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The Best Exercises for Heart Failure

Reviewed by Brunilda Nazario, MD on December 18, 2020

Your heart is your body’s most important muscle. Like all of the others, it needs exercise. That’s true even when you have heart failure.

In most cases, light to moderate exercise isn’t going to make your condition worse. In fact, it’s not only safe, it’s the best medicine, says Suzanne Steinbaum, DO, an American Heart Association Go Red for Women volunteer medical expert and cardiologist in New York City.

It slows your heart rate, opens your arteries, and improves the way your heart works, she says. This means less shortness of breath and less time spent in the hospital -- and possibly a longer life.

Exercise can help you do the activities you love, Steinbaum adds.

The key is to do it smartly to keep your ticker as strong as it can be. Ask your doctor which activities are safe for you and how much you should do, says Brittany Ferri, MS, OTR/L, an occupational therapist in Rochester, NY.

These 3 Types Can Make Heart Stronger

Isaac Gonzalez, 38, knows the power of exercise, along with eating well and sticking to medications. The California man lives with heart failure because of a problem he was born with. Gonzalez stretches and does pull-ups every morning before heading to work.

Stretching gets his blood moving and keeps him flexible for his job working with high-voltage electrical cables, so he protects himself from injury.

A good goal for most people is at least 30 minutes a day of activity on most days of the week, Steinbaum says.

Three types of exercise work together to make your heart and body stronger.

Flexibility. These workouts can improve balance, loosen your joints, and help with range of motion. Exercises like yoga use meditation, breathing exercises, and slow movements. This adds flexibility, improves breathing, and lessens stress.

The ancient Chinese practice of tai chi is often called meditation in motion. It uses slow dance-like movements that can lower blood pressure, ease stress, and give you more energy. One study of people with heart failure found that it improved their quality of life.

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Cardio (cardiovascular). Regular cardio exercise strengthens the heart muscle and gets your blood moving to improve circulation. Here’s how to get started:

  • Put one foot in front of the other. Go for a walk to help your heart. If you’re new to exercise or if your doctor says to go slow, do it for just 10 minutes or so, and keep it light. A good rule of thumb: You should be able to carry on a conversation comfortably while you walk. Add a few minutes at a time as you get used to exercise. You don’t have to bite off a half-hour of nonstop movement. You may be able to handle short blocks of activity several times a day easier than one long exercise session.
  • Do something you enjoy. Bike, dance, swim, garden, or bowl -- they’re all heart-healthy, according to Steinbaum. If you choose something you love, you’re more likely to stick with it, and it becomes a habit and part of your routine. That’s a key to success, Ferri says.

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Strength. This kind of exercise uses repeated muscle movement until the specific one you’re working gets tired. Strength training tones your muscles and builds stronger bones, too. You may even lose weight, because built-up muscles burn more calories. Resistance bands and light weights can help with strength training. But people with heart failure need to be extra careful with this kind of exercise. Ask your doctor for guidance. They may tell you not to lift anything over a certain weight.

Don’t skip 5-minute warm-ups and cool-downs before and after the active period of exercise. “Warm-up could be simple stretches of the arms, legs, and back, or some basic tai chi or yoga poses,” Ferri says. This can prevent sore muscles and lessens stress on your heart.

Afterward, cool down by doing stretches similar to those you did to warm up. This helps your heart and breathing rate return to normal. Don’t sit down too fast without a cool-down. Your heart rate may go up, or you could get dizzy or have other unsafe symptoms.

You might enjoy group fitness classes because they can help you to stick to a routine. But they don’t allow much wiggle room, since they’re usually “one size fits all.” They may not meet your individual needs for rest or water breaks, Ferri adds.

Exercise Caution

Ideally, people with heart failure should start exercise in a safe hospital program before they start a home-based program on their own, Steinbaum says. People who have just been diagnosed and are in early stages of the condition can usually handle more exercise than someone with severe heart failure. But this isn’t always the case, Ferri says. So it’s important that you’re watched every step of the way. This includes checking vital signs such as heart rate, blood oxygen levels, blood pressure, and how many breaths you take each minute (respiratory rate).

It’s important to tell your doctor about symptoms like severe tiredness, dizziness, or shortness of breath. If an activity is painful, don’t do it. Of course, if you have chest pain, stop and call your doctor or 911.

Slight symptoms are normal and shouldn’t keep you from exercising. They should go away once you build strength and energy.

Take Little Bites

Gonzalez understands that it can be tough to get off the sofa or bed when you have low energy or other symptoms of heart failure. His advice: First, eat heart-healthy foods to give yourself the energy to move, and then start exercise slowly. “Take it in little bites. Don’t try to eat the whole cake at once.” Move your arms and legs while sitting down, if that’s all you can do. Eventually, stretch or take short walks outside.

“The most important thing is to love yourself. Your body is your temple, and if you take care of it, your body will start healing itself.”

WebMD Feature

Sources

SOURCES:

Suzanne Steinbaum DO, American Heart Association Go Red for Women volunteer medical expert and cardiologist in New York City.

Brittany Ferri, MS, OTR/L, and occupational therapist in Rochester, NY.

Cleveland Clinic: “Heart Failure: Exercise.”

The Mayo Clinic: “Tai chi: A Gentle Way to Fight Stress.”

ESC Heart Failure: “Exercise and Heart Failure: An Update.”

University of Iowa Hospitals and Clinics: “Activity and Exercise for Patients with Heart Failure.”

Isaac Gonzalez, heart failure patient from California.

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