Competitive squash/strenous exercise

[rob drent]

I am 40, a competitive squash player playing around 5 times a week for an hour a time. I have received an initial diagnosis of HCM after a treadmill test. I showed no symptoms of heart disease, but while other tests are planned I fear I will be advised by my specialist to give up playing squash. Are there any other people out there who have continued strenuous exercise with HCM?

[Sarah]

Re: Competitive squash/strenous exercise

Dear Rob,

Your instincts are right. The official position is NO competitive sports. But, seriously, stop-start type of workouts seem to be particularly hazardous for HCMers (basketball leaps to mind) -competitive or not. One 26-year old dropped during a pick up game in a friends' driveway.

You should look into other types of workouts that are more fluid, lower impact.

Please use the search engine to review other posts on sports and you will find a wealth of info and opinions.

Since you are new to HCM, please understand that is a highly individual disease. Everyone's version is their own. The expression of HCM ranges from minor inconvenience to needing a new heart. So while we can offer you tips, hints, research, support, and help finding a specialist (which is absolutely essential), the final authority is your own body. It will tell you what you need to know if you listen carefully.

Please call the office at 973-983-7429 to talk to Lisa. HCM is not well understood and there is still a lot of outdated info kicking around the local cardiologists office (even the good ones), so please talk to her about seeing a specialist. (We don't do referrals over the board as it is too complicated and individualized.)

Take care and don't forget to read the rest of the site, not just the board. And your kids and parents and siblings all need echos, too. Be sure to have any uninsured folks stock up before going to the doctor.

S

[Lisa Salberg]

Re: Competitive squash/strenous exercise

You are participating in a VERY strenuous activity, I would advise you NOT continue at this time. This activity can place you at an elevated risk for adverse events. You need to get your entire condition assessed and THEN make choices as to what activites are appropriate for you.
Call me in the office if you have any questions.
Lisa

[Pat]

Re: Competitive squash/strenous exercise

Rob,

It seems strange to me that you have been given a diagnosis of HCM based on a treadmill test. Have you had other tests, particularly an echocardiogram? The echo is critical to diagnosis of HCM because in the echo the specialists can image and measure the heart muscle as well as the blood flow through the heart.

Most of us on the board have really benefitted from finding a cardiologist with specialized knowledge in HCM. Do contact Lisa on Tuesday and talk with her about your options.

And, yes, unless you have an "all clear" from your cardiologists, strenuous sports like squash are a BAD idea. Take care of you!

Pat

[Tommy Mac]

Re: Competitive squash/strenous exercise

Not that it's necessary, but here's another vote for NO competitive sports. My doc says no. The world's leading experts say no. It's for your own safety. I had to give up my passion which was competitive volleyball. It's not somethign that is easy to do but for me I just looked at my wife and daughters and saw reason to play it safe.

Good luck to you!

[Darren1]

Re: Competitive squash/strenous exercise

Wow.. isn't that a hard choice to make? I used to play raquetball competitively and it was difficult to accept that I shouldn't anymore. My choice has been to cut back on the raquetball and re-focus my energy on a bit less "dangerous" activity - skydiving (just kidding)... but really, I have cut back on raquetball and now hike more often than I used to. The whole problem with HCM is that no one KNOWS much about it.. they can't predict if you will have a sudden death episode, they can't tell you how much physical activity is ok.. it is a tough place to be. Pro atheletes with HCM play for decades (and stress their hearts like crazy) and then one day drop dead without any apparent warning. Personally, I choose to live life (with a bit more caution) and do what I normally would do. Of course, my HCM is not too extreme (according to the doctors) and I have no symptoms. And I have slowed down some because I do want to live to see my kids grow up and enjoy my "golden years" with my wife. Definetly talk with your doctor and then with another specialist before getting back in the court.

[mtlieb]

Re: Competitive squash/strenous exercise

Hi All,

I agree, it is a hard choice to make! I don't play any competitive sports, but i've had to give up a wonderful career working outdoors because of my HCM, even though i've been doing it for a heck of a lot of years and haven't dropped dead yet

But ya know, maybe i've just been really really lucky...

Jim

[elliekev26]

Re: Competitive squash/strenous exercise

Hi everyone--

I have been looking for some guidance on the issue of competitive sports and HCM for some time. It seems the consensus is no competitive sports, although I often come across articles about college and pro athletes continuing their careers, some with defibullators.

I am 38, diagnosed at 33 with mild HCM. Sports was my passion b/4 HCM; I played squash & basketball regularly (3-4 x week) and ran a marathon 2 years before my diagnosis. I still haven't fully accepted the limitation of no competitive sports, but I too have a family and have followed my cardiologist's instructions. He told me that I could exercise to the point of slight breathlessness, although I find that to be a difficult standard to gauge. He was clear about no competitive sports, although he mentioned that there is some research that may indicate that patients with the mildest HCM conditon (no symptoms, no family history, echo shows only mild enlargement) may have no increased risk of sudden death over the general population. Unfortunately, he believed that it may be years before the research becomes relevant to recommendations to such patients.

My cardiologist advised me that Dr. Barry Maron in Indianapolis is the leading expert in this area of HCM. I hope to get out to see him some day but other priorities prevail at present.

In short, I agree that the only safe way to proceed right now is to avoid competitive sports, although I am hopeful that one day the research will lead to a better understanding the risks that apply to the different classes of HCM patients.

Kevin

[Sarah]

Re: Competitive squash/strenous exercise

Just a clarification, Dr. Maron is in Minneapolis at the Minneapolis Heart Institute. He son, Dr. Martin Maron, is in Boston at the TUfts-New England Medical Center. Links to both are on the links page.

The Cleveland Clinic and the Mayo are both excellent HCM centers, too. And St. Lukes in NY isn't too shabby either. -Just in case MN is hard for you to get to.

take care,

S

[mdolls68]

Re: Competitive squash/strenous exercise

I haven't posted in awhile, but I am an avid racquetball player and have played for years. I've also been heavily into weight lifting, running, cycling, all sorts of aerobic classes, kickboxing, yoga, pilates, basketball, volleyball. I've been doing most of these for years and fairly intensely. It wasn't until around May'03 that they found I had hypertrophy of the heart.

As I read and studied up on it, I was discouraged regarding the HCM and what I couldn't do from what others were suggesting. Come to find out in Jun'03 that I do not have HCM, rather Left Ventricular Hypertrophy (LVH), which is also hypertrophy of the heart, rather induced by exercise (one of the causes). This condition is reversible, unlike HCM. I'm just wondering if others my have LVH instead of HCM and not know it. HCM is worse. I asked my cardiologist why I did not have HCM and LVH and she gave me this super lengthy explanation that I can't really remember. All I know is that I am relieved.

I really had no symptoms that I had a heart issue. My cardiologist told me to lay off the weight lifting until after my pregnancy (I'm due at the end of Sep). At that point, I'll have to find a trainer that knows this heart issue to help me better train.

Anyway, this is another avenue for others to look into.

~Doris

[Lisa Salberg]

Re: Competitive squash/strenous exercise

LVH has many causes - high blood pressure is one and excerise is another. If you have Hi b/p getting your B/P under control the LVH can go away likewise if you "decondition" aka stop working out this too may regress the hypertrophy. It is not very common for a woman to have LVH from excersise - it is make more a male issue - the Hi b/p issue is an equal opportunity offender!
HCM is not simply LVH - as it is a genetic flaw it is a more complicated process.
I really do hope that the LVH in NOT HCM. Best of luck with the baby!

Lisa

[mdolls68]

Re: Competitive squash/strenous exercise

Lisa,

Thank you and yes you are correct on both accounts. Although LVH occurs more in males, it can still happen to women. We'll no more later, so I won't comment further until I truly know it is that I have and not HCM. Most women I know do not train as heavily as I have, nor, do they work in a predominantly male profession.

Anyway, although I do not like the rest I'm having to do over these months, it's better to find out this way than some other ways I can think of.

Thanks,
Doris

[mtlieb]

Re: Competitive squash/strenous exercise

I'm really confused, so somebody please explain it to me, what is the difference between LVH and HCM? Thanks!

[mdolls68]

Re: Competitive squash/strenous exercise

Sorry, I have not been on here for a little bit. LVH is reversible. It is a form of hypertrophy of the heart which can be caused by exercise and high blood pressure.

HCM is genetic and not reversible. As far as I know.

[Sarah]

Re: Competitive squash/strenous exercise

The main differences are that LVH is caused by over-training, high blood pressure, etc, etc and the heart muscle tissue is normal, but has thickened due to over-work.

HCM is due to a genetic mutation that causes the heart muscle tissue to be crumpled up and disorganized, which then causes the left ventricle and/or the septum to get thick. This is not reversible.

When you have HCM, left ventricular hypertrophy is a symptom of your disease. When you have LVH, it is your disease.

How do you know what which you have? See your cardiologist, get an echo. If you work out and pump iron, "deconditioning" should restore the heart to normal. If you have HCM, you are probably not over-training in the first place, but if you are, stopping won't make a difference in your echo measurements.

take care,
S