When can HYROX be bad for your joints? Orthopaedician with 18 years of experience explains the risks, who should consult a doctor and more

HYROX challenges the body with running, lunges, sledge work and other high-intensity exercises, but it also carries a risk of injury and more.

If you are into fitness in any capacity, you must have definitely seen fitness enthusiasts and influencers participating in HYROX, the global indoor fitness race that combines running with functional workout stations. While the high-intensity competition tests your abilities, the question arises as to whether it can also pose health risks.

In an interview with HT Lifestyle, Dr Srikanth KP, consultant — orthopaedics (with 18 years of experience), Fortis Hospital, Bengaluru, explained when HYROX can be bad for your joints, touching on topics such as which joints and muscles are most vulnerable, when high-intensity training increases the risk of injuries, who should consider an orthopaedic assessment before participating, and more.

Which joints and muscles are most vulnerable during HYROX-style training?

Sledge pushing and pulling, rowing, and carrying weights all demand a strong, stable core. When the core tires out, the back often ends up doing the work.

“HYROX is for people who have been trained adequately for the same. HYROX is not for all people, especially those who have uncontrolled medical problems, including cardiac issues. It is also not for people who have frequent muscle or joint pain. The knees take the most punishment. Running, lunges, and wall balls repeatedly load the knee. The kneecap joint and the meniscus, which is the cushioning cartilage inside the knee, are commonly affected,” he cautioned.

Moreover, Dr Srikanth stated that the lower back is also most affected, adding, “Sledge pushes and pulls, rowing and carrying weights all demand a strong, stable core. When the core tires out, the back often ends up doing the work it wasn't designed for.” The hips and groin are also under strain, mainly from lunges and sledge work, and hip flexor and adductor (inner thigh) strains are quite common, the expert highlighted.

Then there are the ankles and Achilles tendons, which absorb the impact of running and the push-off during sledge work, according to Dr Srikanth. “Overuse here can lead to tendinitis or shin splints. Finally, the shoulders and wrists are stressed by rowing, sledge pulls, burpee jumps and wall balls, particularly when the person is fatigued and their form slips. In terms of muscles, the quadriceps, hamstrings, calves, glutes and the muscles around the spine are the ones doing most of the work, and they are also the ones most often strained,” he explained.

When can high-intensity training increase the risk of injuries?

HYROX is designed so that you do heavy movements when you're already exhausted. But that is when injuries can happen.

The activity itself is rarely the problem, Dr Srikanth noted. “Injuries usually happen because of wrong form. I have seen the risk go up in a few situations,” he explained. Here are certain scenarios that increase your risk of injury, per the expert:

• Doing too much, too soon: Bones, tendons and cartilage adapt much more slowly than muscles and cardiovascular fitness do. Someone may feel fit enough to push harder, but their joints and tendons haven't caught up yet
• Poor recovery: Training hard several days in a row, or not sleeping and eating well, doesn't give tissues time to repair. Small strains then build up into injuries.
• Fatigue and poor form: HYROX is designed so that you do heavy movements when you're already exhausted. That's when the knees start caving in during lunges and the back starts rounding during sledge pushes. Most injuries happen at this point.
• No strength foundation: Running fitness alone isn't enough. If the muscles around the hips, knees and core are weak, the joints take the load instead.
• Ignoring old joint issues: An old knee issue, a stiff ankle or a previous back problem tends to come back when the body is pushed hard without proper preparation.
• Wrong footwear or sudden changes in load: Jumping straight to heavy sledges or heavier weights than you're used to is a common mistake.

How can you tell the difference between normal post-workout soreness and an injury?

According to Dr Srikanth, normal soreness usually shows up 12 to 48 hours after a tough session: “It feels like a dull, achy tightness across the whole muscle, and it's usually on both sides of the body. It gets better as you move around gently and typically settles within three to five days.”

However, an injury feels different. He explained, “The pain is often sharp, stabbing or pinching, and it's usually in one specific spot or in a joint rather than the belly of a muscle. It may be on one side only. It often gets worse when you move or put weight on it, and it doesn't get better after a few days.”

There's a difference between normal post-workout soreness and an injury.

Who should consider an orthopaedic assessment before participating?

Before participating in HYROX, Dr Srikanth suggests an orthopaedic assessment for:

• People with a history of joint or spine problems.
• Anyone with ongoing pain or stiffness in the knees, hips, back or shoulders, even if it seems mild.
• Beginners or those returning after a long break.
• Older participants, especially those over 40.
• People who carry extra body weight, since running and jumping increase the load on the knees and hips.
• Those who have had surgery in the past, such as ACL reconstruction or joint or spine surgery.
• Anyone with a condition affecting bones or joints, such as arthritis or low bone density.

What warning signs mean participants should stop training and seek medical attention?

Some symptoms shouldn't be pushed through during HYROX, according to the expert. He cautioned that one should immediately stop and get checked if they notice any of these:

• Sharp or sudden pain during a movement, especially in a joint.
• A pop or snap followed by pain or weakness
• Swelling.
• Locking, catching or giving way in the knee, meaning it feels stuck or unstable.
• Inability to put weight on the leg or to move the joint fully.
• Pain that persists at rest or at night.
• Numbness or weakness in the arms or legs, particularly if back pain travels down a limb.
• Pain that progressively worsens over several days despite rest.
• Visible deformity or significant bruising.

Lastly, he stressed that pain that changes how you move is a red flag. “If you start limping or shifting your weight to avoid a painful spot, the body is compensating and that usually leads to a second injury. Rest early rather than late, and seek medical attention when needed rather than postponing,” Dr Srikanth explained.

Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.