Golf: An Activity-Specific Guide for People with Heart Conditions

James Pickett
Aug 21
5 min read

Professional, friendly guidance to help you enjoy golf safely—whether you’re returning after a cardiac event or starting fresh.

Is golf right for me?

For most people with heart conditions, golf can be a safe, enjoyable way to stay active: it’s low-impact, social, and naturally encourages walking in green spaces. Before you begin (or return), check in with your cardiac rehabilitation (CR) professional to tailor advice to your condition and medications.

If you’ve had open-heart surgery, wait ~12 weeks before full swings; you can usually walk the course and putt from 4–6 weeks. If you have a pacemaker/ICD, typical guidance is to limit overhead/forceful arm movements for ~6 weeks to protect the leads—then build back gradually.

Why golf helps your heart

Cardiovascular fitness & stamina through steady walking over varied terrain. A 9-hole round often means 2–3 miles and >5,000 steps; 18 holes is commonly around 5 miles.

Strength & mobility: repeated squats/lifts for tees and balls, shoulder/trunk rotation, hill walking—great for legs, hips and core.

Balance & coordination: stance, weight transfer and uneven ground challenge proprioception.

Mental health: being outdoors and social can reduce stress and improve wellbeing; golfers in a large Swedish cohort had ~40% lower mortality, consistent with ~5 extra years’ life expectancy (observational data; lifestyle confounders may contribute).

Intensity that suits recovery: golf typically provides light-to-moderate intensity; carrying/pulling clubs increases effort, buggies decrease it. (Approximate METs: carrying ~4.3, pulling ~5.3, power cart ~3.5, driving range ~3.0.)

“Success is the sum of small efforts—repeated day in and day out.” —Robert Collier

Safety first: red flags & pacing

Stop and rest if you develop chest discomfort, palpitations, unusual breathlessness, dizziness or light-headedness. If symptoms do not resolve promptly with rest and/or prescribed GTN, seek medical advice.

Heat & cold: In hot weather, reduce intensity, hydrate generously, avoid peak sun, and consider earlier/later tee times. In very cold or windy conditions, shorten play and dress in layers; cold can raise cardiovascular strain.

“It does not matter how slowly you go as long as you do not stop.” —Confucius

How hard should it feel?

Talk test: aim for moderate intensity—you can talk but not sing during walking between shots.

Heart-rate guidance (when used): early CR often targets <40% HRR progressing to ~70–75% HRR as tolerated, typically RPE 11–14/20. Stay ≥10 bpm below any known ischemic/angina threshold. (Use HR only if it’s part of your CR plan and medications are considered.)

“The more I practice, the luckier I get.” —Gary Player

Getting started (and returning) step-by-step

Build your base walking: regular walks on mixed terrain; add gentle inclines. Work up toward your course distance.
Start on the range & putting green: use half swings, then increase length and speed gradually. Begin with shorter or flatter courses or fewer holes.
Choose your carry method:
- Electric trolley or push-trolley to reduce load at first.
- Carry only when ready (it increases effort).
- Buggies are fine as an accessibility aid; aim to walk more as fitness improves.
Pace of play: don’t let others push your speed—rest as needed; pair with players at similar pace/ability.
Pacemaker/ICD specifics: in early weeks, avoid forceful/overhead swings on the implant side; reintroduce gradually after your team clears you.

“You don’t have to be great to start, but you have to start to be great.” —Zig Ziglar

Warm-up (5–10 minutes) & cool-down (5–10 minutes)

Warm-up:

Easy walk from car park, shoulder circles, thoracic rotations, hip hinges, gentle practice swings without a club, then with a wedge.

Cool-down:

Slow walk to finish; calf/quad/hamstring stretches; deep, relaxed breathing until HR and breathing settle.

Technique & load management tips

Shorten the backswing at first; focus on rhythm and balance.

Use more loft/one more club to reduce strain.

Avoid breath-holding on lifts or tricky shots; exhale on effort.

Mind the lifts: consider fewer clubs or lighter bag; hinge at hips and bend knees to pick up tees/balls.

Sample progression plans

Phase 1 (Weeks 1–2 of return):

Range + short game (30–45 min), RPE 10–12, half swings; walking 20–30 min on flat ground on non-golf days.

Phase 2 (Weeks 3–4):

Par-3/9-hole round on a flat course, optional trolley/buggy; walking breaks between shots; target talk-test moderate.

Phase 3 (Weeks 5–8):

9–18 holes depending on recovery; hills as tolerated; consider carrying for segments; build to 150+ minutes/week of moderate activity overall.

(If you’ve had surgery or device implantation, align phases with your clinician’s timeline; e.g., full swings often from ~12 weeks post-sternotomy.)

Weather, clothing & kit

Hot days: earlier tee time, shade, fluids, light/loose clothing; avoid peak heat.

Cold/windy: layers, windproof outer, warm-up longer; consider shorter rounds.

Footwear: grippy shoes/soft spikes for balance; consider a ball retriever to reduce bending if light-headed after stooping.

FAQs

Can I use a buggy?

Yes—especially early on or on hilly courses. It lowers intensity; try to walk more as fitness improves.

What if I get angina on the course?

Stop, rest, follow your GTN plan. Resume only when fully symptom-free; see your clinician if symptoms persist or change.

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

Use the talk test and RPE 11–14/20; heart-rate zones may read lower than expected.

How much does golf “count” toward my weekly activity target?

Aim for ≥150 minutes/week of moderate activity. Golf that keeps you at a talk-test moderate effort contributes to this total.

When can I swing fully after surgery?

Commonly around 12 weeks, but individual timelines vary—follow your surgical team’s advice.

Quick SMART challenges

This week (Specific & Achievable): Walk your course’s front 3–6 holes at talk-test moderate pace, using a trolley if needed.

This month (Measurable): Log two 9-hole rounds or one 18-hole at comfortable intensity, plus two 20-minute walks on non-golf days.

By 12 weeks (Realistic & Time-bound): Progress to your preferred 9–18-hole format, maintaining RPE 11–14 with steady pacing and full warm-ups.

Helpful tools

Rules & safety: The R&A Rules of Golf app/website for quick rulings and etiquette refreshers.

Self-monitoring: CR-approved heart-rate monitor, pedometer/step counter, or a simple RPE log.

On-course pacing: range/yards apps or your club’s GPS—use to choose smoother swings/club-up, not to chase distance.

Evidence & further reading

Clinical & guideline sources:
- ACPICR Standards for Physical Activity and Exercise in CR (intensity ranges, testing).
- NHS Live Well: what counts as moderate activity (talk test).
- Royal Papworth: return-to-fitness times post cardiac surgery (golf timelines).
- BHF: hot-weather safety with heart conditions; pacemaker early-movement precautions.

Research papers:
- Murray A. et al. BJSM scoping review: golf provides moderate-intensity activity with cardio-metabolic benefits.
- Farahmand B. et al. Scand J Med Sci Sports: Swedish golfers had ~40% lower mortality (observational).
- Ainsworth B. et al. Compendium of Physical Activities: MET values for golf modalities.

Books (friendly, practical reads):
- The Little Book of Big Change (Bond) — gentle habit change strategies for building routines.
- Atomic Habits (Clear) — simple systems to make active choices stick.

Work with My Movement Medicine

If you’d like a personalised return-to-golf plan—including heart-rate targets, pacing, mobility, and strength work—book a one-to-one or join our group sessions. We’ll align your golf goals with safe CR principles and your medical team’s advice.

“A journey of a thousand miles begins with a single step.” —Lao Tzu

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