High-Intensity Exercise Part II: Some common injuries.

Orthocarolina by Aaron Hewitt PA-C, Physician Assistant
OrthoCarolina’s Sports Medicine Center

When it comes to exercise and sports, it‘s human nature to push ourselves and to want to be the best. Whether it’s competitive sports or staying in shape, who doesn’t want to be a lean, fat-burning machine?

One of my favorite parts of my job as a sports medicine provider is working with patients of all ages and helping them understand how all those muscles, bones and joints work together as part of the musculoskeletal system. Your body does a lot for you in a given day and it’s important to feed it well, let it rest and take care of it. As I’ve mentioned before high-intensity interval training (HIIT) is a time-efficient way to work out, intended to build both your aerobic and anaerobic capacity, and improve your cardiorespiratory and metabolic function. It incorporates speed and recovery intervals to make your workout more intense. As the human body develops muscle mass, it burns more fat at a quicker rate because muscle requires more energy.

High-intensity interval training is typically done at around 80-95% of your maximal aerobic capacity. It’s important to start slow and progress bit by bit when participating in HIIT training or any type of intense exercise. People tend to do too much, too fast – especially at the beginning of a new year. Whether it’s in a class or doing workouts on their own, we often test our limits and don’t rest enough.

I’ve worked with athletes my entire career, ranging from workout novices all the way to professionals, and in that time have seen quite a lot. Any type of exercise carries a risk for injury, but I want to share with you some of the more common sports medicine conditions I see related to exercise. This list isn’t intended to scare you; but to make you aware so you don’t overdo it.

Impingement and rotator cuff syndrome – Repetitive overhead lifting can lead to excessive pinching of the rotator cuff, which can become impingement syndrome. If not allowed to heal, the rotator cuff can partially or fully tear, which is full-blown rotator cuff syndrome.

Labral tearing – Excessive weight traction on the arm and excessive overhead movement can occur from pull-ups, kettlebell swings or gymnastic movements.

Shoulder bursitis – This inflammation of the bursa, or sacs filled with lubricating fluid that are found between bone, tendons, muscles and skin, can occur in people who participate in HIIT, barre-style classes and yoga (think movements that require your elbows going about your shoulders repetitively).

Patella femoral pain – Kneecap pain without swelling often comes from muscle imbalances.The male knee is very straight, with the kneecap in the femur like an arrow in a socket. Females have a slight knock-knee, which can be irritated by deep squatting or improper lunge form, and are pre-disposed to patella femoral pain because of how their hips are situated.

HIIT training can be an energizing, fun workout – it constantly challenges you to adapt to what’s going on around you, and if done in a group is usually a very supportive community. Always listen to your body. With any exercise, you should finish a workout feeling like you’ve worked hard and pushed yourself, but not to a point where you feel pain, depletion or that you’ve overdone it.


aaron hewittAaron Hewitt PA-C, is a Physician Assistant with OrthoCarolina’s Sports Medicine Center.

He is a former Assistant Athletic Trainer with the Minnesota Vikings (NFL), and is an orthopedic provider for UNC-Charlotte and Myers Park High School. He also is a Physician Assistant Team Lead for Sports Medicine, Spine, Hand & Pediatrics and a Clinical and Surgical Preceptor for Physician Students.

In addition to CrossFit, Aaron is dedicated to running, yoga and clean eating.


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