Newsflash: If you’re worried that exercise could cause a heart attack, it’s pretty unlikely. A 2015 study published in the journal Circulation found that only five percent of sudden cardiac arrests in middle-aged adults take place during “sporting” activities. Those who do experience heart complications during exercise are much more likely to be witnessed by bystanders, receive immediate care, and have a positive (i.e. survival) outcome. Frankly, you’re much more likely to die of cardiac arrest while sitting on your couch at home than you are to die of one at the gym.
But what’s really significant about this study is easy to miss. Of the heart attacks that take place during exercise, the majority of the victims had one or more risk factors, as well as cardiovascular symptoms in the week preceding the attack, and in some cases, a known preexisting heart disease. In other words, exercise didn’t cause the attacks — underlying conditions did.
Unfortunately, underlying conditions can’t always be seen, or felt, and they often extend far beyond the realm of cardiovascular disease. For instance, overuse injuries are frequently attributable to muscle imbalances or limitations in mobility, while chronic pain may be an indicator of a stress fracture or bulging disc. This is precisely why you should heed your favorite workout DVD’s warning notice and consult a doctor before starting an exercise program.
“Many people are excited to sign up for a gym and get in shape,” says Dr. Kevin Plancher, a leading orthopaedic surgeon and sports medicine expert. “They hit the machines or classes hard, remembering the days when they were 17 or 18 years old.” But the sad reality is, you’re not 17 or 18 years old anymore. Your body has aged, allowing bad health habits to compound, whether you’re aware of them or not.
Plancher recalls one 52-year-old patient who started hitting the gym for an hour and a half a day. It wasn’t long before he showed up at Plancher’s office complaining of groin pain. “Turns out he had a serious fracture of the femoral head — where the femur meets the hip," Plancher says. "He ended up being on crutches for about four months.” This could easily have been headed off by consulting with a physical therapist and working with a trainer to develop a safe, effective program for his specific needs.
Of course, given the right conditions, this can happen to anyone, even those without a preexisting condition. But preventative care can do a lot for identifying areas of concern. “Getting in shape is fabulous, and largely safe, but you need to make sure your family doctor is aware, and that they clear you for exercise,” Plancher says. “And if you’ve had injuries in the past, talk to an orthopedist or physical therapist. They can help you identify areas of weakness and develop a plan that keeps you healthy and safe.”
As a general rule, any pain you've had after four or five days of rest should always be checked out, and you should always ask your doctor about symptoms that relate to the activity you plan to undertake. For instance, if you’re on the heavier side, ask your doctor if there are steps you should take before getting into strenuous or high-impact activities, such as running. Sure, you’re probably gonna be fine. However, your doctor may suggest you see a physical therapist to monitor your running mechanics and correct muscular imbalances prior to a more intense program.
But if there’s one thing that can sabotage your fitness, Placher says it’s ego — especially for men. “They belittle certain symptoms,” Plancher says. “They don’t always ask, ‘I’ve had this ache in my ankle, should I see an orthopedist before using the stair stepper?’” So if you’re in lasting pain, do yourself a favor and get it checked out. It could be indicative of worse problems to come.