Bowls: A Heart-Healthy Guide for People with Cardiac Conditions

“Small steps, done steadily, become big wins.” — Anonymous

Quick take

• Bowls (lawn, indoor, or even tenpin) is sociable, low-impact, and adaptable. Great for balance, gentle strength, confidence, and overall wellbeing.

• Start after (and alongside) your cardiac rehab team’s guidance. Many people can return soon after a stent/heart attack; after surgery, wait for the breastbone to heal as advised.

• Aim for light–moderate effort most of the time (Borg RPE 9–13; occasionally 12–14). Use longer warm-ups and cool-downs.

• Stop if you feel chest pain, palpitations, dizziness, or light-headedness. If symptoms don’t settle promptly with rest and/or GTN, seek medical help.

What counts as bowls?

Bowls includes traditional lawn bowls, indoor bowls, and tenpin bowling. All share similar movement patterns: gentle walking, bending, and a controlled lunge or release. The sport is inclusive—most people, across ages and abilities, can take part with sensible adaptation.

Why bowls is good for your heart (and mind)

• Sociable and fun—great for mood, routine, and confidence.

• Builds balance and gentle lower-body strength (lunge, bend, weight-transfer).

• Supports overall wellbeing and a sustainable active lifestyle.

When can I start?

Tell your cardiac rehab team you want to play bowls; they can tailor exercises to practice lunging and bending safely. Timing depends on your current fitness and general health. Many can restart fairly soon after a stent/heart attack, but after cardiac surgery you’ll usually need to wait for the sternum to heal—your clinician will advise the “all-clear.”

How hard should it feel? (Borg 6–20)

Use the Borg RPE 6–20 scale to guide intensity. Most sessions should feel light to moderate (RPE 9–13): breathing deeper but still able to talk. Short match-style practices may reach RPE 12–14 if you’re ready. If you feel extremely tired afterwards, you likely did too much—shorten the session, add rests, or bowl alternate ends. Keep your feet moving in breaks (march on the spot, gentle foot taps) and avoid stopping suddenly to reduce dizziness.

Getting started safely

• Rehearse the movements. Practice comfortable lunges and bending at home before play.

• Start lighter. Begin with smaller/lighter bowls or balls; only progress once your muscles feel fine the next day.

• “Low and slow.” Build gradually—short social roll-ups before full matches. Consider a club open day to reduce pressure.

Warm-up and cool-down (your safety buffer)

Spend the first 5–15 minutes moving at easy pace: gentle walk around the green, light bends and lunges, shoulder mobility. Finish with 5–10 minutes easy walking and relaxed breathing. Longer sessions call for longer warm-ups/cool-downs. If practical, park a bit further away and walk in.

Technique and pacing tips

• Shorten the lunge depth until confident; aim for smooth, controlled releases.

• Share ends or bowl alternate ends to build stamina without over-fatiguing.

• Footwear with good grip and a stable base helps balance and joint comfort.

• Between ends, keep gently mobile rather than standing still.

“Move well, then move more.” — Unknown

Symptoms—when to stop

Stop immediately if you notice chest discomfort, palpitations, dizziness, or light-headedness. Rest. If symptoms don’t resolve promptly (and/or after GTN if prescribed), seek medical advice urgently.

Equipment, joints, and accessibility

• Joint or mobility issues? Explore disability bowls associations and adapted equipment (e.g., ball grabbers/releasers). A small adjustment can make a big difference.

• Practicalities: play only when you feel well; avoid large meals right before exercise; bring water; mind the gutter.

A gentle 8–12 week progression (template)

Weeks 1–2 — Rehearse and roll

1–2 sessions/week. 30–40 minutes total. Warm-up walk + 10–15 easy ends using lighter bowls if available. RPE 9–11. Practice smooth bending/lunging. Long cool-down.

Weeks 3–4 — Build rhythm

2 sessions/week. 40–50 minutes. Standard bowls. Mix of practice and short social ends. RPE 10–12. Add “alternate ends” if you tire.

Weeks 5–8 — Add challenge, keep control

2–3 sessions/week. 50–60 minutes. Simple match formats or small groups. RPE mostly 11–13, brief spells at 12–14 if you’re coping well. Prioritise form and balance.

Weeks 9–12 — Consolidate and personalise

3 sessions/week as desired. Match play or club roll-ups. Mostly RPE 11–13. Keep warm-ups long, sprinkle in recovery ends, and monitor next-day energy. Deload a week if you feel persistently fatigued.

Special situations

• After cardiac surgery: wait for sternal healing guidance from your clinical team before resuming bowling movements (especially bending/lunging).

• Medications: beta-blockers can blunt heart-rate response—use Borg RPE to steer effort.

• Diabetes: carry hypo treatment, check glucose around sessions, and avoid skipping meals.

• Blood pressure: longer warm-ups/cool-downs help; rise from bends slowly to avoid light-headedness.

Safety checklist before each session

• Feeling well today? No new/worsening symptoms.

• Warm-up planned for at least 5–10 minutes.

• RPE target in mind (9–13).

• Hydration ready; not straight after a large meal.

• Plan to keep gently moving during any rests.

• Know your stop-signs and what to do if they appear.

“Consistency beats intensity when it comes to heart health.” — Anonymous

Important note

This guide complements—not replaces—advice from your doctor and cardiac rehab team, who know your condition best.

FAQs

• Is bowls safe after a heart attack or stent?

Usually yes, once your clinician or cardiac rehab team says you’re ready. Start with short, social roll-ups at light effort (Borg RPE 9–11), build gradually, and extend your warm-up and cool-down.

• How soon after heart surgery can I play?

Wait until your team confirms sternal healing and gives you the all-clear for bending/lunging and lifting. Begin with gentle technique practice and shallow lunges before full games.

• What intensity should I aim for? (Borg 6–20)

Most sessions should feel light–moderate (RPE 9–13). Brief spells at 12–14 are fine if you’re coping well. If you feel wiped out later that day or the next, scale back duration or take more rest ends.

• I’m on beta-blockers—how do I pace myself?

Use Borg RPE rather than heart-rate targets (beta-blockers blunt HR). Keep talk-test comfortable and avoid sudden bursts.

• Is the lunge safe for my joints or back?

Yes with good control and gradual depth. Shorten the step, keep the chest tall, and avoid twisting while bending. Use supportive footwear and consider a light knee sleeve if joints feel sensitive.

• Can I play if I have angina, AF, or on blood thinners?

Often yes—with individual advice. Carry GTN if prescribed, know your triggers, and stop if symptoms appear. On anticoagulants, minimise trip risks (good footwear, tidy mat/area) and avoid overly heavy lifting.

• Indoor vs outdoor—does weather matter?

Extreme heat or cold can add strain. In heat, hydrate, shade rest, and reduce duration; in cold, extend warm-ups and layer clothing. Choose indoor bowls on very hot/cold or windy days.

• How long should a session be at first?

Aim for 30–40 minutes total in Week 1–2 (including warm-up/cool-down), then build toward 50–60 minutes over several weeks as tolerated. Take “alternate ends” or sit a turn out if you tire.

• What symptoms mean stop now?

Chest pain/pressure, unusual breathlessness, palpitations, dizziness, or light-headedness. Rest immediately. Use GTN if prescribed. If symptoms don’t settle promptly, seek medical help.

• Do I need special equipment or adaptations?

Not usually. If bending is hard, consider approved bowls arms/ball releasers or a light reacher. Many clubs can advise on inclusive equipment and technique tweaks.

• How do I progress safely?

Increase only one thing at a time—either duration, number of ends, or lunge depth. Keep most sessions at RPE 9–13, review next-day energy/soreness, and add a lighter “recovery” roll-up each week.

• What else complements bowls for heart health?

Add two short strength sessions weekly (e.g., sit-to-stands, wall push-ups, rows), daily walks, and simple balance drills. These improve stability, endurance, and confidence on the mat.

• Any tips for diabetes or high blood pressure?

For diabetes, time sessions away from insulin peaks, carry hypo treatment, and check levels if needed. For BP, rise slowly from bends, avoid breath-holding (exhale on effort), and prioritise longer cool-downs.

• Can I practice at home?

Yes—rehearse shallow lunges, hip hinges, gentle trunk turns, and accuracy drills with a soft ball. Keep reps smooth and pain-free, focusing on balance and control.

References and further reading

• Association of Chartered Physiotherapists in Cardiovascular Rehabilitation (ACPICR). Bowls — A guide for people with heart conditions (Due for review 2027).

This blog post was written by Jamie Pickett, Clinical Exercise Physiologist, with AI assistance.