After a heart attack, you might think that the last thing you need to do is exercise. After all, your heart’s been injured, right? And when you injure a muscle, the best thing to do is to let it rest and recuperate. …Right?
In the case of your heart, no.
For decades, doctors prescribed bed rest immediately after a heart attack. Heart patients were advised to avoid physical activity, often for weeks or even months. Today we know better. The evidence is overwhelming—exercise is one of the best ways to help heal your heart and prevent a second heart attack. And the sooner you start doing it, the better.
Can exercise mend a broken heart?
You have a heart attack when blood flow to your heart is cut off. This leaves part of your heart muscle starved for oxygen, and the cells start to die. Once heart cells die, they’re not restored—your body fills in the damaged areas with scar tissue. These areas of scar tissue are thinner and weaker than the rest of your heart. They’re not actually cardiac muscle, so they don’t beat with your heart. This means the rest of your heart has to work harder to compensate for the damaged areas.
New research suggests that early exercise after a heart attack can minimize the damage and make your heart stronger. Researchers from Germany and Luxembourg found that mice who began an exercise program five days after a heart attack had less scarring than those who didn’t. The areas which did scar had less thinning. And they had less inflammation, which continues to cause damage even after the initial event.
How soon should you start exercising?
You shouldn’t start any post-heart attack exercise program without consulting your doctor. Each person and each heart attack is unique. However, evidence is mounting that the sooner you start the better. Studies consistently find that people who start exercising one week after their heart attack have the best outcomes, and with each passing week the benefits get weaker.
That’s not to say that you shouldn’t exercise at all if you have to wait longer. Regardless of when you begin, a regular exercise program will cut your risk of a second heart attack.
So what kind of exercise should you do?
You may not realize it, but you probably started exercising while you were still in the hospital.
Walking is actually one of the most beneficial forms of exercise for cardiac patients and chances are you spent some time taking short walks up and down the hall while you were in the hospital. This is the beginning of your exercise program. As your heart and your body get stronger, bicycling and swimming are also good choices.
Although the idea of “taking it easy” after a heart attack is outdated, it’s still important to not do too much, too fast. A cardiac rehabilitation program is one of the best ways to ease into exercise, and I strongly recommend enrolling in one if possible. This lets you train under the watchful eyes of people who know what’s a problem and what isn’t.
When you start exercising post-heart attack—especially if you were sedentary before—it may be hard to know what’s normal and what’s not. A cardiac rehab program can both teach you good habits and put your mind at ease.
Ease into exercise—the first six weeks
Immediately after a heart attack, walking is probably the best thing you can do. Start out slow and build up—aim for five minutes of walking per day the first week, then add one minute per day till you’ve worked all the way up to 30 minutes. Walking on a stable, flat surface is best—stick to the street or sidewalk, or indoor walking. Don’t try to tackle bumpy terrain.
For the first few weeks, walking with a friend or family member is a good idea. Stick close to home in case you get too tired. And pay attention to your speed; start out at a slow pace then gradually speed up. Remember it’s not a marathon. A good rule of thumb is that you should be able to carry on a conversation while you’re walking, but probably not be able to sing. If you can sing you probably need to speed up. The last minute or two of your walk, gradually slow back down.
You’ll need your doctor to sign off on it, but once the first six weeks or so are past, if you’re doing well you can usually add swimming or gentle cycling to your exercise routine.
Exercise is one of the best tools for recovering from a heart attack. However, if you have any of the following symptoms, stop what you’re doing and call your doctor.
- Pain or tightness in your chest
- Pain in your neck, arm, or jaw
- Shortness of breath out of proportion to how hard you’re exercising
- Cold sweat
A heart attack is a life-changing experience. The question is, how will it change your life? It doesn’t mean you have to stop being active, and it’s not a reason to stop doing things you love. Instead, look at is as the chance to make a fresh, healthy start on life.