It's actually not too bad since most of the crashes are at a lower speed than on the road. As for the cups, no one I know wears one. Just like transitions, practice, practice!
Although in all the road races, crits and triathlons I've done, nothing has peaked my max HR as much as a cross race has. The highest I'd seen to date was 201. My first cross race I hit 204max.
It hurts!