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The Risks Of Exercising

Yes, although we are all encouraged to take exercise for our health and long life, there are risks. We have all heard about the fit jogger who died of a heart attack whilst out for his jog. What are we to make of the risks and the benefits?

I you need advice about the wisdom of exercising, you should consult your doctor and physiotherapist. Physios are well qualified to advise you and work out exercise programmes which suit your goals and medical status.

Both sudden death and myocardial infarction (heart attack) seem to be increased when a person is exercising. So when we are out exercising, we are at some increased risk of these events while we are exercising and for about an hour afterwards. Then our risk rate decreases and that’s the benefit. So overall our risk is reduced through our life.

Studies have shown that there is a death rate in healthy men of about 1 in 15,000-18,000 exercisers. This is a very low rate per year. This risk is even less in men who are already very active.

Again, exercise reduces the overall risk, but when you’re actually doing it there is a higher risk of sudden cardiac death and heart attack. Your lifetime risk is lower however. And since coronary artery disease remains the main culprit for early death in both men and women, this indicates that exercise is one of the keys to a long and active life.

Minimising The Risks

What if you are very sedentary and then take up exercise? Or are elderly?

The definition of exercise may be important here. For many people a better term is “physical activity”. If you are sedentary and then take up a modest amount of physical activity, the benefits can be enormous in terms of reduction in risk factors for early death and heart problems. If you are already active the benefits are less, but could still be important over time.

Asking the right questions first is vital – doctors need to find the high-risk individuals with signs and symptoms which need further evaluation and management. Then, with the remaining low risk group (hopefully us), they can increase the exercise stress extremely slowly (a graded exercise programme). With this technique there have been very few problems in studied populations.

The Recommendations

Current recommendations still stand at 150 minutes of exercise a week, broken down into 30 minutes a day of moderate intensity activity over five days a week. Walking is the main recommended moderate activity.

Many physicians recommend 30 minutes walking every single day. The intensity of this walking is equivalent to walking about a mile and a half at a pace of 3-4 miles per hour.

Studies have shown that even in elderly or frail groups this recommendation does not lead to negative results.

Non-Aerobic Exercise

All of what we have discussed so far relates to aerobic exercise, where the body continues with a steady amount of exercise over an extended period such as a half-hour.

Resistance exercise, such as weights or using our own bodyweight, might also be useful.

There is less data to support this recommendation but we do know it to be beneficial. Muscle is the biggest organ in the body in most people and is designed to be used in physical activity. Keeping your muscles strong keeps you independent.

Over 40 years of age we lose 1% of our muscle mass each year, which can make a major difference to how we look and what we are able to do.

The recommendation seems to be a workout once or twice a week, doing exercises for 10 different body muscle groups, two sets of 10-15 repetitions. The high repetitions used means that injury is less likely.

People most likely to benefit here are older individuals, who are slowly losing their muscle mass over time, women and people with diabetes.


Aerobic exercise keeps you alive longer and resistance exercise maintains your functional independence, keeping you out of the nursing home. It is now possible to live long enough so you don’t have enough muscle strength to do what you want, such as move about and live an independent life.

One very strong recommendation comes from the evidence. If you smoke, stop. That’s it.

Remember, if you have ANY doubt about the wisdom of starting an exercise programme, consult your medical adviser before you get going.

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