Exercise Risk Questionnaire:
Do You Need a Physician’s Approval Before Exercising?

Determine Your Cardiovascular Risk


If you have any of the following, you fall into the HIGH RISK category and must seek a physician’s approval to exercise along with specific recommendations concerning the type of exercise you are capable of doing. The physician may require you to undergo a medically-supervised exercise stress test to determine if it is safe for you to exercise.

Any of the following places you in the HIGH EXERCISE RISK category:
  • a diagnosis by your doctor of heart condition or disease, diabetes, or disorders of the lung, thyroid, kidney, or liver
  • pain, pressure, or discomfort in your chest, neck, jaw, or arms not explained by injury
  • shortness of breath while resting or exerting yourself mildly
  • dizziness or fainting
  • the need to sit up to breath comfortably
  • swelling of your ankles
  • unusually rapid heart rate or sensation of pounding heart
  • cramping in your calves
  • heart murmur
  • seizures
  • unexplained fatigue
  • symptoms of stroke (sudden loss of ability to speak, see, or move one side of the body)


Each of the following is a risk factor for heart disease. Count only one yes for each numbered item. How many do you have?
  1. Cardiovascular Disease: Has your father, brother or son under age 55, or your mother, sister or daughter under age 65 experienced a heart attack, heart surgery, other serious heart problems or sudden death?
  2. Age: Are you 45 or more years old?
  3. Smoking: Do you currently smoke or have smoked within the past 6 months?
  4. Blood Pressure: Is your systolic blood pressure 140 or higher, your diastolic blood pressure 90 or higher, or are you on medication to control your blood pressure?
  5. Cholesterol Levels: Is your total cholesterol level above 200 mg/dL, your LDL cholesterol level above 130 mg/dL or your HDL cholesterol level lower than 35 mg/dL?
  6. Blood Sugar: Is your fasting blood glucose 110 mg/dL or higher, or are you on medication to control your blood glucose?
  7. Obesity: Calculate your Body Mass Index as 703 times your weight in pounds divided by (your height in inches times your height in inches). Does your BMI exceed 30? Or is your waist at navel level greater than 39 inches?
  8. Physical Inactivity: Are you physically inactive, not engaging in regular exercise?

Add up the total of cardiovascular risk factors you have, no more than one for each numbered item, for a maximum of 8. Determine your cardiovascular risk category as follows:

YOU ARE UNDER AGE 45 WITH ZERO TO ONE RISK FACTOR: You are at LOW cardiovascular exercise risk and can engage in moderate to vigorous aerobic exercise without a physician’s clearance.

YOU ARE AT LEAST AGE 45 OR YOU HAVE TWO OR MORE RISK FACTORS: You are at MODERATE cardiovascular exercise risk and can engage in moderate exercise without a physician’s cardiovascular risk screening, but you should get a physician’s clearance before engaging in vigorous workouts (exercise that is physically challenging and perceived as difficult). The physician may require you to undergo a medically-supervised exercise stress test to determine if it is safe for you to exercise.

Determine Your Musculoskeletal Risk

If you have any of the following musculoskeletal problems you should see a physician before beginning an exercise program to determine what kinds of exercise and the intensity levels are safe for you.

  • neuromuscular disease or disorder
  • unhealed bone, muscle, tendon, or ligament injury
  • healed injury that limits movement
  • paralysis in any limb
  • left-right limb asymmetry in size, strength, or coordination
  • missing fingers, toes, hands, feet, or limbs
  • balance problems
  • vision problems

Play It Safe!

Please note that, even if the above criteria don’t dictate a doctor’s checkup, if you have any doubt about your ability to exercise, a checkup is highly recommended. Men don't generally visit a doctor often enough, which sometimes leads to unnecessary illness or even premature death. So, err on the side of caution and see a physician.

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