Kids and adults: Both need the ‘OK’ before exercising?

It’s that time of year when children and adolescents are back in school and gearing up for athletic participation. For the last several weeks, local physicians’ offices have been busy with the late-summer routine of pre-participation physical examinations.

Fortunately, the vast majority of kids are healthy and tolerant of exercise, even when they might be starting a new athletic activity. Pre-participation screening is a focused assessment intended to detect a handful of uncommon but important health conditions that might produce problems for the exercising child or adolescent.

For parents who have been through the routine, you recall that there is a questionnaire to complete with your child intended to elicit a history of familial heart conditions, personal history of important injuries such as concussion, as well as any personal history (on the part of the child) of exercise-induced adverse symptoms.

This is commonly followed by a comprehensive physical examination with a focus on cardiovascular and musculoskeletal systems. The so-called sport physical is also an important opportunity to address routine health matters with adolescents, including lifestyle choices affecting health as well as immunizations unique to this age group. For many adolescents, the sport physical is the only general health encounter that they will have for the year.

Perhaps you have been giving consideration to starting an exercise program yourself. Considerable information has been published (including in this column) about the manifold health benefits of an active lifestyle.

Exercise improves physical and mental health. It is a fundamental component of weight management as well as warding off lifestyle diseases such as diabetes mellitus and many cardiovascular diseases. It can be said that routine physical activity is the foundation of a healthy lifestyle.

I recently stepped onto a hotel treadmill machine and noticed a sticker on the front instructing me to “consult with a physician” before starting an exercise program. It struck me that many spuds in the process of transition from the couch to the exercise machine might find pause in such a warning. So what pre-exercise assessment is necessary for the about-to-exercise adult?

In general, health experts agree that the benefits of exercise vastly exceed any risks. A few basic principles apply to starting a safe exercise program.

If you have known heart disease, a family history of heart disease (especially if it includes a relative who had sudden cardiac death with exercise – which is rare), or multiple heart disease risk factors (such as diabetes, high blood pressure, smoking and high cholesterol), you should talk to your physician before engaging in a strenuous exercise program.

Your doctor may advise a graded exercise test or, for those with heart conditions, a monitored exercise regimen known as cardiac rehab.

As a general rule of thumb, you should gradually increase the intensity and duration of exercise, taking time to warm up and cool down before and after.

Of course, if you develop exercise-related symptoms such as chest pain, breathing difficulty or lightheadedness, stop your program and seek medical attention.

Dr. Matthew A. Clark is a board-certified physician in internal medicine and pediatrics practicing at the Ute Mountain Ute Health Center in Towaoc.