|Michael Yurkewicz, DO|
If you aren’t in the right physical condition for the exercise you’re about to undertake, you could do your body more harm than good by jumping into a physical challenge. Whether you are a younger or older athlete, talk with your doctor before starting a new program. An evaluation may be in order to make sure you’re in the right shape to begin.
A sports medicine evaluation will look for subtle underlying cardiac and musculoskeletal disease that could be problematic for the athlete.
For the cardiac evaluation, the first step is to identify risk factors for cardiovascular disease. There are several factors including a family history of heart disease, smoking, hypertension, high cholesterol, impaired glucose tolerance, obesity, and a sedentary lifestyle. All of these can increase one’s risk for heart disease and thus increases risk of death during exercise.
A cardiac evaluation helps to prevent those athletes with underlying cardiac disorders from participating in activities that could increase their risk for sudden cardiac death.
The American College of Sports Medicine stratifies adults into low, moderate and high-risk groups, and recommends testing based on which group they fall into.
Low Risk- Men <45years old and women <55 years old who are asymptomatic and have no more than 1 risk factor
Moderate Risk- Men >45 years old and women >55 years old who have 2 or more risk factors
High Risk- Any adult with any cardiac symptoms as above, including history of peripheral vascular disease or stroke, as well as underlying pulmonary
disease (COPD, asthma), or metabolic disease (diabetes, thyroid disorders)
If you have cardiac symptoms such as chest pain with exercise, shortness of breath with exercise, dizziness/syncope with exercise, or palpitations, your doctor may recommend a prompt EKG and echocardiogram; for the very young, a visit to a pediatric cardiologist may be in order.
The extent of the evaluation depends on the athlete’s age and underlying medical problems. Diagnostic testing may be used in certain older athletes prior to starting a regimen given your history and physical exam findings. For some, testing can include exercise stress testing.
Based on the findings of your evaluation, your physician will decide which type of exercise would be best and may recommend lower intensity exercise or moderate intensity exercise. Most doctors would advise against vigorous training as we age.
It is important to keep in mind that once started in a program, if any new symptoms develop, including unexplained decline in performance, stop the activity and seek prompt evaluation by your physician.