High Intensity Interval Strength Training: Too good to be true?

High Intensity Interval Training (HIIT) has increased tremendously in popularity in the past decade, for good reasons. It is as good as, or better than, other types of exercise in many ways and takes less time to complete. I’ve written in the past about the benefits of HIIT, which are many, so I won’t spend a lot of time here trying to make the case for it. I will briefly touch on it’s benefits with links to some relevant research and then get to the reason for writing this piece.

In summary, multiple studies have shown HIIT to be as good as, or in most cases superior to, “slow and steady” traditional cardiovascular training in these areas:

  • Weight Loss: HIIT is superior to slow and steady cardio for burning fat. The cascade of effects initiated by HIIT can cause fat loss for hours after the exercise session is completed. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2991639/
  • Heart disease: In people with heart disease, HIIT improves one important metric of cardiovascular health by double that of slow and steady cardiovascular training. There are various other studies showing other benefits as well. https://bjsm.bmj.com/content/48/16/1227.short
  • Diabetes. HIIT promotes a significant increase in insulin sensitivity (and weight loss).
  • Increased aerobic and anaerobic fitness. HIIT causes a greater increase in heart recovery rate, peak lactate rate, and peak power/velocity than slow and steady cardio. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5539186/
  • Longevity: Because of the factors listed above and others, a large Australian study showed that introducing HIIT into a workout regimen caused a significant increase in lifespan. https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2212268

Combining HIIT with strength training has been shown to have similar results with the added benefits that you maintain muscle mass (as opposed to just sprinting or cycling) while drastically cutting down on your workout time. You are getting the benefits of cardiovascular exercise and strength training all in one. Sounds too good to be true, I know. But for once, it’s not. It works like this: instead of doing HIIT on a bike or by doing sprints, you do your strength training exercises at a HIIT tempo. Think doing squats for one full minute followed by 20 seconds of rest, etc…

One program that has embraced this type of training has exploded in popularity in the last few years (hint: it begins with a C and ends with a T and there are some “S’s” in the middle). I’m often asked what I think about this type of training. For the most part, I think it is fantastic with one caveat. My biggest concern with most of these programs is that they encourage participants to do extremely difficult, technical moves to fatigue in a competitive environment. Many of these exercises, especially some of the Olympic weight lifting moves, require a lot of instruction and practice to master. Experts spend years developing their technique with many of these moves. For the average person to go into a class and do these moves as many times as they can, with heavy weight, in a competitive environment, is a recipe for disaster.

As a clinician who spends most of his time thinking about joint biomechanics, I have hesitated to encourage this type of strength training in the BackForever program because of the risk of doing exercises poorly, resulting in acute or chronic injury. However, I do this type of training with my clients (whom I can keep an eye on) all the time, and have for years, with great benefits to their health and well-being. With that said, I will be introducing High Intensity Interval Training and High Intensity Interval Strength Training into the BACKFOREVER program this summer. I have put together a few routines which contain exercises with the lowest level of likelihood of error, and therefore injury. Most of you will really enjoy this and will see significant benefits after doing it for a few months. The key is to focus on your movement.

When you begin to move, you must practice the movement patterns you have learned in the program: hip hinging, rotating from the hips, squatting properly, split squatting properly, pushing, pulling, etc. If you must sacrifice any of these foundations of posture and movement to get in that extra rep or go up a few pounds in weight, you do it at great risk. Listen to your body. Make your gains safely. Failure to adhere to this philosophy can lead to a long list of ailments that nobody wants to hear their doctor say: disc herniation, degenerative disc disease, arthritis, rotator cuff tears, tendonitis, ACL tear, meniscus tear, and more. Remember: most spinal problems are the result of thousands of cycles of movement, not just one bad move. Just because you “got away with it” today doesn’t mean that you aren’t doing long-term damage to your body.

For those with heart conditions, a major study of over 4800 participants showed it to be very safe, beneficial, and even recommended it as a part of any program for patients with cardiovascular disease. If you have heart disease, clear it with your doctor first. (https://ahajournals.org/doi/full/10.1161/circulationaha.112.123117?keytype2=tf_ipsecsha&ijkey=d1f3ab7116c73cc8515a00138f6f86fd23370050)

Done correctly, HIIT is a very efficient, safe, and fun way to get fit. The downside: It’s pretty uncomfortable in the beginning. Like anything else, it gets easier with time.

Look for the new HIIT tab in the BackForever program in the coming days. If you feel ready, give it a try. The benefits are real and numerous.

Dr. Jeremy James founded and was director of the Aspen Club Back Institute in Aspen, Colorado, is the coauthor of the bestselling The Younger Next Year Back Book and earned his Doctor of Chiropractic from the University of Western States. Learn more about Dr. James here.

20 Minutes. 5 Easy Moves. 1 Workout to Relieve Back Pain.

Sitting at a desk all day. An extra-hard workout. Sleeping the wrong way. There are plenty of things we do every day that can cause back pain and soreness. Working out might seem like that last thing you should do, but this quick, low-impact workout can help alleviate the pain.

You’ll perform 5 low-impact exercises that will stretch and strengthen the muscles in your back while lengthening the mucles along your front body. This will not only ease your back pain, but it will also strengthen your back and core muscles to help prevent future injuries. Plus, it’s only 20 minutes. Enough said. Do this first thing in the morning when you wake up, when you’re sore, or as a supplement to your usual cardio routine.

All you need is an open space and a mat to get started. Then press play.

To recap, you’ll need an exercise mat. Hold each exercise for 30 seconds and repeat the circuit 3 times.

-Warm Up-

Squat Spinal Length
Back Extension
Back Extension With Locked Heels

-Cool Down-

Looking for more short and effective at-home workouts? Grokker has thousands of routines, so you’ll never get bored. Bonus: For a limited time, Greatist readers get 40 percent off Grokker Premium (just $9 per month) and their first 14 days free. Sign up now!

Low Impact HIIT Routine

What to Do When You’re Injured

Looking for a low impact HIIT routine? When your joints aren’t cooperating, it’s difficult to incorporate exercise of a higher intensity level into your workout routine. If you’ve herniated a disc or your knees are complaining, or if you’ve recently had a surgery that requires some rest, you can listen to your body and heed its warnings to avoid plyometrics or high-impact cardio like running.

However, when my clients have experienced this kind of pain, they also experience the fear of losing results. What if I move backwards?

Their fear of regressing is normal and understandable. I have had minor injuries as an active person, and each time I feel “benched” by nagging pains, I, too, worry that I won’t be able to maintain the weight at which I’m most happy, or that I will lose my cardiovascular endurance. I relate to my clients very much at these times!

The reality is that injuries – whether they’re minor or major – can (and do) happen to many, many active people. While measures should be taken and best practices should be followed to prevent injury, it’s almost inevitable that active people will eventually tweak something or have an unrelated surgery or procedure that takes high-intensity exercise off the table, at least temporarily.

So what should you do?

Many health care providers are hesitant to recommend specific exercises, because of the fear that you (the patient) will hurt yourself. The reality is that you definitely should avoid exercises that feel as though they are irritating your pain or discomfort.

However, in most cases, there are exercises that you can perform (and even get a sweat on!) if you are injured or recovering from an illness or surgery. Being moderately active can actually speed recovery, as long as you don’t over-do it! Just be sure to keep your healthcare provider in the loop and to ask for specific advice.

A Low Impact HIIT Routine

First of all, what is HIIT?

HIIT is high-intensity interval training. It means that you go really hard for a short, specified period of time, and take rests to recover during short breaks. HIIT is all about maximizing your level of effort, and a HIIT workout can also be shorter and more compact than a more moderate workout.

The key to creating a HIIT workout while you’re injured is to reduce rest and to really fatigue muscle groups. You can still move through many ranges of motion with proper form when you’re injured, but the key is to avoid strain. By keeping weight low, reps high, form perfect, and incorporating some iso-holds, you can get a vigorous workout in even without lots of jumping or high weight.

I find that some people prefer the nature of a HIIT workout over long, steady-state cardio anytime, but this can largely be up to personality and taste! However, HIIT also ramps up intensity to the point that your body becomes more efficient at distributing oxygen more quickly throughout your body. This means that even though it’s a shorter workout, your endurance could be improved in all of your athletic activities by incorporating HIIT-like workouts into your weekly mix, even under normal circumstances!

Here’s the at-home routine I would recommend if you are recovering from an injury and need a lower-impact version of a high-intensity workout. All you need is an exercise mat!

But remember, always listen to your body! If something hurts or has a sharp, pinching feeling, you should find an alternative move that does not hurt!

Circuit 1 – complete three rounds, and rest one minute between each round

Alternating Forward Lunges – 15 reps on each side

Alternating Curtsey Lunges – 15 reps on each side

Swiss Ball Hamstring Curls – 15 reps

Bodyweight Squats – 15 reps, end with a 30-second hold, then rest 1 minute before repeating circuit

Circuit 2 – complete three rounds, and rest one minute between each round

Forearm Plank – 30 seconds

Forearm Side Plank – 30 seconds on each side

Alternating Deadbugs – 15 reps on each side

Three Leg Dog Flow – 15 reps on each side, rest 1 minute before repeating circuit

Circuit 3 – BONUS ROUND – complete three rounds, and rest one minute between each round

Marching Bridges – 15 on each side

Single Leg Bridge Push-Ups – 8 on each side

Bird Dogs with Renegade Rows – 15 on each side

Prone Leg Lifts – 15 on each side, rest 1 minute before repeating circuit

Try it out and let me know what you think!

Low-Impact Aerobic Exercise

An important component of any exercise program is aerobic exercise, which elevates the heart rate and improves circulation. Aerobic exercise can help relieve back pain by decreasing stiffness and improving blood flow to the spinal structures, increasing the amount of nutrients reaching the spine.

Low-impact exercise can elevate the heart rate without jarring the spine and worsening back pain, a preferable option for those with back pain.


Benefits of Aerobic Exercise

A regular routine of aerobic exercise can help alleviate neck or back pain by:

  • Reducing the likelihood and/or severity of potential future painful flare-ups
  • Keeping the spine functional and mobile, limiting disability caused by chronic pain. Not exercising with chronic back pain will typically worsen mobility and functionality.
  • See Understanding Chronic Pain

  • Burning calories to help achieve and maintain optimal weight, which can remove excess pressure on the spine
  • See A Healthy Weight for a Healthy Back

  • Increasing production of endorphins, which act as a natural painkiller and can elevate mood to relieve symptoms of depression

Typical recommendations for aerobic exercise include at least a 20 to 30-minute workout between 3 and 5 times a week to effectively improve circulation.1 For severe pain, it may be helpful to start with shorter intervals of exercise, such as 5 to 10-minutes of walking, and gradually work up to a more extensive routine.

In This Article:

Types of Low-Impact Exercise

Popular low-impact aerobic exercises include:

  • Exercise walking. Exercise walking differs from everyday walking in that it is faster paced with the goal of elevating the heart rate and gently working the muscles. Exercise walking has the advantage of being gentler on the spine than jogging, not requiring special equipment (except a good pair of shoes), and being available in almost any location. Wearing ankle or wrist weights can add some resistance to the exercise. Walking can be done inside, such as in a mall or on a treadmill, or outdoors, such as on a nature trail or around the neighborhood.
  • See Exercise Walking for Better Back Health

  • Elliptical trainer or step machine. These machines simulate the movements of jogging, running, and walking up stairs to provide a low-impact aerobic workout. Most machines use pedals or footholds suspended above the ground that glide up and down, so the feet never hit a hard surface during the workout. Additionally, many machines include an array of resistance settings that can help strengthen muscles.
  • See Elliptical Trainer

  • Stationary bicycling. A stationary bicycle mimics the pedaling motion of a bicycle, providing aerobic exercise without the jostling impact of riding on uneven ground. Stationary biking may be preferable as part of a spinning class, which is guided by an instructor and often available in a variety of workout options for beginners or more experienced cyclers. Stationary bikes come in upright models, which involve leaning forward, and recumbent models, which provide back support in an adjustable, reclined position.
  • See Stationary Bike

  • Swimming and water aerobics. Exercise while in the water combines added resistance and natural buoyancy to provide aerobic exercise with minimal impact on the spine. Water aerobics and swimming may be considered if a workout on a hard surface may be too painful. Specific water exercises or swim strokes may be taught as part of a class or recommended by a doctor.
  • See Water Therapy Exercises


Finding the right aerobic exercise routine is typically dependent on personal preferences and may involve a process of trial and error. Other options may be recommended that better suit a particular condition, pain levels, and lifestyle.

  • 1. American Heart Association Recommendations for Physical Activity in Adults . American Heart Association. July 27, 2016. Accessed June 2, 2017.

At some point everyone is a beginner at any given talent, skill, or knowledge and the knowledge and skill of exercise is no different. Though some people may have a fuzzy memory of playing sports as a child others may have never done anything more than attempting to run to their car to avoid being rained on.

No matter which category you identify with most, starting into an physical fitness program and feeling like a beginner can be a scary and daunting obstacle. We have made this video specifically for those who have no formal training or experience following an exercise routine as a way to ease yourself into exercise. We have chosen exercises that can be modified to be easy but can also be modified to be difficult so even if you are starting with very little strength, this routine can work for you and if you are starting from having some strength but just a bit out of shape then this routine can also fit your needs as well.

For example if you know you are particularly weak in your legs then you can limit the distance you move with each exercise motion to make that particular exercise easier to complete. Where if you know you have strong legs then you can attempt a more full range of motion as long as you can comfortably control your body through that full range. Everyone is different so everyone will need to start at a different level of difficulty and the only way you can decide what is right for you is by trying it and listening to your body.

In this video we go through two set of 10 repetitions, meaning we will do 10 motions of each exercise, pause for a small rest then complete another 10. Now, though that is what we use in the video you do have to or need to start there. In fact it would be better to start with just a few repetitions (4-6) and only do one set until you know how your body will react to the entire routine. If you are not sore or in discomfort the next day then by all means add more repetitions or sets until you do start to feel a small amount of soreness the next day. Once you hit that point try to focus on improving your form by completing a more full range of motion every time you do this video again. And once you can do this exercise with perfect form and full range, then you can add additional weight to make each exercise harder.

One of the best pieces of advice I can give to beginners is this; no matter how quickly you want to see results take your time and progress slowly. If you start well below what you think you are capable of and slowly increase it will not only improve your chances of sticking with an physical fitness routine but it will also drastically reduce your chances for injury and overtaxing yourself and giving up.

This video uses the following exercises in the order shown.

Low Impact for Beginners

Warm Up
(1 Set of 20 Seconds for each motion)

Total Body Strength and Toning
(2 Sets of 10 repetitions for each movement)

  1. Alternating Lunge
  2. Push Up
  3. Squat
  4. Bent over Arm Circles
  5. Ice Skaters
  6. Lateral Arm Raises

Core (Abs, Obliques, Lower Back)
(2 sets of 10 repetitions for each movement)

  1. Crunch
  2. Side Hip Raise (Left)
  3. Side Hip Raise (Right)
  4. Pilates Swimmers

Cool Down/Stretch
(1 set of ~20 seconds each stretch)

Hannah was 35 when she had surgery for a brain tumour. The operation was risky and left her with a brain stem stroke. She woke with no movement on her right side, and a host of other problems. Once she left the hospital three months after the event, she could just manage walking across the room. About five months after her operation, Hannah took up Nordic Walking. She was extremely unbalanced but months of consistency have paid off. Hannah can now walk 5kms at a good pace – that’s taken only about 18 months! Nordic Walking is amazing post stroke because the pole action helps those with hemiparesis get used to engaging their affected arm as they walk. She has also found Nordic Walking worked better than any sleeping pill! Since the stroke, Hannah has had difficulty sleeping, but Nordic Walking in the morning always aids her sleep that night. She can actually feel the effect of happiness on her brain after a Nordic Walk, and its amazing anti-anxiety effects. Hannah will continue Nordic Walking, probably forever! And mainly attributes it to her remarkable recovery. What’s Nordic Walking? Research from Europe and the USA has proven that the health benefits of Nordic Walking are significantly greater than regular walking, jogging, swimming and cycling. Public Health England now recommend Nordic Walking as one of the most effective forms of exercise. Kristen Pratt of Capital Nordic Walking first discovered Nordic Walking when she was working on disability and rehabilitation for the World Health Organization in Geneva, Switzerland and saw people cross-country skiing on dry land. As an occupational therapist with a career in health, fitness and rehabilitation, Kristen could immediately see the massive benefits to be gained by Nordic Walking. Kristen sees the life-changing impact of Nordic Walking every day with those she teaches – now over 1000 people in Canberra – many of whom have significant health and mobility challenges such as MS, Parkinson’s and joint pain. Nordic Walking harnesses the power of upper body muscles to propel us along, strengthening the core, back, arms and shoulders while mobilising all of those joints. Proper use of the poles encourages upright posture and reduces strain on legs and lower back. People find that they can walk faster, further and more comfortably and improve their fitness when using Nordic Walking poles. It’s important to use the right equipment and learn how to do it correctly so as to get the maximum benefits and avoid injuries. See capitalnordicwalking.com.au for more details.

Low impact home workouts

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