PT on the Net Research

Controlled Hypertension & Exercise


I have a client who has controlled hypertension. As this precludes the use of isometric exercise and restricts overhead work, could you suggest a suitable selection of core exercises?


Thank you for your question! Before we answer your question, we would like to make it clear by no means would we (or should you) go against your client's doctor's advice! With that said, after the doctor's ok to exercise, we would approach your client in the following way:

  1. Perform a health history including what medication(s) and potentially how the medication(s) will affect movement (exercises of all form).
    • If you’re unsure, ask your client's physician and/or look up the possible contraindications.
  2. Perform a complete physical assessment including ALL functional movements that your client must perform throughout life and at what intensities (yes, this includes overhead movements – because it’s a life function).
  3. Search for the physical weak links.
  4. Design a movement program that enhances your client's movement vocabulary (the ability to carry out tasks of life).

So, to answer your question, we would select total body movements that fortified your clients function, which in turn will lead to greater movement efficiency. This approach allows you create the best exercise(s) versus following the many protocols that potentially are dangerous. For example, many isolated core exercises place tremendous stress through the neck. In addition, many create excessive intra-abdominal pressure for your client's condition. Therefore, to stay away from a standing one arm overhead press (which is a major core exercise) and replace it with a crunch or other isolated core exercise doesn’t make functional sense. Point: use your functional assessment as your guide and take guidelines lightly as they are designed as a “guide” and are often vague. We hope this opens up a new pathway for you and your client. Please see Gary Gray's Functional Video Digest on Abdominals for an exhaustive list of safe, fun and functional core exercises for your client.

Good luck!