Athletes registered to participate in Tough Mudder events in West Virginia and Kentucky this weekend will try to prove their grit on a 12-mile course filled with tough obstacles ranging from wall climbs to swims in icy waters.

Though many athletes will leave the event having successfully proven their toughness –others will be left with serious injuries.

“I would say the most common (injuries) I’ve seen are shoulder dislocations, ACL (anterior cruciate ligament) injuries and fractured ankles – in that order,” Michael Silverman, a physical therapist at the Hospital for Special Surgery (HSS) in New York City, told

As Tough Mudder races continue to increase in popularity, the organization has received growing criticism from people wondering whether the events are truly safe for the average ‘weekend warrior’ – and if they are really worth the risk.

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Dr. Jennifer Solomon, a sports medicine physiatrist at HSS, said she’s treated many patients who had no idea just how ‘tough’ the Tough Mudder would be.

“I’ve had people saying, ‘I didn’t realize what it was,’” Soloman told

Many Tough Mudder participants sign up for the event as part of a team, and while team members can opt out of certain obstacles, all members of each team typically traverse the entire course.

“They don’t record times. The point is to finish and help each other out…You see a lot of teams in Tough Mudders…I think that definitely leads to more people doing it as a result,” said Silverman, who has participated in four Tough Mudder events.

And while the friendly ‘team work’ vibe surrounding the event is certainly a draw, it can also encourage some athletes to sign up who are unprepared and uninformed about the event’s rigorous challenges.

“I am definitely pro doing stuff like this, but you have to do it within reason and train. Don’t just go out and do it,” Silverman said.


While Tough Mudders may present an increased risk for injury, Silverman said that properly training for the event can help decrease the risk.

Many of the injuries Silverman has treated were sustained during falls – whether on obstacles or while running on the course.  He said these problems could have been avoided if people had better prepared themselves for a long distance run.

“The biggest thing I tell people is, ‘Get used to running,’” Silverman said. “People think it’s pure obstacles, but it’s 12 miles long, and if you aren’t in shape for that you’re going to increase your risk for injury.”

Additionally, participants need to build up their overall body strength during the months leading up to the event. Silverman recommends working with a trainer to learn proper form for exercises like squats, lunges and assisted pull-ups. Beyond that, boot-camp type classes can also help prepare athletes for the physically demanding event.

The Tough Mudder organization also offers training programs on the ‘Boot Camp’ section of their web site, noting that preparation is crucial for athletes hoping to participate in an event.

“We stress the need for rigorous training and preparation ahead of registering for a Tough Mudder,” Don Baxter, Tough Mudder’s chief operating officer, told in an email.


The safety of Tough Mudder events fell under increased scrutiny last spring, when 28-year-old Avishek Sengupta drowned while participating in the event’s ‘Walk the Plank’ obstacle, which requires particpants to jump off a platform into icy water.

After this tragedy, the organization vowed to review its safety protocols and examine how water safety personnel are briefed and managed.

Silverman, who participated in last weekend’s Tri-State Tough Mudder in Raceway Park, New Jersey, said he definitely noticed a heavier emphasis on safety protocols compared to previous events he participated in.

“I think it’s definitely evolved over time, it’s much better than it used to be,” Silverman said. “The ‘Walking the Plank’ event has much more supervision than in years past…They’re making sure one person went at a time, you had to jump in a certain direction, the diver was stationed in the water and someone at the top was keeping an eye on you.”

Athletes who train properly for the event should feel assured that plenty of medical staff will be on hand to treat their injuries or transport them to a hospital, should they require further attention.

“Our top objective is – and always has been – to deliver safe events, and we focus a tremendous amount of resources on designing safety procedures,” Baxter said.

To learn more about the Tough Mudder event, visit