High-Intensity Interval Training (HIIT) has gained popularity globally, promising to burn more calories and increase fitness in a shorter time. [1,2] Building more muscles also helps increase the resting metabolic rate. In turn, this adds to the afterburn benefits of excess post-exercise oxygen consumption (EPOC).
Similarly, other forms of aerobic classes such as Les Mills workouts, Bodyweight Tabata classes and Spin classes are trending in popularity. In part because many of these being highly enjoyable with loud party music and motivational coaches.
Is there a downside to High-Intensity Interval Training?
#1 – Possible onset of damage & breakdown of muscles (Rhabdomyolysis)
Intense and unaccustomed workouts can cause muscle damage. Apparently, reports of rhabdomyolysis associated with activities such as spin classes are rising across Emergency Departments around the world.
Physicians locally have also raised concerns over the numerous Spin Class induced rhabdomyolysis especially during their first lesson. Rhabdomyolysis occurs when there is damage and breakdown of muscle cells, releasing enzymes and cell contents into the bloodstream, which may then cause multi-organ failure.
Common symptoms include muscle pain, fatigue, as well as darkened urine. Rhabdomyolysis is more common during the first Spin class in untrained participants and is also more common in women compared to men.
#2 – Bone, joint, muscle and tendon injuries
Unaccustomed exercise in a previously sedentary individual can also cause injuries such as muscle and tendon tears, stress fractures or joint damage. This may be due to a lack of flexibility, strength and endurance, as well as poor form.
What should I look out for before starting?
Am I healthy enough?
Do complete the Get Active Questionnaire (GAQ) to help determine if you’re ready to start a new exercise routine. This step is applicable not just for HIIT but for pre-exercise participation in general. The questionnaire is available on Sport Singapore website here.
Am I fit enough for High-Intensity Interval Training?
Do start aerobic training 3 to5 times a week for 20 to 60mins per session to achieve a basal fitness level prior to engaging in HIIT workouts. Start with once a week HIIT workout and gently increase the sessions to the maximum of three sessions per week with adequate space in between for your body to recover.
Do not undertake HIIT over consecutive days. If you can do more than three sessions a week, then you probably are not doing it right. When you do start, remember to start low, and go slow. Participants new to spin classes should start slow with lower resistance before cranking up the intensity gradually.
5 Tips on How to Exercise Safely
#1 Eat and drink well
Ensure adequate nutrition with carbohydrates for the quick energy release, and hydration before HIIT or Spin classes to reduce the risk of rhabdomyolysis.
#2 Look out for red flags
Look out for symptoms of rhabdomyolysis, including fatigue, muscle pain and darkened urine. See a doctor for blood and urine tests if necessary.
#3 Avoid anti-inflammatories before a workout
Do not take anti-inflammatories (NSAIDS) such as Voltaren or Neurofen prior to exercising as these can affect your kidney function.
#4 Listen to your body
Don’t over-train if you are not feeling up to it or if you are unwell with a fever or viral illness.
#5 Check the safety aspects of your gym
- Ensure that the equipment is ergonomic; and the weights & machines used are appropriate and well-maintained to prevent injuries.
- Ensure that the coaches or personal trainers know basic first aid and resuscitation skills (CPR and AED).
- Ensure that an AED is readily available, and that an Emergency Action Plan with emergency phone numbers and proper evacuation plans are in place.
- Participants should be properly registered. Details of the next-of-kin in case of medical emergencies should be accessible.
In conclusion, high-intensity workouts are great. However we need to learn how to apply the proper safety measures and knowledge, to benefit from HIIT so we all can aspire for a fitter body and healthier life.
Keen to find out more about high-intensity interval training? You can click here for a resource produced by the American College of Sports Medicine (ACSM).
Acknowledgement:
Author: Dr Cheah Si Oon, an Emergency Physician from Urgent Care Clinic International. Reach out to Dr Cheah at sioon@urgentcareclinic.sg
For More Information: Dr Cheah Si Oon
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