The most common risk is injury to the musculoskeletal system, ranging from minor muscle strain to tissue or bone or joint trauma.  The most serious risk of exercise is inducement of a cardiac event.

Cardiac Risk:

People with known or suspected heart disease are most at risk to suffer a cardiac event during exercise.  Individuals with multiple cardiovascular risk factors (smoking, hypertension, diabetes, high cholesterol) may also be at higher risk for exercise-induced cardiac events.  People who are lead less active lifestyles are also at a much higher risk of suffering from a cardiac event while exercising.  However, regular exercise actually reduces risk of an exercise-induced cardiac event.  It is always prudent to consult your healthcare professional before starting a program of moderate to vigorous intensity exercise, or before increasing the exertion level of exercise.

Incorporating more physical activity into your daily life should not require permission of your healthcare professional.  Low-level walking and light calisthenics, likewise, presents minimal risk and should be encouraged by your healthcare professional.  However, prior to increasing to a program of higher exertion (i.e. moving to a moderate level program or moving to or starting a vigorous program) it is recommended that you consult your healthcare professional.

Cardiac risk can be minimized by:

  • Managing cardiac risk factors by taking blood pressure medications, following prudent diet recommendations, adopting a healthy lifestyle. (no smoking, stress management etc.)

  • Addressing any other medical issues promptly.

  • Starting exercise slowly and progressing gradually.

  • Monitoring your responses to increased levels of activity.

  • Being aware of and responding to symptoms that may indicate inappropriate cardiac responses to exercise. (see section below)

Orthopaedic/Muscular-Skeletal Risks:

Injury to muscle, bones or joints is the most common problem associated with exercise.  Although there have been no studies in transplant recipients, it is possible that previous disease (i.e. kidney disease) and some immunosuppression medications may affect bones such that there could be an increased risk of orthopaedic/musculoskeletal injury with exercise.  If you experience joint (hip/knee) discomfort associated with exercise, it is recommended that you consult a professional physical therapist to evaluate the discomfort and appropriate treatment.  The type of exercises recommended may need to be modified (i.e. non-weight bearing exercise such as cycling or swimming instead of weight bearing activity such as walking/jogging).

Musculoskeletal injury risk during exercise can be minimized by:

  • Avoiding high impact activities. (jumping, jogging, etc.)(at least until adequate muscle strength is attained)

  • Starting exercise slowly and progressing gradually.

  • Starting exercise sessions of short duration for poorly conditioned individuals.

  • Developing adequate strength and flexibility.

  • Assuring adequate warm-up and cool-down times into your exercise sessions.

  • Assuring use of appropriate footwear.

  • Monitoring responses to increasing levels of activity.

Precautions due to immunosuppressives:

  • Wear sunscreen, your skin will be more sensitive to the elements.

  • Clean all gym equipment with disinfectant wipes.

  • Speak to a health care team regarding the use of public swimming pools.

It’s vital to listen to your body and be aware of the signs and symptoms it gives you.

When NOT to exercise:

  • If you have a fever.

  • If you have a new illness or medical concern that has not been treated.

  • If you have any pain.

  • If temperatures in the exercise environment are very hot.

When to SLOW DOWN:

Shorten or reduce the exertion level during your next exercise session.

  • If you are breathing too hard and find yourself unable to talk with someone else. (i.e. you should exercise at an intensity where your breathing frequency increases, but you are still able to hold a conversation if someone was next to you)

  • When your muscles or joints get so sore that you cannot exercise the next day.

  • When you do not fully recover from your exercise session within an hour or so.

  • When you have an unusually high heart rate response to the exercise.

  • If the exertion effort of your exercise session feels harder than usual.

When to STOP exercising:

If you notice any of these during your exercise session, stop, cool down and discuss with your health care provider before returning to your exercise program.

  • Excessive Shortness of breath.

  • Chest pain or pressure. (that may radiate into your neck/jaw area or down your arm)

  • Irregular or racing heart beats.

  • Nausea.

  • Dizziness or light-headedness.

  • Blurring of your vision.

  • Excessive fatigue following your exercise (beyond just feeling a bit tired from your workout) also if sleep is affected.

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