Do you need a physical or stress test before you exercise?
Exercise is safe for most of us, but if you’re sedentary, extremely out of shape, or have a number of health risk factors (see list below), you need to check with your doctor before exercising. It’s important for older people or people who are ill to make sure all planned
exercise is safe, appropriate, and effective. It’s also important to know the of your health in order to design an exercise program appropriate for your needs.
If you have osteoporosis, you want to include strength exercises in your program, beginning gently if the bones are fragile and working with exercises that best enhance bone strength. If you have high blood pressure, you need to learn the right exercise techniques for improving the problem.
How do you know if you should check with your doctor before beginning an exercise program? I follow the safety guidelines established by the American College of Sports Medicine. Don’t get discouraged if you’re considered “at risk”: you have all the more to gain from beginning an exercise program and you’ll feel safer with your physician’s approval. If you are at very high risk, you can still improve your health by enrolling in a medically supervised exercise program.
Finally, make sure you understand how any medications will affect your exercise and be sure to inform your trainer about them. For example, beta-blockers taken for high blood pressure keep the heart rate low even during exercise, although other high blood pressure medications don’t have this effect.
Low risk and healthy individuals
If you have only one risk factor (refer to the list below) and are healthy, you won’t need a medical exam or diagnostic exercise test before beginning an exercise program of moderate intensity.
Moderate intensity is noncompetitive exercise that can be comfortably sustained for as much as 60 minutes and includes gradual and slow progression. For example, a healthy woman over 50 doesn’t need medical approval to begin a walking program. Walking programs are generally considered moderate intensity.
If you’re extremely out of shape, you’ll need to begin moderately anyway. If you want to begin a more vigorous program – a program intense enough to represent a substantial challenge at your level of fitness and cause fatigue within 20 minutes – get your doctor’s approval first.
Moderate risk individuals
If you have two or more risk factors and no symptoms of poor health, you technically don’t need doctor’s approval for moderate exercise. For example, if you’re over 50 and are obese, but have no symptoms of disease, you can start a walking program or beginner water aerobics – anything that is a low enough intensity to sustain comfortably for more than 60 minutes. Moving from a sedentary life to walking around 30 minutes each day will improve your health dramatically.
If you have two risk factors, such as age and high cholesterol, and no symptoms of poor health, but you want to achieve a higher level of fitness by engaging in more intense exercise, get your doctor’s approval and take a stress test. These precautions will allow you to safely raise your heart rate at higher intensity levels by including activities like walking up hills or wearing a backpack as you walk.
If you have two risk factors and want to increase your physical fitness with a strength-training program, get your doctor’s approval and take a supervised exercise stress test.
Higher risk individuals
If you have two or more risk factors with active symptoms or you’ve been diagnosed with coronary, pulmonary, or metabolic disease, you need a thorough medical evaluation and a physician-supervised maximal exercise test before beginning any exercise program. Your doctor should give you and your trainer guidelines for exercise intensity and maximum heart rate.
Most Common Risk Factors
- Age – over 40 for men and over 50 for women
- Cigarette smoking
- Blood pressure greater than 160/90
- Serum cholesterol greater than 240
- Family history of parents or siblings with coronary disease before age 55
- Chest pains
- Shortness of breath, severe dizziness, and/or tendency to faint
- Severe joint pain
- Diabetes mellitus
- Thyroid conditions
- Liver or kidney conditions