Occasionally someone will tell me that they are worried they might be too weak or too sick to do any exercise.
Often these people’s fears and worries are egged-on by friends and family members telling them things like, “Now you’re the age you are, you need to slow down. Or, “You’d better take it easy or you might hurt yourself.”
Even though they are usually well-meaning, for most people this is just about the worst advice ever.
I always tell these folks that it is a good idea to check with their physician to see what they think about exercise. Doctors almost never tell people not to exercise but they can have some good hints or ideas about how the exercise might affect your medications or your self-care routine.
Occasionally a doctor might tell someone to wait a few weeks to give them time to heal after a surgery or an acute illness, but just about anyone can safely and profitably get at least a little more exercise than they are currently getting. In fact, in the last 20 some-odd years I don’t think I’ve ever heard of a physician telling a patient that exercise might harm them.
With that said, there are a few conditions that doctors and physiologists are trained to look out for because they can change the risks and benefits for a patient. Most of these are common-sense precautions.
For instance, if you’re having crushing chest pains that your doctor doesn’t know about then you should definitely get that taken care of ASAP instead of exercising.
Or if you know that you’ve had a heart attack or other serious cardiac event within the last week or so then you should probably wait another week or three before beginning an exercise program.
That doesn’t mean you should spend weeks in bed doing nothing for fear of killing yourself — it means don’t go out of your way to get too much extra activity beyond normal for a few weeks.
More common by far — if you have a respiratory virus (cold, flu, COVID) or if you’ve had a fever, diarrhea or vomiting within the last day or two, for goodness sakes, stay home for another day or two and don’t give it to someone at the gym.
Acute infections, like myocarditis, pericarditis, or pneumonia should be taken care of before you continue your workout routine. On the opposite side of that, if your immune system is compromised like by AIDS or by organ transplant medicines you might have to be super-careful about exercising in groups of people so you don’t catch whatever they might have.
If you suffer from severe high blood pressure (above about 200/110 at rest) or uncontrolled diabetes (frequent blood sugars above about 200) or an especially fast or slow heartbeat at rest that makes you feel bad then you’d probably get more benefit out of getting a doctor to fix that than you would get from exercise.
If an irregular heartbeat (like atrial fibrillation or heart block) makes you feel bad then talk to your doctor about it before you exercise.
Sometimes electrolyte abnormalities (sodium, potassium, or magnesium levels out of whack) can lead to other problems (like an irregular heartbeat) especially if you exercise too much, and occasionally too much of the wrong kinds of exercise can make people with neuromuscular, musculoskeletal or rheumatoid disorders (like arthritis, lupus, MS, fibromyalgia, etc) feel worse — so check with your doctor.
Really it all boils down to finding a physician who will take the time to talk with you about any questions or concerns you might have. Sometimes the doctor might even refer you to a physiologist, a therapist, a coach, or some other exercise expert. Make use of these resources because physical activity is a super-important part of a happy, healthy lifestyle.
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Dr. Patrick Parker is the Director of the Cardiopulmonary Rehabilitation program at the Cardiovascular Institute of Mississippi in McComb. Visit RoamingParkers.com to see more of what he does to stay fit, well and healthy.
