Making sure exercise is smart and safe

Common sense tells us that getting off the couch and exercising is one of the best ways in which we can get and stay healthy. And science backs up our common sense. There is strong, scientific evidence for the health benefits of physical activity. Studies show that fit, active people tend to get chronic illnesses like diabetes and heart diseases far less than people who are inactive and unfit. 

The vast majority of inactive people can safely start an exercise programme by walking. Walking has several advantages over other forms of exercise, especially when someone is just starting out.  At the same time, regular walking can result in substantial improvements in fitness and health.

While walking is a great starting point to try our different forms of exercises, it is also important to understand your risks.  Various studies show that the risk of heart disease or cardiovascular complications increase rapidly during strenuous physical activity,  especially for people with heart disease who have been inactive for a long time. So while starting a new exercise programme is always a good idea, there are instances in which you should speak to your doctor first.

When you should speak to your doctor first before starting a new exercise programme

1. If you have a heart condition and you have been advised that you should only do physical activity recommended by your doctor
2. If you have pain in the chest when you do physical activity
3. If you feel dizzy or have suffered an episode of fainting especially with exertion
4. If you have heart rhythm problems
5. If you have bone or joint problems (back, hip or knee) that may worsen with changes in physical activity.
6. If you are on medication for blood pressure or a heart condition or if you have a serious illness, for example cancer

Screening for health risks before starting an exercise programme

An exercise screening test is typically not necessary for people who want to start their journey to fitness. For some individuals, there may be levels of risk associated with exercising, depending on their lifestyle habits and current health status.

For example, a person who is overweight, has high blood pressure and smokes is at a much higher risk than someone who has controlled diabetes but needs to lose some weight.  It is not just the presence of a specific disease, but also the severity of the disease and the person’s unhealthy or healthy lifestyle habits, which contribute to assessing their risk to exercising.

For high-risk individuals, it is very important to have an individual screening test with a doctor, usually a cardiologist, before starting to exercise. This consultation will tell you what your risk is. A stress ECG, where you run on a treadmill or cycle on a stationary bicycle allows doctors to establish maximum heart-rate below which it may be safe to exercise.

Exercising when you have the flu

The idea of sweating out flu with exercise is not the answer. In fact, it could actually be dangerous for your health as strain on an infected heart muscle may lead to further inflammation or even paralysis of it.

Viral infections, such as the flu, can cause temporary muscle weakness. This includes the muscle cells in the heart – and a heart weakened by a viral infection could be hurt by strenuous exercise. But remember a cold is not flu! 

The common cold is an inflammation of the upper respiratory tract, with symptoms such as a runny nose and sore throat, but no fever or body aches and pains. If you have these symptoms, doing mild-to-moderate exercise (a brisk walk or slow jog) does not appear to be harmful, but avoid high intensity exercise until a few days after the symptoms have disappeared.  If you have flu-like symptoms - fever, extreme tiredness, muscle aches, or swollen glands - it’s best not to exercise at all until all the symptoms have subsided. This usually means a week of rest.

A simple guide to whether or not you should exercise is the “Neck Test”: If your symptoms are from the neck up it should be ok to do low to moderate intensity exercise.  Cut back on the amount you do and listen to your body - if you feel exhausted after you exercised, skip the next 2-3 days.

If your symptoms are primarily below the neck (a deep chest cough, fever or generalised muscle ache), take a break from exercise until your fever subsides and you feel much better. Your first workout once you’ve recovered should be very light. You can then progress slowly to return to your normal routine.

When you should rest that injury

Injury is frequent among people who over-train, or those who have been inactive for a long period and ‘jump’ into strenuous exercise too quickly.

Exercise-related injuries can affect any structure in the body - your bones, muscles, joints (where bones meet and move against each other), ligaments (strong fibrous tissue connecting bones or cartilage) or tendons (strong fibrous tissue that joins muscle to bone or cartilage).

In the case of an injury:

1. Control the initial symptoms by applying the PRICE method (Protect from further injury; Rest for more rapid recovery; Ice the area to decrease swelling; Compression to decrease motion; Elevation to decrease swelling and pain).
2. Depending on the severity of the injury, healing time might be required to heal the area and regain strength and coordination.
3. If possible continue exercising using uninjured parts of the body, for example upper body exercises if the injury is in the lower limb(s).
4. Progressively return to activity with no or low resistance and increase slowly.
5. If pain persists, consult a doctor or sports medicine professional.    

References:

1. American College of Sports Medicine. ACSM’s Guidelines for Exercise Testing and Prescription, 8th ed. Baltimore: Lippincott Williams & Wilkins; 2010.
2. AHA/ACSM Joint Statement: Recommendations for Cardiovascular Screening, Staffing, and Emergency Policies at Health/Fitness Facilities.  Med Sci Sports Exerc 30(6) June 1998.
3. http://www.merckmanuals.com/professional/injuries_poisoning/exercise_and_sports_injury/
   approach_to_sports_injuries.html
4. The Team Physician and Return-To-Play Issues:  A Consensus Statement.   Stanley A. Herring et al Medicine & Science in Sports & Exercise, 2002