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Less dramatic but also significant — higher intensity workouts can discourage continued physical activity e.g. http://dx.doi.org/10.1037/0278-6133.21.5.452 https://doi.org/10.1016/j.psychsport.2007.04.002.
A distinction needs to be made based on goals: are you exercising for general wellness, or are you training for a goal? I'm not saying one should injure themselves when training, that's counterproductive. But exercising for general wellness shouldn't be intense. Do something to gently, mildly raise your heart rate for 30 minutes, three times a week. That's a baseline. Try to extend that to an hour a day, but don't up the intensity. That's about optimal for overall health.
This is a really underrated statement. All the conventional wisdom says go intervals not the treadmill slug and make fun of "cardio bunnies" at the gyms. This can be highly misleading to newcomers: turns out intervals aren't fun and people just stop doing them, and exercise that you don't do doesn't count.
What a click baity title, especially for the New York Times.
This.

Summary for people who don't want to deal with it: spin classes sometimes cause rhabdomyolysis--especially in first timers.

AFAICT, Rhabdomyolysis typically presents in the physically fit.
Exercise in general without a warmup up period. certain medications may make it more likely. It could be genetic.

The article is good, and uses an example to show the issue.

Yeah. It's actually not a bad article. Just annoying that NYT resorted to doing title clickbait.
I'm not as offended by this as most people I guess. It's the modern variation of the headline.
#SavedYouAClick:

The condition is rhabdomyolysis:

> [...] a rare but life-threatening condition often caused by extreme exercise. It occurs when overworked muscles begin to die and leak their contents into the bloodstream, straining the kidneys and causing severe pain.

Yes.

My sister got this after a particularly grueling Crossfit session. She chalked it up to her being sore but her fiancé is a pediatrician and recognized the symptoms. Had she gone another 24 hours without treatment she could have destroyed her kidneys.

I knew it was going to be rhabdo.

I've done some extreme things and I've never experienced this. IMO you have to ignore some pretty serious warning signs to even get close to having this problem. Be sane, people.

Indeed, ctrl+f "rhabdo", "ah, yep", ctrl+w.
> The report cautioned that the condition was very rare, and not a reason to avoid high-intensity exercise.

end of discussion i guess?

Well, also:

> While almost any intense activity can cause rhabdo, it almost always strikes people who are doing something new. That is why people should always progress from light to moderate and then vigorous intensity when doing a new exercise

This is decent advice even without considering rhabdomyolysis.

Better to know ahead than to get a nasty surprise. I think it's good to warn people about the what, when, why, and how to recognise it. It might be rare but it's also pretty serious.
Americans are fat and don't work out. Americans work out so much they are killing themselves. The solution is to the happy medium, which can be found on reality television weight loss shows and commercials for 100 calorie Oreo cookie snack packs.
If there is one thing I've learned from friends and acquaintances who have trained for and run marathons it is listen to your body. Stop when it starts to hurt. If you try to push through pain, you are more likely than not winning the battle but losing the war. Many people will suffer worse damage -- stress fractures, sprained ligaments, or a torn meniscus.
Also, waaaayyyyy too many people really underestimate and under train for high intensity stuff like marathons these days. Fitness has become a fade that people are not backing up with actually putting the hard work in to be able to do things safe. A thing called Sudden Adult Death Syndrome has become very prominent in Ireland (including claiming people I knew personally.)

https://en.wikipedia.org/wiki/Sudden_arrhythmic_death_syndro...

Didn't see anything in that wiki article relating training/marathons to SADS. How did you make that link?
It's what a number of people I know who under trained for marathons dropped during/from.
Marathons aren't high intensity workouts. A 20 minute tempo run would be a good example. (I guess it's similar to a 30 minute spinning class.)
>"Marathons aren't high intensity workouts."

It sounds like you've never run one. World class athletes can run an entire marathon at a sub 5m mile pace. While they could run a single mile race in 4:05 or so, it's not even remotely a low intensity effort to run a 5 minute mile, even for the fittest people on the entire planet.

Unless you've put real effort into training, 60+ year-old competitive marathoners have done a 20 minute tempo run faster than you ever have... and repeated it 7 consecutive times without rest.

Marathons are high intensity and extended efforts.

Marathon race pace is ideally ever so slightly below your lactate threshold. The definition of high intensity training is literally anything above that threshold.
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Running is generally considered a high intensity activity, but of course there are different degrees.

>"The definition of high intensity training is literally anything above that (lactate) threshold."

That's far from a universal definition. The phrase "high intensity training" often refers to a type of strength training popularized by the founder of Nautilus that involved lifting until muscle failure. What you're describing specifically is called anaerobic training.

> That's far from a universal definition.

In sports medicine lactate threshold/anaerobic threshold/90(ish)% of VO2max has been the de facto definition for high intensity efforts for many many years.

You'll find plenty of examples on Google Scholar (including papers criticizing people for using these thresholds to define the intensity of workouts...)

> Running is generally considered a high intensity activity

Nope. Running can be a low, medium or high intensity activity depending on how hard you run (relative to your max).

That's an extremely pedantic argument. This isn't a sports medicine journal and you can google to find many other sites focused on health and wellness that go with a more mainstream usage. This even includes the NIH for what it's worth but I'm done on this thread.
The cause of SADS is very often a congenital heart defect. The high heart rate and blood pressure associated with endurance efforts is a good way of triggering an underlying defect that may be benign in a relaxed state.

But to state that these people died because they "underprepared" is ridiculous. That's like saying you could have prevented dying from a brain tumor by doing more crossword puzzles. Just as a tumor, a congenital defect was just a bad dice throw. Exercise triggered it, but so could running to catch a bus.

> listen to your body. Stop when it starts to hurt.

but isn't the point of training to push thru the pain barrier? When do you actually stop and listen, vs when to ignore the pain and keep going?

As I understand it, there's breaking a sweat and being uncomfortable, and then there's pain. If you feel pain it's time to stop for the day or at least take a good rest.
Pushing through the pain barrier is wrong, point of training is to find that subtle balance where you push enough to advance but not too much to avoid injury.
Many beginners would be surprised how slow or lightly they should be going if they monitored and targeted heart rate. There is discomfort and pain. If you're feeling massive exhaustion and/or pain, you may be doing something wrong.
I think one big issue is that people who are new to an exercise (or exercise at all) don't have a sense of scale, and don't realize quite how much progress they'll make early on.

If you know some people can run marathons, it doesn't sound crazy to think "well, I ought to be able to run for 10 minutes without any problems", but there are a lot of people who would risk seriously injuring themselves with 10 minutes of quick-pace running. Not to the point of rhabdo, probably, but certainly not a healthy experience.

It also doesn't sound crazy to think "Well, I'm in agony after two minutes, but there's no way that means I should stop. I'll never get anywhere with only two minutes of running!" But of course, 'beginner gains' are distinctive - someone who hasn't done cardio in years might be at two minutes today and six minutes next week.

The only universal answer I know to solve this is to take your first few outings in a new thing lightly. Don't even set a training plan, just go out until you're a bit uncomfortable, then stop and see how you feel the next day.

I always take the advice of "push through the pain" as pushing through the pain of exhaustion, which will contribute to strength and your ability to push beyond current physical limits; whereas the advice of "listen to your body and stop when it hurts" is more related to injuries - if you have a constant muscle cramp, or joint pain, or a stress fracture, or a ligament issues... REST and recuperate. Pushing through this second sort of pain will very likely result in injuries worsening and requiring even longer to mend down the road.
As always, it depends..

Depends on the end goal. If you can only complete two miles and you're signed up for a marathon a month from now, you're going to have to push past your comfort zones.

But if your end goal is to be able to go up a flight of stairs without heavy breathing, to sustain vitality through your older years, then no, do not push. Do just the amount of effort that will allow you to keep coming back, day after day.

Depends on the pain. If you're running and your muscles get sore, by all means keep going within sane limits.

If you get a stitch in your side there's no harm in pushing through, they're painful but not harmful.

If you get shin splints or your knees hurt, stop and figure out what's wrong before you damage something.

This is very difficult. One thing when you should consider stopping is if the pain becomes chronic and never goes away. I remember seeing a lot of top fighters pretty much living on pain killers. That's probably a clear sign you should stop.

I got a lot of benefit from doing intense martial arts when I was younger but sometimes I wish I had been smarter and not just ignored pain. But again, it's a difficult decision. Some things make you tougher and some things cause problems later on.

In my own experience, as I have not found a way to transfer other people's physical pain unto myself, there are two types of pain: the pain from working your muscles, and the pain from doing something wrong.

The first thing that you should learn when doing a new exercise is what the difference between these two pains are. Then, when performing more rigorous forms of the same exercise, you can establish where you can push through the pain. Is the pain you are feeling exhaustive? Push through. Is the pain something foreign? STOP IMMEDIATELY.

This, I think, is one of the reasons why it is suggested to do a lighter exercise before engaging in the intense stuff. As well, you don't run the risk of learning the difference between the two pains too late into the exercise. In general it follows along with the trite quotes: "You have to learn to walk before you can run," and "Start slow to go fast."

Agree 100%. Recovery is absolutely key to becoming stronger. You don't get stronger during the workout, but after, when your body rebuilds. Listening to your body is crucial to knowing when you've done the appropriate amount of damage (and yes, working out is damage) that can be recovered. Also knowing when you've actually recovered enough to do the next workout is really important. This is why weightlifters rotate their muscle groups, to allow more time to heal and rebuild. You can't really do that with your legs, especially cycling/spinning, so you have to learn how to recover. And really, after some initial phase, cycling is more about cardio vascular health than leg strength.
Agreed, and that's the thing about cycling, it's a "gentle" exercise. Since the persons weight is suspended by the bike frame, the body doesn't experience the same stresses and impacts that runners do, for example. It's also how the big tours like the Tour de France can be 3 weeks long. Only a handful of people on Earth could run a marathon everyday for three weeks, but lots of cyclist can do nearly the equivalent on a bike.
I don't really buy that cycling is "gentle." It's true that it's not high-impact, but that's mostly about joints (IMO, I am not a sports scientist).

And joint stress is probably the reason that most people could not run a marathon every day for 3 weeks. The muscle energy expenditure for the TDF is off the charts--typically 8,000 calories a day, and the vast majority of that is burned in the leg muscles and respiratory system.

I pulled my achilles tendon about 10 years ago and ever since it has been particularly fragile. Angling my foot too far creates an unpleasant sensation and if I'm not really careful about how I place my foot when running it will put me out of commission for several days. I also had a roommate who injured himself doing squats when he was in his early 20s (20 years ago) and has since had six back surgeries and has to work lying down to manage his back pain. Most people don't seem to realize that even casual exercise, if done improperly, can cause permanent, life-altering injuries.
I had an old running coach say something along the lines of, "The hardest part of running a marathon is getting to the STARTING line injury free." I certainly found that to be true - both personally and watching peers train...
That's a really nice way of putting it. Thanks for sharing it with us.
I suffered from rhabdo about two years ago. I was doing 21s (3 sets of 21 barbell curls with a 7/7/7 split of different ROMs). A day or two later my urine was brown and I could not not bend my arm. I ended up self treating by drinking liters and liters of water instead of going to the ER.

It was a pretty scary experience, I would advise any one who hasn't worked out in at least two weeks to start very light and work their way up to a routine.

I also suffered from rhabdo about 2 years ago after only a set of 80 squats. I spent 5 days in the hospital, with daily perfusion of about 3L-5L of liquids. And I also love doing 21s...great minds are doing rhabdo
> great minds are doing rhabdo

What?

From the old saying, "Great minds think alike." It is a joking way to say that you and another person have the same idea.

By saying "Great minds give themselves rhabdomyolysis," the person is making fun of himself even harder.

Rhabdo is supposedly so common in CrossFit that they have a mascot called 'Uncle Rhabdo':

https://medium.com/@ericrobertson/crossfits-dirty-little-sec...

'Pukie The Clown' is another:

https://breakingmuscle.com/fitness/why-pukie-the-clown-isn-t...

Not that I needed another reason not to take up Crossfit, but that's another one added to the list. Thanks for that.
Rhabdo is common in class-based programs (CrossFit, spin, etc.) because you get people from various fitness levels all doing the same workout, and nobody is scaling properly due to ignorance or peer pressure to keep up with the best in the class.

Class instructors need to educate their class better on the risks of rhabdo.

Yeah, personally I find it in poor taste on the part of Crossfit to promote icons like Rhabdo the Clown. Granted, it's not official, but official enough for a decent looking cartoon mascot to exist

They're raising awareness on a very serious problem, sure, but doing so by portraying people who get injured in their classes as clowns.

To some degree the instructor is at fault here. After all, the point of Crossfit is to get people into shape through very hard exercise. It's the instructor's job to push people while somehow making sure that they don't push people past an invisible line that exists in different locations for different people.

I'm not saying the instructors are bad or irresponsible people, merely that they have very strange and very hard jobs. Arguably even Crossfit isn't bad, it's merely a symptom of the root cause. We're too busy and too undisciplined to get into shape with a proper diet and sensible exercise spread throughout the day, so we let "professionals" yell us into shape into a short yet intense time window.

And two of the fruits of this insanity are higher numbers of the population disabled by Rhabdo and this strange cartoon clown hooked up to a dialysis machine.

>> I'm not saying the instructors are bad or irresponsible people

Isn't the most common criticism thrown at Crossfit (beside the cult mentality thing) that their training/certification process for their instructors is woefully amateurish compared to other, typically more responsible, programs?

Yes. They also have a reputation for preferring quantity over quality (half-assed pullups) and a generally sloppy approach to safety (yeah sure do squats while balancing on an exercise ball). Check out the deadlift form in the "crossfit games": https://youtu.be/0lr1p7f2P4Y?t=50s

Or how they do "pullups": https://youtu.be/XQvSmqChm6M?t=1m40s

>> "crossfit games"

Wow, that is scary. Considering that these are supposed to be their top performers (and in a promoted event no less), that is quite a different level of bad than just having some instructors that may not be up to snuff. It's like they purposefully and actively promote bad form and health-damaging training. So the opposite of 'fit' then.

For a more disturbing take on rhabdomyolysis, google for "Uncle Rhabdo".

It's no joke, but perhaps making it into one does increase awareness.

Poor diet and lack of exercise contributing to the obesity epidemic in the United States is the biggest health issue of our time, and yet we get many more articles about "fat acceptance" and "dangers of exercising" than about the opposite.

Many of this comes from news sources that subscribe to the "I fucking love science" ilk of scientism, yet when it comes to things like obesity, they stick their head in the sand in favor of "feelz over realz."

If you read the article, you'll see that they still push for people to continue exercising. They just recommend that you do a light or moderate form of the exercise for the first time or two before committing to a strenuous exercise that you've never done before. Moreover, New York Times specifically has many articles promoting or discussing the benefits of exercise.
In a sad twist of irony, the best cure for my own periodic bouts of depression is intense exercise, controlled diet, and throughly enjoying the way I look and feel as a result. There must be a strong correlation between the decline of the healthful lifestyle (i.e., not so many sedentary jobs) and SSRI prescriptions.
> we get many more articles about "fat acceptance" and "dangers of exercising" than about the opposite.

Where is this movement you're talking about? Most of the articles I've seen in the mainstream media about "fat acceptance" are quite critical of the concept. I've seen exactly one "fat acceptance" article that seemed OK with it (a recent episode of This American Life), and that was a shock to me.

Just out of curiosity, can you even maintain proper form with any type of intense workout training? I'm not a fitness guru by any means, but I've been working out fairly consistently for almost 7 years now and, to me, anything more than 4 or 5 proper sets will start taking toll on the form, at which point it's best to switch to another muscle group or stop all together. If you don't have the form, what are you training?
I've tagged along with friends to various high-intensity workout "classes." (spin, treadmill, crossfit, etc). I never saw / heard form discussed at all. While they don't military-style push you, it's definitely a more intense / semi-competitive environment. It's motivating to some, but I can easily see how new people or ultra-competitive people get injured.

The classes are usually 30-50 minutes, they assume you know form already. With the teacher-student ratio they don't have time to show you anything. It's just start the workout and go.

Most of these places have like a "new person" workout that they run once a week. It's not required and I suppose experienced fitness people assume it's not for them.

I assume you don't, and probably look rather silly from a bystanders perspective. Like someone trying to do push-ups just bobbing their head up and down.
I think the answer is that it's 'working out' not training and they're going for a low weight high rep workout.

When using lighter weights (relative to your bodyweight) you're less likely to seriously injure yourself due to bad form.

Proper form is mainly to prevent injury and to move the most weight the most efficiently but you can still get "gainz" by letting it slip slightly. A good example is elite level power lifters on a deadlift, they round their spines pretty awfully when they approach their 1 rep max but they are trading a potentially slipped disc for CNS improvement and moving a greater load. The trick is knowing when and how to let form breakdown just enough that it doesn't destroy you.

Also there is merit in restricted range of motion training (such as stopping short of chest and lock out on bench press) to increase time under tension and "pump" - not considered proper form but if you want to target a certain muscle/group and really get it burning then it works very well.

Powerlifting is one of my chosen sports. I follow a decent number of elite powerlifters on various social media. I rarely see significant form breakdown in elite lifters in contest footage. Small, yes, but not "pretty awfully."
Fair enough, to me any flexation looks pretty awful when you're lifting as much as they are - I focus more on the body building side of things than power lifting.
With high intensity ballet training certainly, with a good teacher form keeps improving.
> Over the next two days, her legs throbbed with excruciating pain, her urine turned a dark shade of brown, and she felt nauseated. Eventually she went to a hospital, where she was told she had rhabdomyolysis, a rare but life-threatening condition often caused by extreme exercise. It occurs when overworked muscles begin to die and leak their contents into the bloodstream, straining the kidneys and causing severe pain.

Terrifying.

I've seen a lot of people at my open gym get rhabdomyolysis. It almost always afflicts fit newcomers, or people returning from a break, who push themselves more than they should because they think they are fit enough for the intensity. Like the article says, you need to ease into an exercise regime, regardless of how fit you are.
I think that the most important thing I've learned about exercise (and it's taken me most of my almost 40 years to internalize it, and I'm still not great at it by any stretch) is that it's probably the longest game of all. If you're fortunate you're going to keep moving until the day you die, and the volume of work you do over that time between now and that day is so far in excess of the volume you can do on any given day that hurting yourself in an attempt to maximize today's volume is just ridiculous. It's easy to use that as an excuse to not do anything, unfortunately, but it's also a good reminder to slow down when your body tells you to.
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Nailed it.

I used to do endurance sports (Ironman/triathlon, marathon, etc.) and now my ONLY exercise goal is to move around for at least a few minutes every morning. When I'm busy, it's just quick stretches for maybe 2 minutes. When I have more time, it's a bike ride, jog, lifting weights at the gym, etc.

It might sound too simple but that's what made an easy daily habit to start. And it makes me feel good, making me want to eat "clean" to keep feeling good all day long.

Maybe some day I'll get more aggressive again but right now it works really well and it's easy.

This is great. I've spent a couple years now bouncing between various overuse injuries. For people like me who always feel like they need to do a little bit more/faster/etc., what you said seems like a great way to talk yourself into doing less, when your body is pushing back.
I got rhabdo in my arms a few years ago. It was not an intense workout. I had taken a few months off from the gym and was in my first week back. My workout was much lighter and shorter than normal. Doctors suspected it was caused by a combination of returning to the gym and under hydration.

Does anyone know if there has been research into rhabdo frequency? I suspect it became more common as the population became more sedentary.

Interesting did you get your kidney function checked out afterwards?

my Surgeon commented I should exercise more as prep for the eventual kidney transplant I will have to ask about the risks of rhabdo

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My sister recently had this in her arm. It swelled a lot and luckily my father had the gut feeling to take her to the emergency room. I had never heard of it nor would have thought it would be life threatening!

She had mentioned that her workout wasn't very intense, be careful out there.

A more appropriate title might be: "The danger of pushing too hard when starting a new workout".

As it stands, this title seems to imply that progressively intensive workouts are more dangerous, which the article wasn't saying. I don't think the world needs another reason to avoid workouts, certainly when practiced safely.

>Over the next two days, her legs throbbed with excruciating pain, her urine turned a dark shade of brown, and she felt nauseated. Eventually she went to a hospital...

Eh... if your urine starts turning funny colors you should probably head off to the hospital right then and not "eventually".

I've never really taken classes at a gym, but I can see how people wanting to plunge back into fitness could easily go way about their fitness level way too fast.

It's like mountain biking. I remember my first time on a trail I barely made it 1km before I was off the side of the trail feeling totally beyond my level. Over the course of about two months though, I slowly built up my endurance (street cycling casually during the week) until I could do 8km ~ 10km loops without really noticing how far I've gone.

As with any workout, you need to build slowly and give your muscles time to heal.

Ah, the old Crossfit disease:

https://medium.com/@ericrobertson/crossfits-dirty-little-sec...

I've been relatively active (compared to most people) for most of my life, and I've never come anywhere close to rhabdomyolysis. It's incredibly rare. Hell, I'd never heard of it until I heard of Crossfit. Once, my mountain rescue team rescued a guy with a mild case; he had been lost in Death Valley for seven days.

The key is two-fold: like biesnecker says, listen to your body and don't overdo it, but secondly, you have to build up to these things. As secfirstmd says, people are not backing up their goals with the hard work necessary to achieve them. You can't just go from couch to marathon in one day. This isn't helped by the spreading of the lie (mostly by fat acceptance bloggers) that "fat people can do anything healthy weight people can!". If you're fat, you're not fit.

The hard part is past a certain level of fitness/training, you have to keep pushing to improve. The key is knowing the difference between injury and just normal aches and soreness. If you have to ask, you aren't at the level where you need to keep pushing, and you should take a break.

Pretty much all examples of rhabdomyolysis I heard of were non-fat physically very active people able to do hundreds of repetitions. Most examples involved such people after few weeks break - no where near to become excessively fat. If you are fat, you wont be able to do as much exercise rhabdomyolysis requires to build. Your muscles will fail much sooner, so fat acceptance or not, blaming fat people for condition that does not happen to them is odd.
My apologies; perhaps I didn't make myself clear. I believe rhabdomyolysis is like terrorism: scary enough to get you to clickthrough, but not really something most people will ever have to worry about. In the vein of people hurting themselves through exercise, it is extremely more likely that someone will think "hey, I'm obese by muscle, I can deadlift 500lb!" or "I can run a marathon without training!" and then end up injuring themselves permanently, and even if they don't, they'll never take up physical activity again.
In other news: as sedentary lifestyles intensify, a host of harmful side-effects grow more common.
It's not the sedentary lifestyle that causes rhabdo. In fact, your average couch spud probably can't get rhabdo. Their heart and lungs will give out long before that. They'll collapse into a puddle before their arm or leg muscles are even fully warmed up. As others have pointed out, it's often the very active and fit who get rhabdo. It's the hyper-macho hyper-competitive types. The people who brag about how sore they are, who look down their noses at people who don't hit lift enough weight, hit the gym often enough, etc. Maybe those who post in public forums about how unfit everyone else is. I see there are people right here, in this thread, humblebragging about how they got rhabdo. Those are the people for whom no level of fitness can match their need for validation, and push themselves beyond any sane limit.
I ride a real bicycle, plain utility cycling as I have no car and trains don't go everywhere. I have never heard of this injury in the cycling context. I also find it hard to believe that a spin workout is likely to be of higher duration and ferocity than a bike ride. I do know people who go to the gym for spinning classes - fat and female with crash diets and constant snacking on diet foods. I wish I could say something different to that, so anecdotal. I have offered to help them get cycling to work but they don't have the fitness for that, realistically. It is an order of magnitude really.

I think there is a problem with how gyms give this false impression that a mad workout in the gym will somehow work. If you genuinely care about the health of your colleagues and want to ease them onto fruit and cycle commuting then it is hard to do so and be heard. People go for the pretend of the gym and stick with the alcohol. It is not that they don't know they are lying to themselves.

I've been doing a lot of running, and last night I was thinking about my progression and how important it is to not push yourself too far/hard into injury. I've gone through all sorts of bodily injury and growth, and have gradually increased the intensity and duration of my runs over several years.

Here's the advice I decided on:

* First focus on duration. Exercise (cardio, I jog/run) at least 20 minutes. Go as slow as you need to be comfortable and dont worry about distance. Stop or slow down at any sign of injury, focus on good form.

* Gradually increase distance/duration goals. I started aiming for 3 miles or 30 minutes, then I increased gradually to 6 miles / hour (what I currently do). Continue paying attention to your form, and also to your breathing. Sometimes I get pains in the chest or feel short on breath, and if I try mixing up my breathing techniques I feel better. Try to breathe into your nostrils.

* Increase intensity. I commonly get advice from very fit people to do high intensity training. I tried to early on, but my body would just have a really hard time with it. I'm finally just starting to increase intensity, particularly toward the end of my run. Master good form and breathing before doing this, and preferably when your body doesnt hurt.

Speaking of pain, I've had a lot of growing pain through this process. There are certainly different types of injuries in regards to whether you can continue exercising on them. I don't know much about the technicalities here, but if it feels better as you run (this happens with my feet/ankles) then it's prbably good for you to exercise on (RICE vs MEAT or something). Don't run on the injuries that need rest, but don't let the injuries that you can exercise with hold you back.

Also speaking of motivation, I constantly have that lazy and tired feeling of not wanting to go, but I always feel better when I do. Controlling yourself is key for all of the things i mentioned, especially for getting out there and doing it!