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Exercise for heart failure: tips for exercising safely
Exercising when you have heart failure can feel difficult, but it has many benefits. Two experts explain which exercises are best for heart failure, and how to get moving safely.
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Heart failure can leave you feeling breathless and tired – exhausted, even. “If you’ve got heart failure you probably associate these symptoms with being a bad thing.
So if you have heart failure, deliberately making yourself a little breathless and tired through exercise can be scary,” says Susan Eriksen, a physiotherapist who helped start the Heart Failure Unit at St George's Hospital in London.
“In the past, people with heart failure were told they needed rest. But we now know keeping active can be very beneficial.”
Why is exercise good for heart failure?
Exercising when you have heart failure can lead to a reduced risk of being hospitalised. “If you keep your body moving, you’ll help your muscles and lungs work better, which in turn puts less strain on your heart,” says Gill Farthing, a nurse at Hampshire Hospitals NHS Foundation Trust.
Ms Farthing has two decades’ experience of helping people with heart failure through cardiac rehab. She says "It can improve your quality of life, and you’ll benefit emotionally too. I’ve seen people with even advanced heart failure make small improvements after exercising for a period of time, and find it easier to do things in their daily life."It can improve your quality of life, and you'll benefit emotionally too
How to start exercising safely
Ideally, people with heart failure should start exercise in a supervised way, such as in a cardiac rehab class. Some health services offer remote classes.
Ask your doctor or specialist if cardiac rehab is an option for you, and if not, make sure you talk to them before starting any new activity.
- Visit our online cardiac rehab at home programme
5 tips for exercising with heart failure
1. Don't overexert yourself
It can be helpful to use the Borg scale, a way to think about how much you are exerting yourself.
“0 is sitting down doing nothing, and 10 is exhaustion – we say stick to ‘moderate intensity’, so somewhere in the middle where you’re feeling a bit warmer, you’re breathing a bit more heavily but you’re still able to talk while exercising,” explains Ms Farthing.
2. Warm up and cool down before and after exercise
“A slow cool-down is particularly important. We don’t recommend lying down straight after exercise. If you’ve exercised standing up, do some stretches; if you’ve exercised while sitting, do some gentle toe tapping, to allow your heart rate to come down gradually.”
3. Try exercising little and often
“Standard guidance suggests you should do 150 minutes of moderate intensity physical activity a week,” says Ms Eriksen. “But this can be spread out. You could do a few 5-10 minutes sessions over the course of a day and some activity is better than none.”
4. Pace yourself day to day
“You’ll have good and bad days. Listen to your body if you need more of a rest that day. Equally, if you’re having a great day, don’t fall into the trap of doing too much, because you’ll wipe yourself out for the next few days.”
5. Find a time of day that works best for you
“Some people have less energy at night, others find getting ready for the day takes a lot out of them and need to rest a bit before exercising.”
What are the best exercises for heart failure?
Ms Eriksen recommends doing an aerobic activity (something where you’re moving most of your body, which will increase your heart and breathing rate a little, such as moving to music or walking around) and resistance work, where you add light weights to build muscle strength. If you’re doing this at home, this could mean using cans of beans as hand weights. Some activities, like light gardening, offer a combination of the two.
“Pick activities you enjoy, that you’ll actually do,” she says.
- If you find standing too tiring, try our chair-based exercise videos
Exercises to avoid if you have heart failure
It's important to avoid exercise that involves heavy weight-lifting, or holding your breath. Don’t do any exercises that use your whole body as a weight, such as press-ups or planks. And be careful if you’re getting in the pool.
“You can work a lot harder when you’re swimming than you realise,” says Ms Eriksen. “If you love the pool, perhaps do activities like walking in the water, instead of front crawl. As with all exercise, discuss it with your healthcare professional first.”
When should you not exercise?
Stop exercising if you experience palpitations (feeling like your heart is pounding, or skipping a beat), extreme shortness of breath or light-headedness. “If you run out of energy, you may need to stop too,” says Ms Farthing. “It’s not boot camp. You’ll pay the next day if you push yourself too hard.”
She also adds that you shouldn’t exercise on days that you are unwell or feel more tired or breathless than normal. If you find light activities increasingly more difficult, speak to a health professional.
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