2.1. DEFINITIONS

Physical activity
Any movement produced by the musculoskeletal system that results in energy expenditure above resting levels 1.

Sport
Any form of physical activity that, through organized or spontaneous participation, aims to:

  • express or improve physical and mental condition,
  • develop social relationships,
  • achieve results in competitions at any level, from amateur to professional2.

Extreme sport
A sport practiced outdoors, outside predefined organizational or architectural structures (e.g., stadiums or traditional sports facilities) 3 4.

Extreme sport, outdoor sport, adventure sport, and action sport are considered synonyms.

2.2. DIMENSIONS OF THE “OUTDOOR” PHENOMENON

Both physical activity and outdoor sports are experiencing rapid expansion.

In the United States, the outdoor industry grew at an average annual rate of 6.7% between 2018 and 2023, with a marked acceleration following the COVID-19 pandemic 5.

In Italy, a 2022 study conducted on a sample of 1,500 individuals aged between 18 and 90 years found that 88% of those engaging in physical activity did so outdoors, and 52% exclusively outdoors 6.

Participation in extreme sports has steadily increased over the past ten years, in some cases surpassing that of traditional sports, both team-based and individual 7.

In 2023, a significant increase in participation rates was observed across several extreme disciplines, including:

  • cross-country skiing +8.5%
  • BMX cycling +8.3%
  • windsurfing +7.3%
  • scuba diving +7.3%
  • sport climbing +6.6%
  • surfing +6.6% 8

In recent years, mainstream media have contributed to the popularization of extreme sports, alongside the growing culture of wellness and lifelong physical activity. Most of these disciplines developed and became popular in the late decades of the last century and now involve millions of participants worldwide 9.

Participants are predominantly enthusiasts over the age of 25, with a slight male predominance 10.

The growth of the participant community and increasing public interest have progressively led to the inclusion of outdoor and extreme sports in top-level competitions, including the Olympic Games. Ski mountaineering will debut at Milano-Cortina 2026, joining other already Olympic extreme disciplines such as kitesurfing, surfing, sport climbing, skateboarding, sailing, mountain biking, triathlon, skiing, and snowboarding (Fig. 1) 11.

Fig.1. Progressive inclusion of extreme sports in Olympic programs. From Feletti F, Savonitto G. Ital Cardiol, Rome, 202412.

  1. World Health Organisation, Physical activity. 2022. https://www.who.int/newsroom/ fact-sheets/detail/physical-activity. ↩︎
  2. Consiglio d’Europa. Carta Europea per lo Sport. 7° Conferenza dei Ministri europei responsabili dello Sport – Rodi, 1992. ↩︎
  3. Feletti F. Preface. In: Feletti F (ed). Extreme Sports Medicine, Springer, 2017. Front Matter: vii-viii doi: 10.1007/978-3-319-28265-7. ↩︎
  4. Immonen T, Brymer E, Orth D, Davids K, Feletti F, Liukkonen J, Jaakkola T. Understanding Action and Adventure Sports Participation-An Ecological Dynamics Perspective. Sports Med Open. 2017 Dec; 3 (1) : 18. doi: 10.1186/s40798-017-0084-1. ↩︎
  5. Bruton M. Outdoor recreation industry sees significant growth with changes in consumer behavior sparked by Covid-19. Forbes. Feb 28, 2023. https://www.forbes. com/sites/michellebruton/2023/02/28/outdoor-recreation-industry-sees-significant-growth-with-changes-inconsumer-behavior-sparked-by-covid-19 [accesso 6 marzo 2024]. ↩︎
  6. Sport e Salute. Report A2.2.1, 2022. https://www.sportesalute.eu/images/studie-dati-dello-sport/schede/2022/89-Sporte-Salute-SWG-Kratesis-Reportattivitafisica-maggio-2022.pdf [Accessed on March 2024]. ↩︎
  7. Brymer E, Feletti F, Monasterio E, Schweitzer R. Understanding extreme sports: a psychological perspective. Front Psychol 2020;10:3029. ↩︎
  8. Outdoor Industry Association. 2023 Outdoor participation trends report.
    Boulder (CO), USA, 2023. https://oia.outdoorindustry.org/resource/2023-outdoor-participation-trends-reportexec-summary [Accessed on March 2024]. ↩︎
  9. Caspersen CJ, Powell KE, Christenson GM. Physical activity, exercise, and physical fitness: definitions and distinctions for health-related research.
    Public Health Rep 1985;100:126131. ↩︎
  10. Fortuin-de Smidt MC, Sewe MO, Lassale C, et al. Physical activity attenuates but does not eliminate coronary heart disease risk amongst adults with risk factors: EPIC-CVD casecohort study. Eur J Prev Cardiol 2022;29:1618-29. ↩︎
  11. Valenzuela PL, Ruilope LM, Santos-Lozano A, et al. Exercise benefits in cardiovascular diseases: from mechanisms to clinical implementation. Eur Heart J. 2023;44:1874-89. ↩︎
  12. Feletti F, Savonitto G Ital Cardiol (Rome). 2024 Jun;25(6):441-449. Italian. doi: 10.1714/4269.42468.  ↩︎