Can too much exercise be dangerous? Neurologist explains when intense workouts may harm the heart

From heart attacks to sudden death, intense exercise has been linked to several tragic deaths. A neurologist explains when it could raise serious health risks.

Raju Srivastava, the 58-year-old comedian, collapsed and experienced chest pain while working out on a treadmill. However, this is not the only case where an intense workout has been linked to death. Videos of people collapsing during marathons, intense gym workouts, or dancing are frightening. They raise a natural question: Can too much exercise harm the heart? Dr Sudhir Kumar, MD, DM, neurologist at Apollo Hospitals, Hyderabad, took to social media X on August 30, 2026, to explain when intense workouts can turn dangerous.

Can intense workouts really be life-threatening?

According to Dr Sudhir, intense exercise can occasionally trigger a serious event, but that does not mean exercise is dangerous.

He highlighted that exercise is overwhelmingly good for the heart. Regular physical activity reduces the risk of heart disease, stroke, diabetes and premature death. However, the recommended minimum for adults is:

150–300 minutes/week of moderate exercise or 75–150 minutes/week of vigorous exercise, along with strength training at least 2 days/week.

Why do some people collapse during exercise?

Intense physical exertion dramatically increases the heart's workload.

In a person with an underlying, often undiagnosed problem, this can occasionally act as the trigger for:

Heart attack

Dangerous heart rhythm

Sudden cardiac arrest

The exercise may not have caused the underlying disease; it may have unmasked it.

“The highest immediate risk is often in the weekend warrior. Suddenly performing vigorous exercise when you are sedentary, unfit or inadequately trained can transiently increase the risk of a cardiac event,” said Dr Sudhir.

That's why the golden rule is:

Don't go from the sofa to a marathon.

Go from the sofa to a walk, and progress gradually.

Is there a U-shaped relationship?

Dr Sudhir highlighted that possibly yes, but the science is more complicated than social media headlines suggest. Some research has suggested that the benefits of exercise may diminish at extremely high volumes and intensities, with possible associations with atrial fibrillation and certain cardiac changes in some endurance athletes. However, the best recent review found limited evidence that very high exercise levels actually increase cardiovascular mortality. The benefits may simply plateau rather than turn harmful.

Strength training helps maintain muscle mass, bone strength, physical function, and metabolic health.

Is running a marathon unhealthy?

According to Dr Sudhir, not necessarily.

For a well-trained person, marathon running can be undertaken safely.

But a marathon is a sporting challenge, not a requirement for good health.

You don't need to run 42 km to get the cardiovascular benefits of exercise.

For most people, regular moderate exercise provides enormous health benefits with far less physiological stress.

Strength training in important

Here are the benefits of strength training:

Aerobic exercise strengthens the heart and improves endurance.

Strength training helps maintain muscle mass, bone strength, physical function, and metabolic health.

The ideal exercise prescription for health is not “cardio versus weights.” It is both.

At least two days of muscle-strengthening activity per week is recommended.

Know when to stop and seek help

Don't ignore the following symptoms:

1. Chest pain or pressure during exercise

2. Unexplained fainting or near-fainting

3. Sustained palpitations

4. Unusual breathlessness

5. A major unexplained drop in exercise capacity

These symptoms deserve medical evaluation, especially before returning to intense exercise.

Who should be more cautious?

“People with known heart disease, multiple cardiovascular risk factors, or a strong family history of premature cardiac disease should discuss an appropriate exercise plan with their doctor,” highlighted Dr Sudhir.

Being slim, muscular or physically active does not automatically guarantee that the heart is healthy.

For a well-trained person, marathon running can be undertaken safely.

The biggest mistake is the fear of exercise

“The risk of sitting all day, being physically inactive and progressively losing fitness is far greater for most people than the risk of exercising regularly. In fact, fitness itself is one of the strongest markers of long-term health. The answer to the rare tragedy during exercise is not to stop exercising. It is to exercise intelligently,” explained Dr Sudhir.

The sweet spot of exercise

For most of us:

1. Move every day

2. Do regular aerobic exercise

3. Strength train 2–3 times/week

4. Increase intensity and mileage gradually

5. Prioritize recovery and sleep

6. Listen to warning symptoms

Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. It is based on user-generated content from social media. HT.com has not independently verified the claims and does not endorse them.