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ACSM Information On

Extreme Conditioning Programs

A relatively new form of exercise referred to as extreme conditioning programs (ECPs) is currently marketed to a wide, active
population. These are vigorous exercise workouts that are physically demanding.

Extreme Conditioning Programs often consist Improve cardiovascular health

A Complete Physical Activity Program of a variety of training methods such as Improve insulin sensitivity (i.e., the uptake
A well-rounded physical activity program includes
resistance training with kettlebells and barbells, and utilization of blood glucose)
aerobic exercise and strength training exercise, but
not necessarily in the same session. This blend helps
repeated body weight exercises, explosive Lower blood pressure (when elevated)
maintain or improve cardiorespiratory and muscular movements, sprints and flexibility. This variety Improve the good HDL-cholesterol.
fitness and overall health and function. Regular physical can prevent boredom and participants often
activity will provide more health benefits than sporadic, feel motivated, challenged and excited. These Another focus of ECPs is functional fitness.
high intensity workouts, so choose exercises you are ECPs boast claims of vastly improved fitness Program designers of ECPs describe functional
likely to enjoy and that you can incorporate into your in rather short periods of time. Many of the fitness as the ability to repeatedly perform
schedule. whole-body or multi-joint movements under
ECPs provide the convenience of working out
in settings other than a gym, such as parks fatiguing conditions.
ACSMs physical activity recommendations for healthy
adults, updated in 2011, recommend at least 30 minutes and warehouses. This may be attractive for
of moderate-intensity physical activity (working hard some exercise enthusiasts who are interested Concerns About ECPs
enough to break a sweat, but still able to carry on a in exercise, but not interested in paying costly Certain characteristics of ECPs appear to
conversation) five days per week, or 20 minutes of more fitness facility fees. ignore many of the current standards for safe
vigorous activity three days per week. Combinations participation in exercise. For instance, the
of moderate- and vigorous-intensity activity can be performance of very fast, timed repetitions
ECPs are high repetition, vigorous training
performed to meet this recommendation.
workouts that incorporate challenging exercises with insufficient rests periods between sets
Examples of typical aerobic exercises are: performed in sequence with short rest periods contrasts with currently held scientific evidence
between sets. ECPs combine aspects of circuit to improve muscular strength. Controlled
Walking training (going from station to station of movements with adequate rest reduce the risk
Running exercise), resistance training, high-intensity of injury. Unskilled participants who are not
Stair climbing ready to perform a complex movement with
interval training and body weight calisthenics.
Many certified exercise professionals use these weights are at risk for musculoskeletal injury.
Cross country skiing same training programs, although very safely Insufficient rest between exercise sets and
Swimming and effectively, with clients on a daily basis. circuits may be a precursor to overtraining
syndrome. Overtraining syndrome manifests
In addition, strength training should be performed a Potential ECP Benefits itself with physiological and psychological
minimum of two days each week, with 8-12 repetitions Many ECPs integrate high intensity interval signs and symptoms that impair performance
of 8-10 different exercises that target all major muscle
training, often referred to as HIIT, workouts. and delay the normal recovery from exercise.
groups. This type of training can be accomplished using
body weight, resistance bands, free weights, medicine This system of training involves repeated bouts Many ECP instructors encourage participants
balls or weight machines. of high intensity efforts followed by recovery to push themselves to compete athletically with
periods of varying lengths of time. HIIT more experienced members in the ECP class.
programs have been shown to have several In this type of competitive setting, it becomes
health benefits including: difficult for a novice exerciser to scale back
to the appropriate training intensity. There Other Health Risks
appears to be a wide range of variability in how Exertional Rhabdomyolysis: Some
Staying Active Pays Off!
these programs are being taught, as the owners exercise participants may develop exertional Those who are physically active tend to live longer,
of many ECP programs may not regularly rhabdomyolysis. In this condition, the muscle healthier lives. Research shows that moderate physical
employ certified exercise professionals to teach cell membranes begin to break down leading activitysuch as 30 minutes a day of brisk walking
significantly contributes to longevity. Even a person
these classes (such as ACSM Certified Health to spillage of some proteins (like myoglobin)
with risk factors like high blood pressure, diabetes
Fitness Specialists and Personal Trainers). into the blood. This leakage of cellular or even a smoking habit can gain real benefits from
Finally, despite the growing popularity of proteins into the blood may cause kidney incorporating regular physical activity into their daily
these programs, very little research has been damage and unsafe heart rhythms. Reports of life.
conducted and published on the specific health ECPS resulting in exertional rhabdomyolysis
and fitness benefits, injury patterns and risk include exercise situations where persons were As many dieters have found, exercise can help you
stay on a diet and lose weight. Whats more regular
factors for injury. exposed to doing hundreds of push-ups or
exercise can help lower blood pressure, control blood
squat jumps in a workout session, or perform sugar, improve cholesterol levels and build stronger,
Who Should Not Participate? explosive squats to exhaustion. A common denser bones.
Individuals with certain medical and health- factor with exertional rhabdomyolysis seems
related factors should avoid ECPs, including to be exertion beyond the point of fatigue. The First Step
persons with: Only a doctor can diagnose an individual with Before you begin an exercise program, take a fitness test,
Traumatic brain injury (including concussion) exertional rhabdomyolysis. What to look or substantially increase your level of activity, make sure
A recent musculoskeletal injury (such as ankle for: The common symptoms include reddish to answer the following questions. This physical activity
sprain) brown (or cola-colored) urine, muscular pain, readiness questionnaire (PAR-Q) will help determine if
A medical condition who has been advised by and weakness. youre ready to begin an exercise routine or program.
her/his health practitioner not to participate Musculoskeletal Injury: Exercise should
in vigorous exercise Has your doctor ever said that you have a heart
not be performed if there is pain in joints condition or that you should participate in physical
Current medication use which may impair or soft tissues. If pain worsens during the activity only as recommended by a doctor?
balance exercise, the participant should stop. Exercise
can be modified based on the individual to Do you feel pain in your chest during physical activity?
Safety Considerations for the prevent development of pain. For example, In the past month, have you had chest pain when you
Participant older participants may be able to perform half were not doing physical activity?
Exercise equipment needs to be structurally Do you lose your balance from dizziness? Do you ever
squats instead of full squats to minimize joint lose consciousness?
sound and designated away from walking,
or soft-tissue injury. Activities that induce Do you have a bone or joint problem that could be
running and exercise pathways in a fitness
pain should not be performed. What to made worse by a change in your physical activity?
look for: While muscle soreness is expected Is your doctor currently prescribing drugs for your
The equipment, facility, and the exercise blood pressure or a heart condition?
after unaccustomed aggressive exercise, pain
environment should be inspected and Do you know of any reason you should not participate
greater than a three out of ten points (where
maintained daily in order to prevent injury. in physical activity?
0= no pain, 10= worst possible pain) should
Effective exercise programs should be
not be present 24 hours after a session. Pain If you answered yes to one or more questions, if you are
introduced gradually with a planned, stepwise
indicates that the session was excessive and over 40 years of age and have recently been inactive,
progression in exercise intensity and duration,
the intensity and/or volume need to scale or if you are concerned about your health, consult a
particularly for beginning students with low physician before taking a fitness test or substantially
back or the exercise modified.
fitness levels. increasing your physical activity. If you answered no to
Safe, effective exercise programs should be Summary Thoughts: Put Balance in each question, then its likely that you can safely begin
individualized, and based from appropriate exercising.
Your Exercise Program
fitness assessment by certified exercise Exercise enthusiasts can readily participant
professionals. Prior to Exercise
in high-intensity exercise, at the appropriate
Training sessions should ensure appropriate intensity level, when balanced with other Prior to beginning any exercise program, including
recovery between exercise sets. the activities depicted in this brochure, individuals
popular training modes such as yoga, resistance
Avoid any exercise program that encourages should seek medical evaluation and clearance to engage
exercise, body weight training and flexibility in activity. Not all exercise programs are suitable for
participants to perform excessive amounts of training. Suitable rest periods (i.e., about two everyone, and some programs may result in injury.
repetitions or training movements that lead to to three minutes) between sets of exercise are Activities should be carried out at a pace that is
exhaustive fatigue. essential for effective muscle training. And, comfortable for the user. Users should discontinue
ECP workouts should be separated with days if participating in an ECP, regularly monitor participation in any exercise activity that causes pain or
of rest, relative rest (mild, low volume activity signs for overtraining such as lingering muscle discomfort. In such event, medical consultation should
with low impact) or of different exercise be immediately obtained.
soreness, elevated heart rate upon awakening
modes (e.g., cycling, swimming, yoga). (about five or more beats higher then normal)
Personnel who are properly trained with on multiple mornings, and a decrease in
appropriate certifications should supervise all exercise performance and motivation. Lastly,
training sessions and assist with spotting and exercise enthusiasts are encouraged to seek out
monitor the safety of the participant. qualified fitness trainers who are trained to
appropriately design, individualize, implement,
and oversee an effective and progressive
exercise program.

ACSM grants permission to reproduce this brochure if it is reproduced in its entirety without alteration. The text may be reproduced in another publication if it is used in its entirety
without alteration and the following statement is added: Reprinted with permission of the American College of Sports Medicine. Copyright 2015 American College of Sports Medicine.
This brochure was created and updated by Len Kravitz, Ph.D., FACSM, and is a product of ACSMs Consumer Information Committee. Visit ACSM online at