Exercises for CHFers Exercising with heart failure
Flexibility and balance
Lifting weights
Resistance training
Endurance training
Exercise equipment
Examples of workouts
Exercise and supplements


Walking is the best way to increase endurance with heart failure. Your body is designed to walk and it's a daily activity for everyone, so getting better at it improves your quality of life. I strongly recommend a motorized treadmill.
     Why not go to the mall to walk? Why not walk around your own neighborhood? Weather is one reason. Walking outside means handling heat, humidity, cold, wind, sun, rain, snow and all the rest. When you're healthy, these don't matter. With heart failure, weather always matters.
     Mall walking is fine. However, you must have reliable daily transportation and you must still deal with weather getting there and back. Also consider what you're going to do with your coat, boots and gloves in cold weather while you're working up a sweat walking inside the mall. 

How long do you walk, how fast, how often? Two things must be considered:
1)  How severe is your heart failure and your other health problems?

  1. Class 4 heart failure patients should not exercise except under direct medical supervision.
  2. Class 3 CHFers should talk to their doctors before starting an exercise program. Your doctor may want you to learn a specific exercise routine from a professional, or he may want you to avoid certain exercises.
  3. Class 2 and class one CHFers should exercise - both resistance training of some kind and endurance training. However, if you also have other health problems, talk to your doctor first.
  4. If you have implanted devices; arrhythmia (abnormal heart rhythm); lung disease or pulmonary hypertension; arthritis; diabetes; or back, knee or hip problems, talk to your doctor about potential dangers before beginning your exercise routine.
  5. If you are more than 25 pounds overweight, begin more slowly and increase your workouts more slowly. Otherwise, you will just get more tired, get frustrated, and give up.

2)  How out of shape are you?

  1. If you have reduced your normal daily activities because of CHF symptoms - and who hasn't - you are more out of shape than you think! If you are frightened of being too active because you have a weak heart, you are even more out of shape.
  2. If you have gained weight from being less active, yes, it's worse yet.

 Let's Get Specific

After my EF went up to 45%, I still felt awful. After 2 years of getting physically fit, I feel much better all the time. Fitness is as necessary as heart function to feel good! For the reasons why to exercise, read this page. This very short page tells you how to handle good days and bad days. I'm not gonna repeat it here.

How often do you walk? Start with every other day, no more. If you can't recover enough this way, walk every third day to start, but no less than that. Over the first 12 months, slowly work this up to walking about 4 out of every 5 days.
     How long do you walk each session? Start with 6 minutes. At 4 walks per week, raise this no more than one minute per every 20 walks up to 14 minutes, and raise it by no less than one minute every 50 walks up to 14 minutes.
     When you reach 14 minutes, needs are different from person to person. Raise your walk time and speed as you think best. However, burnout and not enough recovery can sneak up on you, so increase things cautiously.

How fast do you walk? This depends on how out of shape you are at the start. I suggest starting at a speed of about 2.8 miles per hour if you are class one, 2.5 miles per hour if you are class 2, and 2 miles per hour if you are class 3.
     Raise your speed slowly! This must go up more slowly than walk distance. If you are class one, shoot for a final goal of 4 miles per hour. If you are class 2, also shoot for 4 miles per hour but don't be in any hurry to get there - it took me well over a year to get there starting as class 2 and already in pretty good shape. If you are class 3, shoot for a final walking speed goal of 3 miles per hour. It may take quite awhile to reach this goal.

Speed versus time. Both matter, but time counts a little more. I walk over 30 minutes a day. If I am struggling on a session, I reduce my speed and go for the 30 minutes. For what to do on a bad day, see this page.

Technique Yes, how you walk matters. The key to getting full benefit is to always walk naturally. This means letting your arms swing in a natural rhythm as you walk. Holding onto the side rails does not work the upper body while walking. If you let those arms swing naturally, your shoulders and entire back get worked while your legs are a'walkin! Your lower back and stomach also get a much better workout.

Safety Keep a phone right next to the treadmill - on the floor. Keep one on each side if you have two. If you fall, this puts a 911 call within your reach. Walk in shorts and a short-sleeved shirt - that way you don't catch a pants cuff on a shoe or a shirt sleeve on part of the treadmill, causing a fall.
     Wear the same shoes every session so you are used to them. Try a pair of walking shoes with rounded heels to prevent stumbling. If you are too tired to walk properly, don't walk today! If you have any problems while on the treadmill, always grab the side rails first! Hang on tight, then get off the tread. This prevents a fall.


I never use bicycle machines simply because they make my butt uncomfortable. <g> So I really don't know that much about them. Personally, I believe that walking is more all-body and a more natural movement, thus a better exercise. However, you can definitely get an excellent aerobic workout on a decent cycle machine. The only advice I can give here is to start slowly and increase your effort slowly.


This is another exercise I just don't know very well. I recommend taking a class at your local YMCA first so you know how to do specific routines instead of just trying to swim for a certain amount of time. Water aerobics can be very effective but you will need to adjust the routine because of your heart failure, so you don't overdo it.
     Since in-the-water workouts build both strength and endurance, don't also lift weights. Your muscles will not properly recover and you will just get tired. If you are also lifting weights or doing other resistance training, walking is the best endurance exercise. The main problem with training in the water is the hassle of getting to and from the pool.
     Please do not do this alone - if you hurt yourself or have a heart event during your workout, you could literally drown, and a phone is not usually at hand.


Activity means all the daily motions and physical stresses of every day life. Exercise is a regular, strictly controlled group of physical movements done on a schedule. You need both. In fact, the whole point of exercising with heart failure is to make daily activity easier.
     If you exercise to the point that you can't do your daily activities because your exercises leave you too tired, you are over-exercising. Cut back your exercise routine. A well-planned weight lifting routine can take as little as 20 minutes a day. An endurance routine - once you have built up your physical fitness - is going to take at least 20 minutes four times a week.


All information on this site is opinion only. All concepts, explanations, trials, and studies have been re-written in plain English and may contain errors. I am not a doctor. Use the reference information at the end of each article to search MedLine for more complete and accurate information. All original copyrights apply. No information on this page should be used by any person to affect their medical, physical, legal, educational, social, or psychological treatment in any way. I am not a doctor. This web site and all its pages, graphics, and content copyright © 1997, 1998, 1999, 2000, 2001, 2002, 2003, 2004, 2005 Jon C.

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