The concern underlying this oft-repeated statement is that there are rare cases where a person can die suddenly during exercise. When this happens, it’s usually in a person who (a) had some kind of underlying medical issue; (b) was not used to exercising; and (c) did very intense exercise that they were unprepared for.
While it sounds like a good idea, the screening got out of hand. One of the most common screening tools was a questionnaire that would ask about your own health as well as things like how old you were, whether you had smoked, and whether you were overweight. One study from 2014 found that it would flag more than 90% of middle-aged and older adults. In other words, these are people who wouldn’t be permitted to exercise until and unless they got a medical clearance.
The American College of Sports Medicine did a deeper dive into the numbers, and found that the risks they were screening for were very common; the outcomes they were trying to prevent were very rare (one sudden cardiac death per 1.5 million vigorous workouts, in one study), and screening people based on risk factors didn’t actually seem to reduce the number of people dying during exercise.
How to know if you’re one of the people who really should check with a doctor before exercise
How much you exercise currently
How intensely you would like to exercise
Even if you have one of these health conditions, you can usually exercise if you’ve gotten clearance from your doctor in the last 12 months (and your condition hasn’t worsened since then), or if you already exercise regularly and you just want to continue at the same level. There is a flowchart here to walk you through the question of whether you need medical clearance.
Compared to the old guidelines, the proportion of people over 40 who need to get medical clearance before exercise has been cut almost in half. And as part of the same guidelines, the doctor’s visit itself will probably be a lot simpler. Specific tests are no longer recommended; what happens at that visit is up to your provider and their clinical judgment.
So, yes, some people do still need to check with a doctor before starting an exercise program. But it’s nowhere near everybody. Most people can get started right away, and even people with medical conditions will likely be told that there is some kind of exercise they can do.
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