Evidence-Based Contraindications to Initiating a Running Program

I love the fact you want to get running, but unfortunately there are some contraindications you must consider.

  1. Introduction: Balancing the Benefits and Risks of Starting Running

Regular aerobic exercise, such as running, offers substantial and well-documented health benefits. Engaging in physical activity contributes positively to cardiovascular health, aids in weight management, improves mood regulation, and reduces the risk of numerous chronic diseases including heart disease, type 2 diabetes, and some cancers.1 Running is classified as a vigorous-intensity aerobic activity, meaning it requires a substantial effort resulting in a significantly faster heartbeat and rapid breathing, where speaking more than a few words without pausing for breath becomes difficult.6 While the advantages of such activity are clear, and public health guidelines strongly encourage reducing sedentary time 2, embarking on a vigorous exercise program like running necessitates careful consideration of individual health status and potential risks.

A contraindication is a specific medical condition or circumstance that makes a particular treatment or activity—in this instance, starting to run—potentially inadvisable due to the risk of harm. Identifying contraindications is not intended to discourage physical activity altogether, as inactivity itself poses significant health risks.2 Rather, the goal is to ensure participant safety, guide necessary medical consultations, and potentially modify the exercise approach to suit individual needs and limitations.10 This is particularly pertinent for vigorous exercise, which places greater demands on the cardiovascular, respiratory, and musculoskeletal systems.12

Research indicates a transiently increased relative risk of adverse cardiovascular events, such as sudden cardiac death or myocardial infarction, during or shortly after vigorous-intensity exercise. This risk is most pronounced in individuals who are habitually sedentary and have underlying, sometimes undiagnosed (occult), cardiovascular disease, especially when they engage in unaccustomed strenuous activity.10 Therefore, a systematic approach to identifying individuals who might be at higher risk before they start running is a cornerstone of promoting safe exercise participation.

The landscape of pre-participation health screening has evolved. Earlier models often relied heavily on counting cardiovascular disease risk factors, which frequently led to recommendations for medical clearance for a large proportion of the population, potentially creating barriers to exercise adoption.10 Current approaches aim for a more targeted strategy, focusing on identifying individuals with known disease or significant symptoms suggestive of underlying conditions that could be exacerbated by exercise, thereby facilitating physical activity for most while ensuring appropriate caution for those at highest risk.10

  1. Pre-participation Health Screening: Identifying Initial Risk

The primary purpose of pre-participation health screening before initiating an exercise program like running is to identify individuals who possess medical conditions that could elevate their risk for adverse events during physical exertion.10 This process is particularly focused on detecting known or potential cardiovascular conditions that might predispose an individual to serious complications, such as exertion-related sudden cardiac death or acute myocardial infarction, when undertaking vigorous activity.10 The screening helps determine whether obtaining medical clearance from a healthcare provider is necessary before an individual begins running or significantly increases their current exercise intensity.7

Current Screening Paradigm (ACSM Model)

The American College of Sports Medicine (ACSM) has updated its pre-participation screening guidelines, shifting away from the previous emphasis on cardiovascular disease (CVD) risk factor profiling.10 The rationale behind this evolution stems from the recognition that older methods, based on factors like age, family history, smoking status, obesity, hypertension, dyslipidemia, and prediabetes, often resulted in excessive referrals for medical clearance.10 In some populations studied, conventional screening based on risk factors could advise physician consultation for over 90% of individuals before even moderate-intensity exercise, creating substantial logistical and cost barriers to participation in beneficial physical activity programs.10 While the absolute risk of a major cardiac event during exercise is generally low for most individuals, especially when activity is progressed gradually, the health burden of widespread physical inactivity is immense.2 The updated guidelines therefore adopt a more pragmatic approach, aiming to balance safety with feasibility. Screening efforts are focused on identifying individuals whose underlying conditions place them at higher risk specifically when initiating new activity or increasing intensity significantly.10

The current ACSM algorithm centers on three key factors 10:

  1. Current Physical Activity Level: This distinguishes individuals who are currently regularly active from those who are not. "Active" is typically defined as performing planned, structured physical activity of at least moderate intensity for at least 30 minutes on at least three days per week for the past three months.10
  2. Presence of Known Cardiovascular, Metabolic, or Renal Disease: This identifies individuals with diagnosed conditions such as heart disease (cardiac, peripheral vascular, or cerebrovascular disease, including previous myocardial infarction, heart surgery, pacemaker implantation, valve disease, heart failure, or structural heart disease), type 1 or type 2 diabetes mellitus, or kidney disease.10
  3. Presence of Signs or Symptoms Suggestive of Cardiovascular, Metabolic, or Renal Disease: This involves checking for specific symptoms that may indicate underlying, potentially undiagnosed disease (detailed below).7

Additionally, the Desired Exercise Intensity (light, moderate, or vigorous) is considered, as recommendations for medical clearance may vary based on the planned level of exertion.10 Running is generally considered vigorous intensity (≥ 6 METs, or an intensity evoking substantial increases in heart rate and breathing).6

When Medical Clearance is Recommended (Based on ACSM)

Based on these factors, the recommendations for seeking medical clearance before starting to run (vigorous activity) are as follows 10:

  • For Individuals NOT Currently Meeting Regular Physical Activity Criteria:
  • Medical clearance is recommended before initiating any intensity of exercise, including light, moderate, or vigorous (like running), if they have known cardiovascular, metabolic, or renal disease, OR if they have any signs or symptoms suggestive of these diseases (see Table 1).
  • If they have no known disease AND no signs or symptoms, medical clearance is generally not necessary for light-to-moderate intensity exercise. They can begin and progress gradually. However, given running is vigorous, a cautious approach including gradual progression towards this intensity is paramount.
  • For Individuals Who ARE Currently Meeting Regular Physical Activity Criteria:
  • Medical clearance is recommended if they develop new signs or symptoms suggestive of cardiovascular, metabolic, or renal disease. They should discontinue exercise and seek medical evaluation.
  • If they have known cardiovascular, metabolic, or renal disease but are asymptomatic, medical clearance is recommended before engaging in vigorous-intensity exercise like running, if they are not already accustomed to this level of intensity. If already participating in vigorous exercise without issues, they may continue but should seek clearance if they wish to significantly increase intensity or volume, or if symptoms develop.

Key Signs and Symptoms Prompting Evaluation

The presence of any of the following signs or symptoms necessitates medical evaluation before initiating or continuing an exercise program, particularly a vigorous one like running. These serve as critical indicators of potential underlying disease.7

Table 1: Key Signs & Symptoms Requiring Medical Evaluation Before Starting/Intensifying Exercise

 

Symptom

Description/Clarification

Chest Pain/Discomfort (Anginal Equivalent)

Pain, pressure, tightness, or discomfort in the chest, neck, jaw, arms, or other areas that may indicate myocardial ischemia.

Shortness of Breath (Dyspnea)

Shortness of breath occurring at rest or with only mild exertion.

Dizziness or Syncope

Feeling faint, lightheaded, or actually fainting, especially during or after exercise.

Orthopnea or Paroxysmal Nocturnal Dyspnea

Difficulty breathing when lying flat (orthopnea) or waking suddenly from sleep with shortness of breath (PND).

Ankle Edema

Swelling of the ankles, particularly if bilateral and unexplained.

Palpitations or Tachycardia

Awareness of a forceful, rapid, or irregular heartbeat; resting heart rate >100 bpm.17

Intermittent Claudication

Pain, aching, cramping, or fatigue in the lower leg muscles (usually calves) during exercise, relieved by rest.

Known Heart Murmur

Previously diagnosed heart murmur requires evaluation regarding its significance for exercise.

Unusual Fatigue or Shortness of Breath

Fatigue or breathlessness occurring with activities that are not normally strenuous for the individual.

Sources: 7

Self-Screening Tools

Self-guided screening tools, such as the Physical Activity Readiness Questionnaire for Everyone (PAR-Q+), are available and can help individuals identify whether they should seek medical advice before becoming more physically active.16 These tools are designed to reduce unnecessary barriers while still flagging potential risks.

III. Absolute Contraindications: When Running Should Generally Be Avoided

Absolute contraindications represent medical conditions or clinical states where the potential risks associated with exercise, especially vigorous exercise like running, are deemed unacceptably high and outweigh any potential benefits.17 Individuals presenting with these conditions should refrain from initiating a running program until the condition has been effectively treated, stabilized, or resolved, and they have received explicit medical clearance from a qualified healthcare provider.17

These conditions typically reflect a state of acute instability or severe, uncontrolled dysfunction primarily within the cardiovascular or respiratory systems. Vigorous exercise imposes significant physiological stress, including marked increases in heart rate, blood pressure, cardiac workload, and oxygen demand.12 In the presence of the conditions listed below, the body's ability to cope with this stress is severely compromised, creating a high probability of immediate, life-threatening complications such as malignant arrhythmias, acute ischemia, hemodynamic collapse, or structural failure (e.g., aortic rupture).18 The emphasis is often on the "acute," "unstable," "uncontrolled," or "active" nature of the condition, signifying a vulnerable physiological state unable to safely tolerate the demands of running.

Table 2: Absolute Contraindications to Starting a Running Program

 

Condition

Rationale/Risk Associated with Running

Acute Myocardial Infarction (MI)

Recent heart attack (typically within 2-5 days, potentially longer restriction for training).19 High risk of arrhythmias, infarct extension, heart failure, rupture.

Unstable Angina

Chest pain that is new, worsening, or occurs at rest.17 Indicates severely compromised coronary blood flow and high risk of imminent MI.

Uncontrolled Arrhythmias

Cardiac rhythms causing symptoms (dizziness, syncope) or hemodynamic instability (low BP).17 Risk of exacerbation to life-threatening rhythms.

Severe Symptomatic Aortic Stenosis

Critical narrowing of the aortic valve causing symptoms (chest pain, syncope, heart failure).18 High risk of sudden cardiac death with exertion.

Uncontrolled Symptomatic Heart Failure

Decompensated heart failure with worsening fluid retention or shortness of breath at rest.17 Inability of the heart to meet exercise demands.

Acute Pulmonary Embolism (PE) or Infarction

Recent blood clot in the lungs.18 Severe strain on cardiopulmonary system, risk of hemodynamic collapse or worsening hypoxemia.

Acute Myocarditis or Pericarditis

Active inflammation of heart muscle or surrounding sac.18 Risk of worsening inflammation, heart failure, dangerous arrhythmias.

Suspected or Known Dissecting Aortic Aneurysm

Tear in the wall of the aorta.18 Risk of catastrophic rupture with increased blood pressure during exercise.

Acute Systemic Infection with Fever/Symptoms

Active infection accompanied by fever, body aches, swollen glands.17 Risk of worsening illness, dehydration, potential myocarditis.

Deep Vein Thrombosis (DVT)

Blood clot in a deep vein, often leg.17 Risk of clot dislodging and causing pulmonary embolism.

Acute Respiratory Failure / Severe Resting Hypoxemia

Inability to maintain adequate blood oxygen levels at rest (e.g., SpO2 <85%).18 Exercise would induce severe oxygen deficit.

Uncontrolled Diabetes

Markedly unstable blood glucose levels.19 Risk of severe hypo- or hyperglycemia, ketoacidosis.

Uncontrolled Asthma

Severe, poorly managed asthma with frequent symptoms or exacerbations.19 Risk of severe bronchospasm induced by exercise.

Sources: Synthesized from 17

It is crucial to understand that these are generally considered absolute contraindications to starting vigorous exercise like running. Once these conditions are adequately treated and stabilized, exercise, potentially including running, might become possible under medical guidance.

  1. Relative Contraindications: Proceeding with Caution and Clearance

Relative contraindications encompass a range of medical conditions where initiating a running program might be feasible, but carries potential risks that necessitate careful consideration and management.17 Unlike absolute contraindications, these conditions do not automatically preclude running. However, they mandate a thorough medical evaluation, explicit clearance for vigorous activity from a healthcare provider, and often require specific precautions, activity modifications, or ongoing monitoring to ensure safety.17 The decision to proceed involves an individualized assessment of the potential benefits versus the risks, performed by a clinician familiar with the patient's specific condition and the demands of running.

A key factor influencing whether a condition acts as a relative contraindication is the planned exercise intensity. Many conditions listed below might pose minimal risk during light or moderate physical activity, but the substantial physiological demands of running (a vigorous activity) could significantly increase the potential for adverse effects.10 For instance, stable coronary artery disease might be well-tolerated during brisk walking, but the higher heart rate and blood pressure response during running could provoke myocardial ischemia.18 Similarly, the high-impact nature of running places far greater stress on joints compared to lower-impact activities, making conditions like severe osteoarthritis a more significant concern for runners.17 Therefore, medical clearance for individuals with relative contraindications must specifically address their suitability for running and its associated vigorous intensity, not just general physical activity.

Furthermore, the nature of the risk often differs between categories. While cardiovascular relative contraindications frequently involve managing the risk of ischemia, arrhythmias, or hemodynamic compromise 18, musculoskeletal relative contraindications (such as severe osteoarthritis or recent injury/surgery) are typically focused on managing pain, maintaining function, and preventing further joint damage or re-injury.17 This distinction influences the evaluation process and management strategies. Musculoskeletal concerns often require input from orthopedic specialists or physical therapists, focusing on biomechanics, strength, range of motion, and pain tolerance, potentially leading to recommendations for modified running techniques, orthotics, specific strengthening exercises, or choosing lower-impact alternatives if running proves unsuitable.17

The following table outlines common conditions often considered relative contraindications to starting a running program, categorized by system.

Table 3: Common Relative Contraindications to Starting a Running Program

 

Condition Category

Specific Condition(s)

Key Considerations/Potential Modifications

Cardiovascular

Known Stable Coronary Artery Disease (CAD) (e.g., post-MI >3 weeks, stable angina, post-bypass/stent)

Requires assessment of ischemic threshold & functional capacity (often exercise stress test); may need medication optimization; gradual progression critical.7
 

Controlled Hypertension

Monitor blood pressure response to exercise; ensure medication adherence; avoid excessive intensity if BP poorly controlled; severe uncontrolled HTN (e.g., SBP>180 or DBP>100-110) may be absolute/strong relative contraindication.12
 

Mild-to-Moderate Stenotic Valvular Disease (e.g., asymptomatic moderate aortic stenosis)

Requires careful evaluation of severity (echocardiography) and symptomatic status; monitor for symptom development with exertion.18
 

Known Stable Chronic Heart Failure (Compensated)

Requires stable condition on optimal medical therapy; exercise prescription guided by functional capacity (e.g., peak VO2); close monitoring for symptoms.18
 

Controlled/Asymptomatic Arrhythmias (e.g., stable atrial fibrillation with rate control)

Requires assessment of rhythm response to exercise; ensure rate control is adequate; monitor for symptoms.19
 

Hypertrophic Cardiomyopathy (HCM)

High-risk condition, especially for competitive/intense running; requires expert cardiology evaluation and risk stratification; may limit intensity/duration.18
 

Significant Left Main Coronary Stenosis

High risk; requires careful evaluation and likely revascularization before vigorous exercise.19

Musculoskeletal

Severe Osteoarthritis (OA) in Weight-Bearing Joints (Knees, Hips)

High impact may worsen pain/degeneration; consider pain levels, function; may need modifications (surface, footwear, reduced volume/intensity), strengthening, or alternative activities.17
 

Recent Musculoskeletal Surgery or Acute Fracture (Post-Rehabilitation Phase)

Requires clearance from surgeon/therapist confirming adequate healing, strength, range of motion to tolerate impact; gradual return essential to prevent re-injury.17
 

Symptomatic Herniated Disc / Spinal Stenosis

Running impact can aggravate symptoms; requires evaluation; may benefit from core strengthening, gait modification, pain management, or alternative activities.
 

Significant Limb Length Discrepancy / Severe Biomechanical Issues (e.g., severe cavus feet with history of stress fractures)

May increase injury risk; requires assessment; consider orthotics, specific footwear, targeted strengthening; monitor closely for injury patterns.21

Respiratory

Asthma (Controlled)

Ensure good control with medication; may need pre-exercise inhaler; proper warm-up/cool-down; avoid known triggers (cold, pollen); monitor for exercise-induced bronchospasm.19 Uncontrolled asthma is absolute contraindication.18
 

Chronic Obstructive Pulmonary Disease (COPD) (Mild-to-Moderate)

Exercise is beneficial but capacity may be limited; requires assessment of severity (spirometry), oxygen saturation monitoring during exercise; tailored program needed.18 Severe/exacerbated COPD is absolute contraindication.18
 

Significant Pulmonary Hypertension

Often limits exercise capacity significantly; risk of right heart failure; requires specialist evaluation and management.19

Metabolic

Diabetes Mellitus (Type 1 or 2)

Requires good glycemic control before starting 19; monitor blood glucose before/during/after exercise; adjust insulin/meds as needed; be aware of hypoglycemia risk; proper foot care essential.10 Complications (neuropathy, retinopathy) need specific consideration.
 

Severe Obesity (esp. with comorbidities like HTN, DM, OA)

Increased joint stress and cardiovascular load 10; gradual progression essential; may start with lower-impact activities; address comorbidities.
 

Known Electrolyte Abnormalities (uncorrected)

E.g., significant hypo/hyperkalemia; risk of cardiac arrhythmias; requires correction before vigorous exercise.18
 

Severe Hyperthyroidism (uncontrolled)

Risk of tachycardia, arrhythmias 17; requires medical management and control before vigorous exercise.

Other

Pregnancy (with certain complications)

While exercise is generally encouraged 4, specific conditions (e.g., severe pre-eclampsia, certain placental issues, cervical insufficiency, uncontrolled T1DM, significant heart/lung disease) are contraindications (absolute or relative).26 Guidelines evolve; medical advice crucial.26
 

Neurological Disorders (affecting balance/coordination/sensation)

E.g., Parkinson's, MS, significant peripheral neuropathy; increased fall risk; may require gait assessment, assistive devices, or modified environment.23
 

Cancer (during/after treatment)

Exercise generally safe/beneficial 23; contraindications usually related to acute treatment side effects (e.g., severe anemia, febrile neutropenia, unstable bone metastases) or significant comorbidities.29 Individualized prescription vital.28

Sources: Synthesized from 12

  1. Recommendations for Safely Embarking on a Running Program

Successfully and safely integrating running into one's lifestyle involves more than just avoiding contraindications; it requires a thoughtful and proactive approach to preparation and participation. Based on established guidelines and sports medicine principles, the following recommendations are key for individuals considering learning to run:

  • Seek Appropriate Medical Advice: The cornerstone of safe exercise initiation is obtaining medical guidance when necessary. Consultation with a healthcare provider is strongly recommended for any individual who identifies with an absolute or relative contraindication, or who experiences any of the key warning signs or symptoms outlined in Table 1, before starting to run.6 This consultation allows for proper diagnosis, risk assessment, and personalized advice regarding the safety and suitability of running. Even generally healthy older adults, individuals with stable chronic conditions not explicitly listed as contraindications, or those who have been sedentary for a long time may benefit from discussing their plans with a physician to ensure readiness.6
  • Embrace Gradual Progression: Perhaps the single most important principle for safely starting running is gradual progression, often summarized as "start low and go slow".7 Abruptly beginning a high-volume or high-intensity running program significantly increases the risk of both musculoskeletal injuries and, in susceptible individuals, adverse cardiovascular events.10 A beginner's program should start with manageable durations and frequencies (e.g., incorporating walk/run intervals) and gradually increase these variables over several weeks or months.7 Increases in session duration (e.g., by 5-10 minutes every 1-2 weeks for the first 4-6 weeks) should generally precede increases in intensity (e.g., running faster or on hills).7 This methodical approach allows the cardiovascular system, muscles, tendons, ligaments, and bones to adapt progressively to the stresses of running, thereby reducing injury potential and enhancing safety.10 This adaptive process is protective; it helps mitigate the acute cardiovascular risks associated with unaccustomed vigorous exercise by improving physiological function and reducing the hemodynamic stress for a given workload over time.
  • Listen to Your Body: Self-awareness is crucial. Individuals should learn to distinguish between the normal muscle soreness associated with new exercise and pain that signals potential injury.12 Pushing through sharp, localized, or persistent pain can lead to more significant injuries. Paying attention to fatigue levels, overall well-being, and other bodily signals is important. Incorporating rest days and adjusting training based on how the body feels are essential components of a sustainable running practice.36
  • Individualize the Program: There is no one-size-fits-all running program. Plans should be tailored to the individual's starting fitness level, health status, specific goals (e.g., running a 5k vs. general fitness), available time, and personal preferences.2 What constitutes a safe and effective starting point or progression rate will vary significantly between individuals.
  • Consider Contributing Factors: While not primary contraindications, several other factors contribute significantly to running safety and injury prevention. These include selecting appropriate running shoes suited to one's foot type and gait, choosing running surfaces (softer surfaces like trails or tracks may reduce impact compared to concrete), performing adequate warm-ups before and cool-downs after running, maintaining proper hydration and nutrition, and incorporating strength training.21 Recent evidence suggests that strengthening exercises focusing on the hip and core muscles may be particularly effective in preventing running-related overuse injuries in novice runners.37
  1. Conclusion: Prioritizing Health for a Sustainable Running Journey

Running is an accessible and effective form of vigorous physical activity that offers profound benefits for physical and mental health. However, its demanding nature necessitates a prudent approach, particularly for individuals new to the activity or those with pre-existing health concerns. A thorough pre-participation assessment, guided by current evidence-based screening recommendations, is a critical first step to identify potential contraindications and ensure individual safety.

This report has delineated the key evidence-based contraindications to initiating a running program, distinguishing between absolute contraindications—conditions requiring avoidance of running until resolved or stabilized under medical care—and relative contraindications—conditions necessitating careful medical evaluation, clearance specific to vigorous activity, and potential modifications or precautions. Recognizing the signs and symptoms that warrant medical attention is paramount for all prospective runners.

Ultimately, the goal is not to deter participation but to promote safe and sustainable engagement in physical activity. For the vast majority of individuals, including many living with stable chronic health conditions, running can be pursued safely and beneficially when approached thoughtfully.2 By seeking appropriate medical guidance when indicated, embracing gradual progression, listening attentively to bodily feedback, and individualizing the training approach, individuals can mitigate risks and maximize their potential to enjoy the long-term health rewards of a running journey.

Works cited

  1. Physical Activity Guidelines - ACSM, accessed on April 26, 2025, https://acsm.org/education-resources/trending-topics-resources/physical-activity-guidelines/
  2. acsms-complete-guide-fitness-health-sample-download.pdf, accessed on April 26, 2025, https://acsm.org/wp-content/uploads/2025/01/acsms-complete-guide-fitness-health-sample-download.pdf
  3. World Health Organization 2020 guidelines on physical activity and sedentary behaviour - PMC - PubMed Central, accessed on April 26, 2025, https://pmc.ncbi.nlm.nih.gov/articles/PMC7719906/
  4. Physical activity - World Health Organization (WHO), accessed on April 26, 2025, https://www.who.int/news-room/fact-sheets/detail/physical-activity
  5. Physical Activity Guidelines for Americans, 2nd edition - Office of the Assistant Secretary for Health, accessed on April 26, 2025, https://health.gov/sites/default/files/2019-09/Physical_Activity_Guidelines_2nd_edition.pdf
  6. ACSM's General Exercise Guidelines - East Tennessee State University, accessed on April 26, 2025, https://www.etsu.edu/exercise-is-medicine/guidelines.php
  7. Physical Activity and Exercise Prescription - Physiopedia, accessed on April 26, 2025, https://www.physio-pedia.com/Physical_Activity_and_Exercise_Prescription
  8. 4 General Principles of Exercise Prescription - Centre for Health Protection, accessed on April 26, 2025, https://www.chp.gov.hk/archive/epp/files/DoctorsHanbook_ch4.pdf
  9. World Health Organization 2020 guidelines on physical activity and sedentary behaviour | British Journal of Sports Medicine, accessed on April 26, 2025, https://bjsm.bmj.com/content/54/24/1451
  10. Preparticipation Screening Prior to Physical Activity in Community Lifestyle Interventions - PMC, accessed on April 26, 2025, https://pmc.ncbi.nlm.nih.gov/articles/PMC6411298/
  11. National Athletic Trainers' Association Position Statement: Preparticipation Physical Examinations and Disqualifying Conditions | NATA, accessed on April 26, 2025, https://www.nata.org/sites/default/files/preparticipation_physical_examinations_and_disqualifying_conditions.pdf
  12. Exercising Your Way to Lowering Your Blood Pressure | ACSM, accessed on April 26, 2025, https://acsm.org/wp-content/uploads/2025/02/Exercising-Your-Way-to-Lowering-Your-Blood-Pressure-handout.pdf
  13. Updating ACSM_s Recommendations for Exercise Preparticipation Health Screening - Newcastle Sports Medicine, accessed on April 26, 2025, https://newcastlesportsmedicine.com.au/wp-content/uploads/2019/06/Updating_ACSM_s_Recommendations_for_Exercise.28.pdf
  14. Price, OJ and Tsakirides, C and Gray, M and Stavropoulos-Kalinoglou, A (2018) ACSM pre- participation health screening, accessed on April 26, 2025, https://eprints.leedsbeckett.ac.uk/5566/1/ACSMPre-participationHealthScreeningGuidelinesAM-PRICE.pdf
  15. Recommendations for Preparticipation Screening and the Assessment of Cardiovascular Disease in Masters Athletes | Circulation - American Heart Association Journals, accessed on April 26, 2025, https://www.ahajournals.org/doi/10.1161/01.CIR.103.2.327
  16. Certified™: February 2018 - New Preparticipation Guidelines Remove Barriers to Exercise - ACE, accessed on April 26, 2025, https://www.acefitness.org/continuing-education/certified/february-2018/6898/new-preparticipation-guidelines-remove-barriers-to-exercise/
  17. What Are The Contraindications To Exercise? - Breeze Academy, accessed on April 26, 2025, https://breeze.academy/blog/what-are-the-contraindications-to-exercise/
  18. Cardiopulmonary Exercise Testing - StatPearls - NCBI Bookshelf, accessed on April 26, 2025, https://www.ncbi.nlm.nih.gov/books/NBK557886/
  19. Exercise Training in Heart Failure Patients With Persistent Atrial Fibrillation: a Practical Approach - PMC - PubMed Central, accessed on April 26, 2025, https://pmc.ncbi.nlm.nih.gov/articles/PMC6125706/
  20. Running Injuries > Fact Sheets > Yale Medicine, accessed on April 26, 2025, https://www.yalemedicine.org/conditions/running-injury
  21. (PDF) Prevention of Running Injuries - ResearchGate, accessed on April 26, 2025, https://www.researchgate.net/publication/44593092_Prevention_of_Running_Injuries
  22. Pre-Participation Screening: The Use of Fundamental Movements as an Assessment of Function – Part 1 - PMC - PubMed Central, accessed on April 26, 2025, https://pmc.ncbi.nlm.nih.gov/articles/PMC2953313/
  23. WHO Releases New Guidelines on Physical Activity and Sedentary Behavior - ACE Fitness, accessed on April 26, 2025, https://www.acefitness.org/resources/pros/expert-articles/7751/who-releases-new-guidelines-on-physical-activity-and-sedentary-behavior/
  24. Guidelines for Physical Activity during Pregnancy: Comparisons From Around the World - PMC, accessed on April 26, 2025, https://pmc.ncbi.nlm.nih.gov/articles/PMC4206837/
  25. Exercise in Pregnancy: Guidelines - PubMed, accessed on April 26, 2025, https://pubmed.ncbi.nlm.nih.gov/27398880/
  26. Why can't I exercise during pregnancy? Time to revisit medical 'absolute' and 'relative' contraindications: systematic review of evidence of harm and a call to action - PubMed, accessed on April 26, 2025, https://pubmed.ncbi.nlm.nih.gov/32513676/
  27. Modify, don't stop! Time to reconsider the 'relative' and 'absolute' contraindications to physical activity in pregnancy: an opinion piece - PubMed, accessed on April 26, 2025, https://pubmed.ncbi.nlm.nih.gov/34455691/
  28. Pre-exercise screening and prescription guidelines for cancer patients - PubMed Central, accessed on April 26, 2025, https://pmc.ncbi.nlm.nih.gov/articles/PMC3615547/
  29. Health care professionals' understanding of contraindications for physical activity advice in the setting of stem cell transplantation - PMC, accessed on April 26, 2025, https://pmc.ncbi.nlm.nih.gov/articles/PMC9420674/
  30. Evidence-based risk assessment and recommendations for physical activity clearance: cancer - PubMed, accessed on April 26, 2025, https://pubmed.ncbi.nlm.nih.gov/21800938/
  31. Prescribing Physical Activity: Applying the ACSM Protocols for Exercise Type, Intensity, and Duration Across 3 Training Frequenc - FCT Unesp, accessed on April 26, 2025, https://www.fct.unesp.br/Home/Pesquisa/labsim/prescribing-physical-activity-applying-the-acsm-protocols-for-exercise-type-intensity-and-duration.pdf
  32. Physical Activity Guidelines for Older Adults - AAFP, accessed on April 26, 2025, https://www.aafp.org/pubs/afp/issues/2010/0101/p55.html
  33. What doctors wish patients knew about healthy running | American Medical Association, accessed on April 26, 2025, https://www.ama-assn.org/delivering-care/public-health/what-doctors-wish-patients-knew-about-healthy-running
  34. What Do Recreational Runners Think About Risk Factors for Running Injuries? A Descriptive Study of Their Beliefs and Opinions - jospt, accessed on April 26, 2025, https://www.jospt.org/doi/10.2519/jospt.2014.5710
  35. RECOMMENDATIONS - WHO Guidelines on Physical Activity and Sedentary Behaviour - NCBI Bookshelf, accessed on April 26, 2025, https://www.ncbi.nlm.nih.gov/books/NBK566046/
  36. Injury Prevention and Running With Health Concerns - Verywell Fit, accessed on April 26, 2025, https://www.verywellfit.com/running-injury-prevention-4157122
  37. Is it possible to prevent running-related injuries? - BJSM blog - social media's leading SEM voice, accessed on April 26, 2025, https://blogs.bmj.com/bjsm/2024/09/02/is-it-possible-to-prevent-running-related-injuries/
Follow us and stay up to date