Before beginning an exercise program, people are encouraged to consult with a physician. The American Heart Association (AHA) particularly urges people who are older, overweight and inactive or have a family history of heart disease to seek medical advice before starting a fitness program. Once cleared by a physician, it will be important to exercise within 70 to 80 percent of one’s maximum heart rate and to take healthy precautions, such as warming up beforehand and cooling down afterward. Exercise is a lifelong habit, and people are encouraged not to rush into it too quickly or too strenuously. Ideally, it will be enjoyable as well as heart-healthy.
An exercise program should not be implemented without a physician’s approval.
About exercise safety
Before beginning any exercise program, individuals should get a complete physical examination and discuss any fitness plans with a physician. A physician will be able to help formulate a fitness program based on your age and health status or, at the least, recommend a suitable fitness trainer. The physician may also order an exercise stress test, which can help determine a safe level of exercise for a patient's individual needs.
According to the American Heart Association (AHA) and other healthcare professionals, certain are especially urged to seek medical advice before beginning an exercise program. This include people who:
Have reached or passed middle age
Are significantly overweight or obese
Have a family history of heart disease
Desire to begin a fairly strenuous exercise program despite having been inactive for quite some time
Are taking medication for high blood pressure (hypertension), heart disease, stroke or diabetes
Have any joint problems (e.g., arthritis), bone problems (e.g., osteoporosis), muscle problems or other conditions (e.g., unstable heart failure) that may be worsened or complicated by exercise
Have noticed new symptoms in the past month (e.g., chest pain)
Are pregnant
Have been ordered by a physician to only engage in medically supervised exercise programs
Exerience severe shortness of breath, fainting (syncope), or pain in the chest, arm, shoulder or left side of the neck following mild exercise
Target heart rate
To make the most of your aerobic exercise, an individual needs to exercise within 70 percent to 80 percent of his or her maximum heart rate. Exercising within this range is the target heart rate (THR). To calculate the target heart rate, use the following formula:
Maximum heart rate (MHR) = 220 – age. For example, the MHR of a 50-year-old would be 170 (220 – 50).
MHR multiplied by 0.7 is the low range of the target heart rate. For example, a 50-year-old could reach or exceed a heart rate of 119 (170 x 0.7).
MHR multiplied by 0.8 is the high range of the target heart rate. For example, a 50-year-old should not exceed a heart rate of 136 (170 x 0.8).
The THR is the pulse rate at which exercise “counts.” With the help of a physician, an individual can also identify warm up exercises appropriate for reaching this target rate. Typically, 30 minutes of exercise while at the target heart rate is adequate. Most experts recommend participating in an aerobic exercise at least three days a week. Other experts believe that shorter workouts (e.g., 10 minutes) every day is also effective.
While exercising, people are encouraged to monitor their heart rate regularly to make sure that they are staying within the appropriate range for their age.
Many exercise machines (e.g., treadmills, stationary bicycles) provide a heart monitor to help people remain within their target heart rate. If a computerized monitor is not available, people may try using a simple "talk test." During moderate exercise, a person should be able to carry on a normal conversation comfortably.
If someone is gasping and unable to talk, he or she has probably reached or exceeded his or her optimum aerobic zone. At any time, if chest pain (angina) or shortness of breath is felt, stop exercising immediately and consult a healthcare provider.
Strategies for exercising safely
There are certain strategies that should be done as part of any exercise program in order to be safe. These include the following:
Warming up and cooling down. Regardless of the type of exercise performed, it is necessary to prepare for the workout by gradually increasing the heart rate (warming up), exercising at an increased heart rate for a given period of time (working out) and gradually decreasing the heart rate until it nears the resting rate (cooling down). This places less stress on the heart and muscles.
Stretching before and after exercise. Before exercise, use lighter weights than normal and jog in place slowly or perform other light but full-movement activities. The goal is to begin speeding up the heart rate. After exercise, the goal is to decrease the heart rate. Slow stretches, which focus on movement of particular muscles or body regions, will allow the body to “wind down.” Older people are encouraged to take extra time in warming up and cooling down.
Knowing when to stop. If not done correctly, exercise could cause unwanted stress to the body. Immediately stop exercising if there is any pain, tightness or pressure in the chest, left side of the neck, shoulder or arm. Dizziness, feeling faint or nauseous is an indication the body needs a break. Pain in the joints, feet, ankles or legs is not normal during exercise. Stop at the first sign of these pains. Becoming out of breath is a sure sign that it is time to slow down.
Not trying to do too much too fast. Overexerting can lead to injury and a much lower chance that a person will continue to exercise in the future. When starting an exercise program, take it easy at the beginning and work up to a comfortable level.
Wearing appropriate clothes and shoes. Clothes should be loose-fitting, and shoes should be properly fitting. For example, people should not be hiking up a mountain in flat shoes with no support. People with diabetes are urged to take especially good care of their feet, wearing clean and supportive shoes and socks and checking their feet after exercise for any sign of redness or injury. Some women may want to consider wearing a sports bra.
Drinking plenty of water. This tip is particularly important for people who are exercising in hot climates or who are taking medications that stress the need for plenty of water. People with diabetes should also have a light, sugary snack on hand in case they begin to feel light-headed or notice other symptoms of hypoglycemia.
Having proper identification on hand. People with medical conditions and drug allergies should always wear their medical identification bracelet when exercising. When exercising away from home, it is also a good idea for a person to carry his or her own address and phone number, as well as those of a physician, in case of emergency.
Questions for your doctor on exercise safety
Preparing questions in advance can help patients to have more meaningful discussions regarding their conditions. Patients may wish to ask their doctor the following questions related to exercise safety:
Do any of my health conditions or medications prohibit me from using any particular type of exercise?
What is my target heart rate?
What exercises do you recommend to reach my target heart rate?
For how long should I warm up and cool down before and after exercise?
What health benefits I can expect from exercise?
Can you recommend a trainer, instructor, health club, or other form of assistance?
