The heart rate of my client goes up significantly every time she does any type of cardio training. Is there anything I could do?
This is a particularly challenging situation. Any time we are dealing with heart rate or cardiovascular issues we must be ultra concerned. Before giving any personal suggestions you must do a couple of things. First, a competent physician who knows about cardiovascular issues must look at her. I would actually recommend a cardiac stress test and possibly an echocardiogram. If she does not have good insurance this can be expensive, but so is the cost of her health. The second thing I recommend is to consult a specialty trainer or therapist who is well versed in the ACSM guidelines and doing medical exercise.
You mentioned that a physician checked her out, but you didn’t mention to what degree. If it were my mom, I would insist on going to a cardiologist to make sure. We can never underestimate the possibilities. In 2002, a 33 year old professional baseball pitcher died of a massive heart attack in his sleep without prior warning. These things just can’t be taken lightly.
Now that we have discussed the medical side of things, we can talk about the next step. When consulting the ACSM handbook, it states that any accelerated or irregular heart rate with little or mild exertion should be reported to a physician. If a physician has ascertained that her heart is healthy enough for a supervised exercise program, I would look at some of the outside stimuli that may be causing the heart rate. Stress is usually somehow related to the issue. It may be appropriate to steer her in the direction of some mind/ body exercise such as yoga, tai chi or Pilates. If doing traditional cardiovascular work is what she desires, you must be cautious to say the least. Start her with mild walking either on a treadmill or outside. Constantly check her heart rate with some type of monitor. Keep her heart rate within 40 to 60 percent of her heart rate maximum. Typically, the heart rate max is calculated by subtracting her age from the constant of 220. Then take that answer and multiply by .4 and .6. This will give you a range to keep your client’s heart rate in. If she cannot tolerate any activity without her heart rate exceeding these limits, it is my suggestion that you send her back to the doctor and demand the expensive tests. Provided she can tolerate some exercise and stay within the range, slowly increase one variable by 10 percent every other week. The variables you can choose from would be the length of time at that rate or the speed of the walk. With this individual I would slowly increase the speed variable until she can tolerate a brisk walk for at least 20 minutes while remaining in the afore mentioned heart rate zone.
With most orthopedic situations we are quite aggressive in our training programs but we do not take that approach to issues involving the heart. There are just too many things that can go wrong too quickly to be that aggressive. Never be afraid to refer out to another medical professional. This referral can start your circle of care for many clients to come. Thank you for the question, I am sorry if it wasn’t as much of an answer as you wanted. Matters of the heart can never be dealt with that easily.
- ACSM. Guidelines for Exercise Testing and Prescription, fifth edition, 1994.
- NCEP Manual, 3rd edition, 2001.