Is It Really Necessary to Consult a Doctor Before Starting Sports?

I’m sure you’ve heard it everywhere: consult your doctor before starting any exercise program. It’s a standard warning in any fitness advice, one that most of us probably ignore. But should you? It turns out, you don’t have to.

Why is it important to consult a doctor before starting physical exercise?

This oft-repeated claim stems from the fear that, in rare cases, a person can die suddenly while exercising. When this happens, it usually occurs in someone who (a) had an underlying medical condition; (b) was unaccustomed to exercise; and (c) was performing very intense exercise for which they were unprepared.

For a long time, many medical and fitness professionals believed that the best way to address the problem was to focus on the first part: people with hidden conditions. And since not everyone knows whether they have such conditions, you should also consult a doctor if you suspect you have a hidden condition or if there is a history of the disease in your family.

While this sounds like a good idea, screening got out of hand. One of the most common screening tools was a questionnaire that asked about health status, as well as age, smoking status, and excess weight. A 2014 study found that it identified over 90% of middle-aged and older people . In other words, these people were not allowed to exercise until they received medical clearance.

Given the cost and availability of healthcare in this country (not to mention the difficulty of getting an appointment, taking time off from work, and so on), this is a huge barrier for many people. Ironic, considering that exercise is beneficial for health.

The American College of Sports Medicine conducted a deeper analysis of the data and found that the risk factors they were identifying were very common, the outcomes they were trying to prevent were very rare (one sudden cardiac death per 1.5 million intense exercise sessions, according to one study), and screening people based on risk factors did not appear to actually reduce the number of exercise-related deaths.

How to know if you really need to consult a doctor before starting exercise

Changes have been made to current guidelines for pre-exercise screening. The American College of Sports Medicine now states that “most people can exercise without seeing a doctor first.” The current guidelines, which should be used by most gyms and trainers, consider only three factors during screening:

• How much exercise do you do now?

• If you have signs or symptoms of certain medical conditions

• How intensely would you like to exercise?

Diseases that fall under the second point include cardiovascular, metabolic, and renal diseases. If you have diabetes, you have a metabolic disease. If you have been diagnosed with heart disease, peripheral arterial disease, or cerebrovascular disease, you have a cardiovascular disease.

Even if you have one of these conditions, you can generally exercise if you’ve received a doctor’s clearance within the last 12 months (and your condition hasn’t worsened since then), or if you already exercise regularly and simply want to continue at the same level. Here’s a flowchart to help you understand whether you need a medical clearance .

Even without a preliminary diagnosis, signs and symptoms of the conditions mentioned above mean you should stop exercising and consult a doctor before continuing. These include shortness of breath at rest or with light physical activity; chest, arm, or jaw pain; dizziness or fainting; and others. If you’re wondering if you meet the criteria, start by taking the PAR-Q , which consists of seven yes-or-no questions. If you answer yes to any of them, you’ll be offered the more detailed PAR-Q+ questionnaire.

Compared to the old guidelines, the proportion of people over 40 who require medical clearance before starting exercise has been nearly halved . Furthermore, under these same guidelines, the doctor’s visit itself will likely become much simpler. Specialized tests are no longer recommended; further actions during the visit depend on the doctor’s decision and clinical judgment.

Yes, some people do need to consult with a doctor before starting an exercise program. But that’s not all. Most people can start right away, and even those with medical contraindications will likely be advised that there’s some type of exercise that’s right for them.

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