High Intensity Workouts: A no pain, no gain attitude can get you injured.

By Leslie Czarny and Carol Triest, P.T.

High Intensity Interval Training classes like CrossFit, Insanity, and P90X continue to be a favorite amongst exercisers. The draw – a quick intense workout (15-20min) in a fun and challenging setting. Pushing one’s self to extreme limits is an attraction to many who thrive in this type of environment. However, according to Bergeron, Nindl and Deuster, there seems to be a high occurrence of military personnel suffering from muscle strains and joint injuries as a result of participating in these types of workouts.1 If military personnel are getting injured, how about the rest of us?

“There are great benefits to high intensity workouts; however, I see a lot of patients who get injured from overdoing it, particularly those who participate in group classes”, says Daniel Alvarez, a Doctor of Physical Therapy at BaySport. “Poor form is one of the main culprits for injury and it’s harder for the instructor to gauge mechanics when in a large group setting.” He goes on to say, “…muscle weakness and going all out when there is poor postural alignment, history of trauma, overuse or instability of the joint promotes injury as well.” There is also the crowd mentality: Feeling like you have to push yourself because others in the class are increasing the intensity of the workout.

As with any type of fitness training, a good warm-up and cool down is necessary to limit risk of injuries. It is important to gauge how you feel: If you are suffering from soreness and fatigue, your body is telling you that you need a break. It is time to go for a walk, or perform a gentle stretching routine. No Pain, No Pain should replace the No Pain, No Gain slogan. It is a healthier and more sustainable attitude towards fitness.

1. Bergeron MF, Nindl BC, Deuster PA, . Consortium for Health and Military Performance and American College of Sports Medicine consensus paper on extreme conditioning programs in military personnel. Curr Sports Med Rep. 2011;10:383–389. Google Scholar CrossRef, Medline

Injury Prevention Tips for Cyclists

Physical therapists can recommend ways to prevent or recover from a cycling injury. Your physical therapist can assess cycleyour “bike-fit” to maximize your efficiency, reduce pain, and prevent injuries.

Bike Fit-Related Tips:

1. Frequently change your hand position on the handlebars to decrease stress to your upper body.

2. Keep a relaxed grip of the handlebars.

3. When pedaling, your knee should be slightly bent at the bottom of the pedal stroke.

4. Avoid rocking your hips side to side when pedaling.

Overuse injuries can be prevented when a bike is fit properly for you. Physical therapists can aid you in getting your bike fit and suggest individual stretching and strengthening exercises to maximize your bike efficiency. Common cycling injuries include anterior knee pain, neck pain, low back pain, hamstring tendinitis, hand numbness or pain, IT band tendinitis, and foot numbness or pain. A possible cause for low back pain and hamstring tendinitis could be inflexible hamstrings. If your saddle is too low you may be experiencing knee pain and if your saddle is too high you may have symptoms of hamstring or IT band tendinitis. Pedaling at a low speed may cause anterior knee pain, low back pain, or foot pain. Handlebar and saddle position are important in preventing neck pain, low back pain, and hand numbness. For example, if your handlebars are too low or at too great or short of reach this may cause neck pain. Please contact your physical therapist for an individualized evaluation and assessment on how to recover or prevent bike fit related injuries from happening.


1. Moen, Erik. July 2014. “Tips for Avoiding Bike Fit-Related Injuries.” Retrieved from http://moveforwardpt.com/resources.
2. BikePT. 2011. “Bike Injury.” Retrieved from http://bikept.com/bike-injury/

About the Author:

Natalie Grant, D.P.T.
Natalie graduated with a Bachelor of Science in Physiology from Michigan State University and received her Doctorate of Physical Therapy from Central Michigan University. She has exceptional experience in treating orthopedic musculoskeletal injuries with use of evaluating impairments, functional limitations, and disability. Natalie’s approach is personalized and unique to each patient including manual therapy, functional assessment and treatment. She specializes in running injuries, hip and shoulder dysfunctions, knee and ankle pain, and sports related injuries. She has significant experience in assessing biomechanics of gait when walking and running with use of video. Natalie has recently moved from Chicago and is looking forward to hiking, biking, and running all over the Bay Area.