High Intensity Interval Training (HIIT) is a form of exercise that alternates short bursts of high intensity activity with short periods of rest. The evidence that HIIT is superior to steady-state exercise for fat loss and endurance is quite strong: it can be successful for fat burning, increasing basal metabolic rate, and increasing aerobic and anaerobic endurance.
Its popularity has skyrocketed and in 2014, it was ranked the number one fitness trend in the world by the American College of Sports Medicine.
As a practicing Orthopedic Spine Surgeon, I often recommend this type of training to my patients as it can provide significant health benefits. It can even be performed safely in patients who have had previous extremity, back and neck surgery.
Although the benefits of this type of exercise can be quite dramatic, it does come with an increased risk of injury. Below are five of the most common orthopedic warning signs that indicate there may be something wrong with the way you're training and can indicate a more serious underlying injury.
1. Shoulder Pain
A common complaint after overhead HIIT movements is shoulder pain, usually caused by shoulder impingement syndrome followed by rotator cuff tear. Impingement is caused by inflammation to the tendons around the rotator cuff, but in the shoulder. Signs of this condition include pain in the front of the shoulder and side of the arm. It usually starts with pain with overhead lifting but then can begin to become painful even after exercise.
Rapid, forceful movements of the arms when they're above the shoulder joint can create an injury to portions of the labrum and sometimes even involve a tear of the biceps. This usually presents with pain with overhead lifting, sensation of the shoulder joint feeling like it's going to” pop out,” loss of motion and loss of strength. Treatment of this condition will ultimately be based on whether or not strengthening of the surrounding musculature can eliminate the pain.
The same types of exercises that can create impingement syndrome can also create a rotator cuff tear, a much more serious condition.
2. Back Pain
The most common reason for back pain — during or after a workout — are muscle/tendon sprains and ligament strains. These are often short-lived and will go away after a short period of rest and anti-inflammatory medications. Unfortunately, back pain can indicate a more serious injury.
Injury to the disk found between the bones of the lumbar spine can create disk tears and/or herniation, resulting in back and/or leg pain. This type of injury can sometimes present as immediate, disabling pain or can progress over time. These types of injuries usually occur when the spine is in flexion and a significant load is passed through the disc such as in performing deadlifts or snatches. There are many other exercises performed in HIIT training, which can overload the spine if performed with incorrect technique.
3. Neck Pain
As with back pain, muscle/tendon sprains and ligament strains in the neck account for a majority of the pain developed following HIIT workouts. Most of these can be cured with a self-imposed rest period.
More serious neck injuries include disc herniation to the joints of the cervical spine. Common symptoms include neck pain, headaches, pain between the shoulder blades and pain radiating into the arms and hands. Overhead lifting and exercises that strain the neck, and a flexed position are often culprits behind these injuries.
4. Knee Pain
The most common reason for anterior knee pain following HIIT is patellar tendonitis, also known as jumpers knee. This involves an inflammation to the patellar tendon, which connects the kneecap to the tibia. Jumping exercises, squats, lunges and running can all lead to this kind of injury.
This condition can progress to the point where there is severe limitation in continuing HIIT routines, as well as interfering in daily life. Muscular imbalance is often a factor in increasing the forces on the patellar tendon and therapy is usually designed to reduce this. With persistent stressing of the patellar tendon, tears can develop and progress.
5. Elbow Pain
The two most common causes of workout-related elbow pain are lateral epicondylitis (tennis elbow) and by medial epicondylitis (golfers elbow). These are often a result of poor technique and overuse, as well as muscular imbalance and inflexibility.
Tennis elbow presents with pain on the outside bump of the elbow, made worse with gripping, lifting, opening the fingers and pressure in the outer elbow. Micro tears within the tendon can progress with overuse and become disabling. Golfers elbow presents with pain on the inside bump of the elbow, with pain increased by making a fist, gripping and pressure over the middle of elbow. Both of these conditions can be progressive and lead to pain in daily activities, as well as dull, chronic pain. These injuries even when managed properly, can sometimes take many months to improve.
If you find yourself experience any of these symptoms, make sure to check with a doctor before continuing any exercise routine.