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Exercise Guidelines For Individuals With Heart Disease

Health professionals all agree that exercising along with not smoking and eating a healthy diet is essential in helping prevent cardiovascular heart disease (CHD).

However, if you already have heart disease it’s not a reason to avoid exercise altogether. As long as you are medically cleared by your doctor there are adjustments in exercise selection and intensity that can be made.

Once clearance is obtained, there are special considerations to take into account for exercise prescription. As a certified Charleston personal trainer and instructor for CPR training in Perth, I regularly work hand in hand with local physicians and cardiac specialists on exercise program design for clients with heart disease.

It’s important to seek the guidance and coaching from a trained professional as there are obviously inherent risks with any physical activity.

Movement considerations and the monitoring of exercise intensity are both essential in program design. In today’s post we’ll cover the basics about what you need to know about exercise and heart disease.

More after the jump…

Easing in to a workout program is probably the most important factor for individuals with heart disease. Because exercise is a stressor, you need to condition your body to handle the demands before progressing to higher intensities.

Don’t overexert yourself by starting an interval training program or by attempting to run/jog for long distances or durations.

Start up slowly with walking or other low-intensity aerobic exercise for anywhere between 12 to 30 minutes daily. You’ll want to keep yourself in an aerobic state by maintaining a low heart rate, ideally at 50-55% of your max heart rate.

Make sure that you are properly hydrated and aren’t exercising in extreme cold or heat. The combination of overexertion plus extreme temperatures (such as exercising in the heat of the day) is a primary cause for sudden cardiac arrest.

Building a target heart rate zone is an excellent tool to make sure you don’t overdo it while exercising. However, for exercisers with CHD it’s important to take into consideration whether or not you are on a beta blocker.

If you are, then you’ll want to consult with your doctor or cardiologist and perhaps get a sub-max exercise test (stress test) while you are taking the medicine.

This is because beta blockers lower heart rate and essentially affect heart rate responses in exercise. This means you don’t really know if you are in the right zone and could be taxing the heart more than you want to be.

But if you undergo a stress test where you’ve taken your beta blocker, you’ll have a more accurate account for what your ideal heart rate range should be.

If you don’t take a beta blocker, you can estimate your max heart rate by subtracting your age from 208 (208-age = max heart rate).

Another approach can be to use a scale of ratings of perceived exertion, also known as RPE’s. Using this scale of 6-20, 6 approximating about how you would feel just sitting in a chair and 20 being the hardest thing you’ve ever done.

Most experts agree that individuals with heart disease should focus on an intensity within the range of 11-15.

The phrases that correspond to this range are:

11 – fairly light

13 – somewhat hard

15 > – hard.

While vigorous overexertion should be avoided (17 and up), eventually pushing yourself to higher intensities can be beneficial in helping to manage or improve your CHD, as long as you are exercising smart and safely.

Safety precautions to consider when exercising with heart disease…

It’s always good to exercise with a partner or fitness coach, not only because of the support, but also because if something happens, you will have help.

Remember exercise is a stress on the body; albeit a good stress, but stress nonetheless. Done incorrectly it could trigger a heart attack in someone with heart disease. Additionally, carrying aspirin and or nitro (as prescribed) can be a life saver in the event of a cardiac emergency.

These precautions should be discussed in detail when talking to your doctor about starting an exercise program.

You’ll also want to make sure that the facility where you’ll be exercising has staff on hand trained in CPR and/or there’s a AED available. Not all gyms and fitness centers have trainers with CPR certification or AED’s on hand, so you’ve got to do your homework.

The ideal form of resistance exercise will be functional exercise incorporating the use of things like medicine balls, resistance bands, free weights, and adjustable cable machines.

The benefit of functional exercise is that it will not only help develop strength but also balance, proprioception, and motor skills.

These things are all essential in completing every day human movements. In other words, it will help keep you mobile and active. I’m not a big fan of using seated weight machines that isolate muscle groups.

While there’s certainly a place for such machines, you’ll want to make sure you’re incorporating functional movements as well.

Intensity can always be scaled appropriately with the guidance of a trained fitness professional. It’s a misconception that individuals with heart disease must abandon weight training altogether.

While this may be recommended in the beginning of an exercise routine, a lot of individuals will be able to progress to resistance based exercise.

Once again, this is always an individual specific situation. Make sure to consult with your physician or cardiologist on what will be the best way for you to exercise.

A few final tips I have for exercising with heart disease…

Number one:

Avoid movements that involve you getting up or down off the ground quickly.

Sudden level changes are not recommended. Take your time when transitioning from prone or supine based movement on the ground to those done while on your feet.

Number two:

Make sure you always allow sufficient time for adequate warm-up and cool down.

A light warm-up where you activate the central nervous system and warm up the muscles, something like dynamic stretching for example, is always a good idea.

The cool down is equally important as you want to slowly bring down your heart rate. If you’re running or jogging on a treadmill, never stop cold to answer your cell phone, etc. The sudden stop can trigger blood pooling in your legs and not allow enough to get to your heart and brain.

Number three:

Avoid heavy exertion with overhead based movements.

If you’re pressing for example, you’ll want to do so while on your back (bench press) or in a prone position (push-up).

Shane Doll is a certified Charleston personal trainer, fat loss expert, speaker, and founder of Shaping Concepts Personal Training Studios. He specializes in helping people achieve a body transformation with burst training exercise and whole food nutrition. You can receive a FREE no-obligations trial of his Charleston personal fitness programs and start experiencing the Shaping Concepts difference today.

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Category: Fitness Training.