          Be conservative with adding volume, though. I got a case of tendinitis when I was doing 10-15 sets per day. I did have a pre-existing problem in that area, but just to be safe I would recommend limiting it to eight sets per day, every other day.

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          • Brandon Berg:
            A good way to increase your pull-up count is to do several small sets throughout the day. The key is not to get anywhere close to fatigue. If you can do three, you might start by doing several sets of one pull-up, or maybe sets of two in the morning and one in the evening, with long periods of rest between sets (like 30+ minutes). This allows you to get lots of training volume in without fatigue.

            Be conservative with adding volume, though. I got a case of tendinitis when I was doing 10-15 sets per day. I did have a pre-existing problem in that area, but just to be safe I would recommend limiting it to eight sets per day, every other day.

            Yep.

            Submaximal effort plus progressive overload over an extended period of time can contribute to signficant improvements without too much stress. Progressive overload can mean as little as one additional pull up per day. It adds up.

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            • So, I’ve been doing my pull-ups. I’d like to have followed ‘s advice in part because I did that about 7 years ago with some success. But with the pull-up bar being *ALL THE WAY* in the basement, it’s a bit tough. I’ve instead just done sets of 5 every other day with bands to reduce the amount I’m pulling.

              This morning I did 4 sets of 5 using the thinnest band I had. Maybe I’ll do a set or two more when I get back home from work.

              This Saturday I’ll try 5 strict pull-ups with just body weight. It would seem to me that I ought to be able to do that without injury. One mental queue that has been helpful is making sure I bring in my scapulae in a distinct motion before doing the pull-ups themselves.

              Incidentally, when I say pull-ups, I’ve actually been doing them from these, which hang from my pull-up bar at a 90 degree angle, so my palms are actually facing each other. It’s in-between a pull-up and a chin-up. https://www.amazon.com/Metolius-Rock-Rings-Blue-Swirl/dp/B002N55HDK/ref=sr_1_1?ie=UTF8&qid=1469114467&sr=8-1&keywords=rock+rings

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      • “Remember, someone getting off the couch and doing just about anything to the best effort possible will lead to those short term improvements…”

        This is an important point. I know people who go to the gym after having never been or not been in forever and they are trying to find the perfect workout. “Am I going high reps with low weight or low reps with high weight? HIIT or standard workouts?” Honestly, just get in the gym. Or on the floor. Whatever will get you moving. Go for a work. Exercise SAFELY but just get going. Getting some momentum, some confidence, and some comfort and familiarity with the basics will give you the foundation you need for long-term success, more than scanning Men’s Health magazines for the new perfect workout (which they miraculously seem to rediscover every month or two).

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