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As many were tuning into the summer Olympics, some may have wondered what are the hardest Olympic sports? Both the question itself and the answer are up for debate.

“What’s harder?” Dr. Rand McClain rhetorically asked Insider, who originally posted this article. Dr. McClain is the chief medical officer of LCR Health. He also treats elite and amateur athletes.

“Holding your breath under water while pushing most of your lower body above water? Continuing to bicycle right at your anaerobic threshold for as long as possible? Standing opposite an opponent who just hit you squarely in the jaw … in fear of being permanently injured or dying?”

The level of competition at the Olympics are all incredibly challenging. But a handful of sports stand out above the rest as the hardest Olympic sports.

Insider asked six sports medicine professionals to name the toughest sports we saw in Tokyo based on the physical, technical, and mental strength needed.

Water polo was named the most physically strenuous Olympic sport

Often topping the lists of most difficult sports is water polo. In 2016, Bleacher Report declared it to be “the toughest sport in the world”. This was decided on six parameters: strength, endurance, speed, agility, skill, and physicality.

On top of treading water for 30 minutes and swimming up to a mile per game, athletes “sneak in blows to each other similar to ice hockey and soccer, while trying to not touch the ground, not drown, and score points all at the same time,” Nandini Collins, a trainer and exercise physiologist who works at Noom, told Insider. “Water polo is played with reckless abandon and is more violent than spectators assume.”

The head physician for the US men’s water polo team, Dr. Naresh Rao, agrees that water polo is unique. Rao, an osteopathic primary care physician, says water polo is strenuous because it requires both aerobic (used for endurance) and anaerobic (used for sprints) capacity.

Gymnastics won the most points for technical and mental strength

Based on the categories of physical, technical, and mental strength, gymnastics was voted the most demanding sport in at least one category by four of the seven experts.

“There is a high level of risk with the elements, and gymnasts are required to master balance, strength, flexibility, and endurance of both upper and lower extremities in order to achieve Olympic-level greatness,” Dr. Kathleen Davenport, the director of Physiatry HSS Florida who works with dancers, said.

They also need “power and explosiveness” Nandini said. And mentally, Davenport added, they need “an extreme level of focus” to perform dangerous stunts — even after they endure a crushing fall.

A few other sports took bronze for hardest Olympic sports

Swimming earned a vote for overall toughness as well as for mental strength, since it’s a “sensory deprivation sport,” HSS’s Dr. Tate Greditzer, a former professional water polo player, said.

Others noticed with a vote for the most physically challenging sport were boxers, decathletes, and 800-meter sprinters.

In the 800, “runners literally have to run at 90% of their full speed for well under two minutes,” trainer Jon P of Stop Crying Studiostold Insider. The one time he ran it, he felt “complete numbness, inside and out” afterwards. “My vision blurred, I couldn’t catch my breath, or gather enough oxygen to stand upright for a while,” he said.

As for the most technically difficult sport, surfing and pole vault receive a vote.

For mental strength, tennis, and the marathon earned a vote, though all Olympians are exceptional in that department, Dr. Kevin Bernstein, the chief medical officer at Peaks Coaching Group, told Insider.

“Most of those that lack mental strength do not get this far solely with raw physical talent, regardless of sport.”

Author Dr. Rand

Dr. McClain has dedicated over 35 years of his personal and professional life studying nutrition, exercise, herbs and supplements and is also a Master of Acupuncture and Traditional Chinese Medicine.

More posts by Dr. Rand

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