A Step In The Right Direction! | Outdoor Channel
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A Step In The Right Direction!

By: Frank M. Krakowski, MD

From boonDOCS Medicine

Golf: FORE! Your Health!

There are some golf purists who argue that the only way golf should be played is while walking. Speaking purely from a health perspective, it’s hard to argue with their logic. Walking is a healthy form of exercise. Therefore, walk whenever you can.

On the other hand, golfers with certain physical impairments have virtually no choice. They either ride or give up the game completely.

Then there's the group of people where the decision to ride or walk is slightly blurred, yet, even more crucial—those with or at risk for peripheral arterial disease (PAD). They might want to walk the entire course but cannot do so because of their medical condition. For them, walking is an essential part of their therapy, and the more often they choose to walk, the better they may be able to forestall or even avoid progression of their disease.

PAD is a condition that affects as many as 8-12 million Americans, but only 4 million of them actually have symptoms (in other words, it can be a “silent” disease). It is a systemic vascular condition in which atherosclerosis—the plaque-forming disease that narrows and, eventually, helps to occlude coronary arteries—attacks the arteries that supply blood to the periphery of the body, most notably the legs and arms.

At first, the lack of oxygen (or ischemia) caused by the condition may only produce easily fatigued muscles. Eventually, however, it causes a symptom called intermittent claudication (IC), a severe cramping pain in the calves, thighs, or buttocks, typically made worse by activity and relieved by rest. As PAD progresses, the activity a person can tolerate before symptoms occur gradually decreases and the time needed to rest increases. Because people with symptomatic PAD have a five-year mortality rate of nearly 30%, the condition warrants special attention. The symptoms of PAD are fairly easy to recognize and include:

  • Tiredness or heaviness in the calves, thighs, or buttocks after exercise that takes a prolonged time to clear
  • Aches, pains, or cramps in the same areas brought on by activity and that subside with rest
  • Numbness, tingling, or coldness in the lower legs or feet
  • Weak or absent pulses in the legs
  • Cuts or wounds on the legs or feet that won’t heal

Some of the major risk factors for developing PAD are age greater than 50 years, obesity, elevated cholesterol levels, diabetes, high blood pressure, unstable angina or a prior myocardial infarction (i.e., heart attack), lack of physical activity, smoking, and occurrence in other family members. Also, PAD can be associated with erectile dysfunction. People with risk factors should be screened annually for possible PAD to help prevent, detect, and treat it early.

People experiencing PAD symptoms should visit their physicians to undergo proper testing and to start therapy immediately!

The added importance of recognizing symptoms of PAD is twofold:
1. People with PAD have much higher risks of developing other problems like coronary artery disease, heart attacks, and strokes, and...
2. A well-designed management plan that combines medications with efforts directed at progressively increasing activity tolerance (i.e., walking distances on the golf course) are crucial in improving long-term prognosis.

The bottom line is that there’s a place for both walking and riding when playing golf. If you are able to walk, by all means do so. If you have physical limitations or medical conditions that might worsen with walking or severely limit your round, take a cart and don’t let anyone tell you you’re not playing golf.

If you have PAD (or think you might) discuss with your physician the best way to treat your condition while playing your round by, for example, walking as much as possible but using a cart for backup. Studies have shown that a 3- to 6-month supervised walking program could help to increase pain-free walking times by 165% and peak walking times (i.e., the maximum distance you can walk even with pain) by 96%.

Finally, the rest of us golfers should encourage this “step in the right direction” by being patient with anyone in front of us trying their hardest to combine a little exercise with a round of golf. Who knows? It may be you who, one day, is pushing yourself to be able to enjoy more golf for far more years to come.

And, after all, isn’t that every golfer’s goal?

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