Extreme Conditioning:
Popular But Risky?

by Len Kravitz, PhD and Justin D. Baca on Oct 24, 2013

Extreme conditioning programs (ECPs) promise vastly improved fitness in relatively short periods of time, which appeals to a cross-section of the U.S. civilian and military populations. Yet many health professionals fear that these high-powered, widely marketed programs increase the risk of musculoskeletal injuries.

Michael Bergeron, PhD, and colleagues summarized the controversy over ECPs in 2011. While their report focuses on issues central to preparing U.S. soldiers for combat missions, it provides broad guidance to fitness professionals who are participating in or leading ECPs.

What Are the Benefits of Extreme Conditioning Programs?

Many ECPs are designed to employ high-intensity metabolic conditioning, which Bergeron et al. describe as exercises that “impose a moderate to high demand on the cardiovascular system and energy metabolism of the active muscle fibers to meet with the muscles’ repeated high-energy requirements.” Observed benefits of using these programs include reduced body fat, increased local muscular endurance and increased cardiovascular capacity (Bergeron et al. 2011).

Another focus of extreme conditioning is functional fitness. To this end, ECPs concentrate on a person’s ability to perform whole-body (or multijoint) movements repeatedly under highly fatiguing conditions (Bergeron et al. 2011). The multifaceted nature of ECPs leads participants to believe they are getting benefits beyond those gained through typical physical fitness programs, say Bergeron and colleagues. And many soldiers believe that ECPs not only increase combat readiness (as mentioned above) but also enhance camaraderie and teamwork. These beliefs heighten the appeal of individual and/or group ECP sessions.

What Are the Risks of Extreme Conditioning?

Bergeron et al. say certain characteristics of extreme conditioning workouts appear to disregard current standards for developing muscular fitness. For instance, repetitive performance of maximal timed repetitions—with insufficient rest periods between sets—may readily lead to

  • premature fatigue,
  • elevated oxidative stress (inability of the body to remove biological products that lead to cell damage),
  • increased risk of musculoskeletal strain and injury, and
  • impaired exercise technique.

Bergeron and colleagues add that extremely challenging training regimes may lead to overuse injuries, overtraining and overreaching (going beyond normal progressive overload training parameters).

Injury risk also increases when exercise sessions become competitive. For example, military personnel and exercise enthusiasts in a class often seek peer approval by attempting to keep up with others who may be fitter and stronger. In recreational sports conditioning, where training as a team is very important, this same mindset occurs. Individuals are often encouraged to push themselves unknowingly to excess, leading to a greater potential for injury. In a team setting, it becomes difficult to scale back.

Although individual pacing and progression are essential for proper fitness development, respect for these guidelines is often perceived as a sign of weakness (Bergeron et al. 2011). The overreaching phenomenon may be more common in entry-level participants in ECPs.

Recommendations to Improve ECP Safety

So what can you take away from this research and implement to keep your clients safe if you are doing ECP with them?

Reducing injury risk and improving the implementation of extreme conditioning programs are of paramount importance. Among Bergeron and colleagues’ recommendations for safe ECPs:

  • Conduct careful inspections of designated exercise equipment and areas.
  • Introduce ECPs gradually with a planned, stepwise progression for exercise intensity and duration, particularly for beginning students with low fitness levels.
  • Base individualized supplemental conditioning programs on fitness, training goals and job-specific functional needs and demands.
  • Plan regularly scheduled days of reduced or no supplemental conditioning, especially in more active populations such as the military and recreational athletes.
  • Watch for preworkout use of caffeine and products containing substantial levels of caffeine, such as popular energy drinks. Use should be discouraged, as caffeine can easily mask fatigue, leading to overreaching and overexertion.

Practical Suggestions for Successful ECP Implementation

Source: Bergeron et al. 2011.

Also keep these strategies in mind when leading ECP workouts:

  • Encourage clients to attain adequate sleep (7–8 hours nightly) and optimal pre- and post-workout nutrition.
  • Mandate suitable rest periods between sets.
  • Gradually introduce advanced skill exercises. Assure proper technique prior to increases in exercise intensity and duration.
  • Monitor signs of overtraining, such as lingering muscle soreness, a drop in exercise motivation, a decrease in fitness results, an increase in emotional stress and irritability, and ongoing tiredness.
  • Balance high-intensity training with stress-reducing alternatives such as yoga, pranayama breathing and meditation.
  • Make sure people with clinical conditions have been cleared by a doctor for participation in ECPs.

For a more complete discussion of extreme conditioning programs, plus references, please see “Extreme Conditioning Programs: High-Risk or Vulnerable Risk Takers?” in the online IDEA Library or in the September 2013 issue of IDEA Fitness Journal.

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About the Authors

Len Kravitz, PhD

Len Kravitz, PhD IDEA Author/Presenter

Len Kravitz, PhD, is the program coordinator of exercise science and a researcher at the University of New Mexico in Albuquerque, where he recently won the Outstanding Teacher of the Year award. Len was also honored as the 2006 Fitness Educator of the Year by the American Council on Exercise.

Justin D. Baca

Justin D. Baca IDEA Author/Presenter