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Exercise - Risk & Precautions

Do I need to talk to my healthcare provider before I start exercising?

You should talk to your healthcare provider before beginning an exercise program if you:

  • have heart disease, have had a stroke, or are at high-risk for either
  • are middle-aged (45 to 50) or older and currently inactive
  • have diabetes or are at high risk for it
  • are taking blood pressure medication
  • are obese (body mass index [BMI] of 30 or more)
  • are pregnant
  • have a medical condition or disability that may affect your ability to exercise (e.g., knee problems, arthritis)

Your healthcare provider can help you choose suitable activities. You may be sent for an exercise stress test to determine the amount and type of exercise that is right for you.

What are the risks of exercise?

The main risks of exercise are pulled muscles and sprains. The risk of injury is higher for more vigorous activities, especially competitive sports.53 If you are obese (body mass index of 30 or higher, or about 30 pounds overweight for a woman of average height [5'4”]), you are more prone to injury.

Walking is a low-risk activity even for women age 70 and older.54 And unlike running or jogging, your risk of injury does not increase the more you walk.55 To avoid injury with any type of activity:

  • start out slowly and gradually build up to a level that is comfortable for you
  • stop if you feel pain
  • stretch before and after each workout
  • wear appropriate clothing including footwear and safety gear (e.g., a bicycle helmet)

What are the chances of having a heart attack or dying when exercising?

The chances of having a heart attack or dying suddenly during exercise are very low.56, 57 An analysis from the Nurses' Health Study found that the risk of suddenly dying was 1 per 36.5 million hours of moderate-to-vigorous activity.58 The risks are highest for people who are not active on a regular basis and are virtually nonexistent for regular exercisers. To minimize risk, anyone with heart disease or people who do not exercise regularly should begin slowly and progress gradually to meet recommended levels (30 minutes moderate intensity activity most days of the week). Experts discourage people with heart disease from participating in competitive sports that are very demanding. Remember, go at your own pace—what is moderate exercise for one person may be vigorous exercise for you, depending on your age and fitness level.

Benefits of Exercising


To enjoy a long and healthy life, everyone should make lifestyle choices that include a healthy diet, regular exercise, and maintaining normal weight. The combination of inactivity and eating the wrong foods is the second most common preventable cause of death in the United States (smoking is the first).

Most research on the benefits of exercise focuses on heart protection. Studies clearly show that exercise helps the heart. In addition, studies are reporting that even people at higher risk for heart disease may gain important protection from exercising.

Tips for Exercising:

Drink plenty of fluids before, during, and after a workout.

Do warm-up exercises for 5 - 10 minutes at the beginning of an exercise session. Strengthening exercises, quiet calisthenics, and walking are ideal.

Do not eat for 2 hours before vigorous exercise.

When exercising, listen to your body's warning symptoms

The benefits of exercise include:

  • Decreased risk of cardiovascular (heart) disease, high blood pressure, and stroke
  • Decreased risk of colon and breast cancers
  • Decreased risk of diabetes
  • Decreased risk of osteoporosis
  • Decreased risk of depression and dementia
  • Decreased body fat
  • Improved metabolic processes -- the way the body breaks down and builds necessary substances
  • Improved movement of joints and muscles
  • Improved oxygen delivery throughout the body
  • Improved sense of well-being
  • Improved strength and endurance

In addition, exercise can help change other dangerous lifestyle habits. A 2007 review of existing studies found that moderate exercise, for as little as 5 minutes at a time, can help combat the nicotine withdrawal symptoms people experience when they try to stop smoking.

No one is too young or too old to exercise. The United States Surgeon General recommends at least 30 minutes of moderate exercise, such as brisk walking, nearly every day. However, vigorous exercise carries risks that people should discuss with a doctor. You should always check with your doctor before starting a new exercise program, especially if you have any of the following risk factors:

  • A symptom you have never told your doctor about
  • Arthritis of the hips or knees
  • Blood clots
  • Chest pain
  • Chronic lung disease
  • Diabetes
  • Eye injury or recent eye surgery
  • Family history of a cardiovascular disease
  • Foot or ankle sores that won't heal
  • Heart disease
  • Heart palpitations
  • Hernia
  • High blood pressure
  • History of smoking
  • Infections
  • Joint swelling
  • Obesity
  • Pain or trouble walking after a fall
  • Shortness of breath

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