Buzz
You’ve probably heard it a thousand times: Always check with a doctor before starting any exercise routine. It’s a standard disclaimer that accompanies most fitness advice, and it’s something many of us tend to overlook. But should you be following this rule? Not necessarily, as it turns out.
Why is it recommended to see a doctor before exercising?
The main concern behind this frequently mentioned warning is that, in rare instances, someone may experience sudden death during exercise. This usually happens to individuals who (a) have some underlying health condition; (b) are not accustomed to exercising; and (c) engage in highly intense physical activity they weren’t prepared for.
For many years, a consensus among medical and fitness experts was that the most effective way to approach the issue was by focusing on individuals with existing medical conditions. Since not everyone is aware of their health status, it’s recommended to consult a doctor if you suspect you may have an underlying condition or if there is a family history of medical issues.
Though initially this approach seemed sound, the screening process quickly became overly extensive. A typical tool used was a questionnaire asking about your health, age, smoking habits, and weight. A 2014 study showed that this screening would identify over 90% of middle-aged and older adults, meaning they couldn’t exercise without obtaining medical clearance.
The high costs and limited access to healthcare, along with the challenges of securing appointments and taking time off work, create significant barriers for many. This is rather ironic, as exercise is generally beneficial for your health.
The American College of Sports Medicine dug deeper into the statistics and found that the risks being screened for were quite common, while the outcomes they aimed to prevent were exceedingly rare—such as one sudden cardiac death for every 1.5 million vigorous workouts, according to one study. Furthermore, screening based on these risk factors didn’t seem to reduce exercise-related deaths.
How to determine if you need to consult a doctor before starting exercise
Recent changes to the guidelines for screening individuals before exercise now recommend that most people can begin exercising without needing to consult a doctor first, according to the American College of Sports Medicine. The new screening protocol focuses on three factors that gyms and trainers should use to assess readiness for exercise:
Your current level of physical activity
Whether you have any symptoms or risk factors for certain health issues
The intensity of exercise you're aiming for
Health issues like cardiovascular, metabolic, and kidney diseases are the primary conditions that determine whether you need additional screening. For example, diabetes is classified as a metabolic disease, while heart conditions, peripheral artery disease, and cerebrovascular diseases fall under cardiovascular issues.
If you have any of these conditions, you can typically still exercise as long as you have medical clearance from a doctor within the past 12 months (and your condition hasn’t worsened since). Alternatively, if you’re already physically active and intend to continue at the same level, you can go ahead. A flowchart is available to help you determine if medical clearance is necessary.
Even without a formal diagnosis, experiencing symptoms of the mentioned diseases should prompt you to halt exercise and consult a healthcare provider before proceeding. Symptoms such as shortness of breath at rest or with light activity, chest or arm pain, dizziness, or fainting are key indicators. If you're unsure whether you meet these criteria, start by taking the PAR-Q test, which asks seven yes-or-no questions. If you answer 'yes' to any, there's a follow-up PAR-Q+ questionnaire with more detailed questions.
Under the updated guidelines, the number of individuals over 40 who need medical clearance before engaging in exercise has been significantly reduced, dropping by nearly 50%. Additionally, the doctor's visit is expected to be much simpler, as specific tests are no longer required. The nature of the visit will depend on the doctor's discretion and professional judgment.
While some individuals still require a doctor's approval before beginning an exercise regimen, it's far from a widespread requirement. Most people can start exercising immediately, and even those with pre-existing health conditions will likely be advised on some form of exercise they can safely engage in.
