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To HIIT or Not to HIIT: The Benefits of High-Intensity Interval Training

Updated: Mar 7


Questioning and thinking about an answer

Introduction


While Shakespeare was one of the most prolific writers the world has seen, the answer to the question he posed, and the one that I modified ever so slightly, is indeed to HIIT!

Don't worry—I'm not inciting violence here. HIIT refers to High-Intensity Interval Training in case you were wondering. So please don't go and hit your brother or anyone else just because I said to HIIT!


Now that you know the answer to the question, let's explore why high-intensity interval training can be so beneficial and why you may want to discuss incorporating interval training into your exercise routine.


Alright, enough already—let's move it!





What Is Interval Training?


Before we begin "moving," I want to emphasize that you should be screened for exercise appropriateness by the proper medical professional first.


In my clinic, clients have their blood pressure, heart rate, oxygen saturation levels, weight, and/or height measured before starting a rehabilitation, wellness, or performance-based program.


TRUE STORY: I had a client whose blood pressure measured 230/110 mmHg, and needless to say, we didn't do any exercise that day! In addition to taking vital signs, I review clients' thorough medical history and screen them for red flags, so please see your medical professional first!


Now, what exactly is interval training?


Interval training involves periods of intense activity alternated with periods of rest and recovery.



What Defines "Intense"?


Woman exercising and performing intensity intervals

Exercise can be performed on a spectrum of intensity levels—from requiring little to no effort (such as walking at a slow pace) to requiring a full-on maximal effort (such as sprinting as fast and as hard as you can).


Objectively speaking, high intensity can be defined as:

  • 85-95 percent of maximum heart rate (HRₘₐₓ)

  • A self-rated score on the BORG scale (see below)


To find my clients' maximum heart rate, I use a mathematical formula that's slightly more complicated than the standard 220 minus age in years. I base my calculations on whether or not my clients take medication for their heart. Additionally, I use a self-perceived rate of exertion score from the Borg scale to help understand the intensity my client is feeling during a HIIT workout.


BORG Scale of Perceived Exertion


PERCEIVED EXERTION

RATING

PERCEIVED EXERTION

6

no exertion

13

somewhat hard

7

extremely light

14

​

8

​

15

hard

9

very light

16

​

10

​

17

very hard

11

light

18

​

12

​

19

extremely hard

13

somewhat hard

20

maximal exertion


Remember: You should seek personalized advice from a qualified medical professional before engaging in exercise, training, or activity to minimize your risk of injury, heart attack, or stroke.





What Kinds of Activities Can Be Performed With High Intensity Interval Training?


The scientific literature indicates that the type of HIIT task performed—whether cycling, calisthenics, rowing, running, or functional activities/training—does not significantly change cardiovascular fitness outcomes (Gist et al., 2014; Petersen et al., 2022; Buckley et al., 2015; Menz et al., 2019).


In essence, it doesn't matter what activity is performed when choosing HIIT!


This is critical because it:

  • Allows clients the variability they need to remain engaged with their rehabilitation or wellness journey

  • Enables me to utilize my expertise in designing the best program without being limited to one specific mode of interval training


For example, I might have a runner with plantar fasciitis (aka plantar fasciosis) perform HIIT with rowing or cycling while progressing toward a return-to-running program. When it comes to choosing an activity, HIIT provides a variety of options.


HIIT for the win!





Putting It All Together


When prescribing exercise, I consider the volume and frequency of the program to ensure appropriate client response.


The length of time and number of sets prescribed for HIIT is based on my client's exercise capabilities—is my client a total couch potato or a weekend warrior?


For example, a 52-year-old sedentary male might have part of a HIIT routine look something like this:

15-60 seconds of stationary cycling followed by 15-120 seconds of recovery, repeated 4-10 times.





What Are the Benefits of HIIT?


When compared to traditional cardio programs (i.e., low or moderate continuous intensity training), HIIT has numerous added benefits for specific population types. Some of these benefits, as found in the scientific literature, include:

  • Reduced systemic inflammation (Khalafi & Symonds, 2020)

  • Greater positive psychological effects (Martland et al., 2020)

  • Improved body composition (Petersen et al., 2022)

  • Decreased blood pressure (Molmen-Hansen et al., 2012)

  • Improved heart function (Molmen-Hansen et al., 2012)

  • Improved insulin sensitivity (Petersen et al., 2022)


If you're not impressed yet, just wait.


I've got one last but extremely important benefit that has been validated in research.


Are you ready for this last and most important benefit?


A benefit that likely prevents most people from engaging in exercise.


A benefit that ironically I've been intentionally building up to make a timely point.


Here it is: HIIT requires significantly less time commitment than typical moderate continuous interval training (MCIT). Yes, you read that right. HIIT saves on time while still improving body composition and muscle function.


How much time is saved, you ask?


A research study by Tabata et al. (1996) found that while both MCIT and HIIT improved aerobic capacity following 6 weeks of training, HIIT alone improved anaerobic capacity (muscle strength) 28% more than MCIT, and at one-fifteenth of the time commitment!


So there's really no comparison between the two, unless of course you like spending more time exercising inefficiently (28 hours more according to Tabata)!






HIIT requires 15x less time commitment than MCIT!


Conclusion


Just like the game of golf, sometimes less is more.


In the case of HIIT, less time spent in a rehabilitation or fitness program means having more time to do other things, like playing a round of golf!


While exercise is an important tool for rehabilitation and fitness professionals, it is critical that clients recognize the value and benefit of properly prescribed exercise.


HIIT is a fantastic tool that I use in my clinical practice, and hopefully, it's something you will consider discussing with your medical professional at your next appointment.



Here's to your health and your golf game!


Dr. David Didlake, DPT

PT, Cert. SMT/DN, CSCS, Cert. TPI Medical Level 3, Dip. Osteopractic, FAAOMPT

Owner, Integrative Therapeutics "Home of the Saint Louis Golf Doc"

Follow me @theintegrativeclinic @thestlgolfdoc


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References

For those interested in the scientific evidence behind HIIT, we've included some key research citations:

  1. Nes BM, Janszky I, Wisløff U, Støylen A, Karlsen T. Age-predicted maximal heart rate in healthy subjects: The HUNT fitness study. Scand J Med Sci Sports. 2013 Dec;23(6):697-704. doi: 10.1111/j.1600-0838.2012.01445.x. Epub 2012 Feb 29. PMID: 22376273.

  2. Brawner CA, Ehrman JK, Schairer JR, Cao JJ, Keteyian SJ. Predicting maximum heart rate among patients with coronary heart disease receiving beta-adrenergic blockade therapy. Am Heart J. 2004 Nov;148(5):910-4. doi: 10.1016/j.ahj.2004.04.035. PMID: 15523326.

  3. Gist NH, Freese EC, Cureton KJ. Comparison of responses to two high-intensity intermittent exercise protocols. J Strength Cond Res. 2014 Nov;28(11):3033-40. doi: 10.1519/JSC.0000000000000522. PMID: 24832968.

  4. Petersen MH, de Almeida ME, Wentorf EK, Jensen K, Ørtenblad N, Højlund K. High-intensity interval training combining rowing and cycling efficiently improves insulin sensitivity, body composition and VO2max in men with obesity and type 2 diabetes. Front Endocrinol (Lausanne). 2022 Nov 1;13:1032235. doi: 10.3389/fendo.2022.1032235. PMID: 36387850; PMCID: PMC9664080.

  5. Buckley S, Knapp K, Lackie A, Lewry C, Horvey K, Benko C, Trinh J, Butcher S. Multimodal high-intensity interval training increases muscle function and metabolic performance in females. Appl Physiol Nutr Metab. 2015 Nov;40(11):1157-62. doi: 10.1139/apnm-2015-0238. Epub 2015 Jul 28. PMID: 26513008.

  6. Menz V, Marterer N, Amin SB, Faulhaber M, Hansen AB, Lawley JS. Functional Vs. Running Low-Volume High-Intensity Interval Training: Effects on VO2max and Muscular Endurance. J Sports Sci Med. 2019 Aug 1;18(3):497-504. PMID: 31427872; PMCID: PMC6683610.

  7. Khalafi M, Symonds ME. The impact of high-intensity interval training on inflammatory markers in metabolic disorders: A meta-analysis. Scand J Med Sci Sports. 2020 Nov;30(11):2020-2036. doi: 10.1111/sms.13754. Epub 2020 Jul 13. PMID: 32585734.

  8. Martland R, Mondelli V, Gaughran F, Stubbs B. Can high-intensity interval training improve physical and mental health outcomes? A meta-review of 33 systematic reviews across the lifespan. J Sports Sci. 2020 Feb;38(4):430-469. doi: 10.1080/02640414.2019.1706829. Epub 2019 Dec 31. PMID: 31889469.

  9. Molmen-Hansen HE, Stolen T, Tjonna AE, et al. Aerobic interval training reduces blood pressure and improves myocardial function in hypertensive patients. Eur J Prev Cardiol 2012;19(2):151–160.

  10. Tabata I, Nishimura K, Kouzaki M, Hirai Y, Ogita F, Miyachi M, Yamamoto K. Effects of moderate‐intensity endurance and high‐intensity intermittent training on anaerobic capacity and VO2max. Med. Sci. Sports Exerc. 1996; 28(10):1327‐30.


This article is for informational purposes only and does not constitute medical advice. Always consult with a qualified healthcare provider before beginning any new treatment.

 
 
 

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