It is definitely possible to get too much of a good thing. But athletes and fitness buffs are not known for moderation. And how could they be? After all, moderation does not get you extremely fit, extremely strong, extremely fast, extremely limber, or extremely skilled. Athletes are clearly doing something above and beyond the norm. Nothing about what they do is middle of the road.

But extremes have their limits. And it is only a matter of time before those limits start to push back. Exercise is one of the best things we can do for ourselves. So it is hard to imagine anything bad coming from a good fitness regimen. Sprains, strains, dislocations, and tendonitis are among the most common injuries. But there are far worse injuries to muscle and bone common to health enthusiasts. Here are some of the inevitable consequences to overdoing it:

Performance-enhancing Drugs

Although steroids are legal in some countries, there are good reasons why they are illegal in most amateur and professional sports. There is a risk of liver and kidney tumors, heart conditions, and psychiatric symptoms to name a few. The need to continue enhancing performance can create a dependency on ever more dangerous performance-enhancing drugs.

There are many drug and alcohol detox treatment programs that specialize in helping people recover from this type of addiction. It is not uncommon for extreme athletes to have difficulty placing limits on themselves in pursuit of their goals, even when that pursuit leads to risky behavior.

Ironically, the unbridled pursuit of health is often the gateway to an unhealthy lifestyle. This pursuit can lead to body image distortion and a focus on body modification. At some point, it becomes less about the health and more about the exercise. Performance-enhancing drugs often have a short-term gain, but negative long-term consequences.

Managing Pain

Health enthusiasts tend to be catastrophically bad at managing pain. They have mantras such as, “No pain, no gain!” They push themselves past the breaking point because they have been conditioned to believe that a workout is useless unless it cranks the pain up to eleven.

While WebMD describes 7 pains you shouldn’t ignore, all pain is a warning that something is not quite right with the body. Athletes consider ignoring pain a badge of courage. But chronically ignoring pain usually ends up leading to unignorable chronic pain, or worse.

This is yet another area where drugs can get a foothold into a health enthusiast’s life. At some point, willpower is not enough to manage the pain. Prescription drugs become dependencies. What athletes need to understand is that excessive pain is not beneficial. It is almost always detrimental. So here is a better rule to live by: Ignoring pain is insane.

Personal Injuries

A lot of little injuries add up over the course of a lifetime. More and more, people are getting knee replacements in their forties due to a lifetime of abuse. Football players are some of the healthiest humans alive. Yet they will suffer from some of the worst pain and injury in their later years. Tendonitis can take you out of work for weeks at a time. A badly sprained ankle or a leg in a cast can be the difference between you working or filing for unemployment.

It is often a matter of just knowing when to back off. For some, it is full-blown exercise addiction or body image disorder. In those cases, a medical professional is required. Being healthy does not require performance-enhancing drugs, excessive pain, or a lifetime of little injuries.