Hiking for Heart Health: A Comprehensive Guide

Quick Take on Hiking

Hiking is more than just a walk; it’s a journey through nature. With proper planning, most individuals in cardiac rehabilitation can enjoy hiking safely. Aim for light-to-moderate effort (Borg RPE 9–13). Build up your stamina gradually. Always include longer warm-ups and cool-downs in your routine.

What Counts as Hiking?

Hiking encompasses any purposeful walk on trails, parks, hills, or coastal paths. These routes often feature uneven ground, steps, mud, or gradients. Hiking can be short and local or involve longer hill days and multi-day treks. If you are new to hiking or returning after a cardiac event, begin with easy, well-marked routes. Choose paths with modest elevation gain to ensure a comfortable experience.

Benefits for Heart and Mind

Hiking offers numerous benefits for both heart health and mental well-being:

• Aerobic Fitness: Improves overall cardiovascular health.

• Blood Pressure: Helps in managing and reducing blood pressure levels.

• Cholesterol Profile: Positively affects cholesterol levels.

• Insulin Sensitivity: Enhances the body’s ability to use insulin effectively.

• Leg Strength: Builds strength in the legs, improving balance and bone health, especially on gentle hills.

• Weight Management: Supports maintaining a healthy weight.

• Mood Enhancement: Reduces stress and promotes better sleep.

• Social Interaction: Hiking in green spaces can boost overall well-being.

  
  

Is Hiking Suitable for Me? (Readiness Checklist)

Before you hit the trails, ensure you meet the following criteria:

• You have been cleared by your cardiac team to exercise and can walk 30–40 minutes on flat ground at RPE 11–13 without symptoms.

• Your medication is stable, and you understand how it affects your heart rate and effort.

• You can manage small hills on local walks without undue breathlessness (RPE ≤ 13).

• You have a plan for hydration, weather changes, and know how to get help if needed.

  
  

Safety First: Delay or Stop If…

It’s crucial to listen to your body. If you experience any of the following, stop immediately:

• Chest pain, tightness, significant breathlessness, palpitations, dizziness, or faintness. Sit down and follow your clinical plan. If symptoms persist for more than five minutes, call emergency services.

• Feeling unwell, febrile, or if your resting heart rate is unusually high or low.

• Missing key cardiac medications or feeling “off”—postpone the hike.

• Extreme weather conditions (very hot, very cold, high winds, ice, lightning) or trail warnings advise against hiking.

  
  

“Go as far as you can see; when you get there, you’ll be able to see further.” — Thomas Carlyle

How Hard Should It Feel? (Borg 6–20 + Heart Rate)

Understanding how hard your body is working is essential. Here’s a simple guide:

• Warm-up: RPE 8–10 for 8–10 minutes.

• Main Hike on Easy Terrain: RPE 11–13 (comfortable conversation).

• Short Hills/Steps: Brief rises to RPE 13–14, then settle back.

• Cool-down: RPE 7–9 for 8–10 minutes.

  
  

If you monitor your heart rate, a typical target is 40–70% of your heart-rate reserve (HRR). If you are on beta-blockers or find your heart rate unreliable, prioritise Borg RPE and the talk test.

Warm-up and Cool-down

Warm-up (8–10 minutes): Start on flat ground, gradually increasing your pace. Include gentle ankle circles, calf raises, knee lifts, hip openers, and shoulder rolls.

Cool-down (8–10 minutes): Ease into a very easy walk, then hold light calf, hamstring, quad, and hip-flexor stretches for 20–30 seconds each. Incorporate relaxed breathing to help your body recover.

Technique and Pacing Basics

To enhance your hiking experience, consider the following techniques:

• Shorten your stride and increase your cadence slightly on hills to keep RPE ≤ 13–14.

• Use trekking poles for stability, joint unloading, and maintaining rhythm.

• On descents: Soften your knees, keep your hips under you, and place your feet flat to reduce impact.

• Take micro-breaks (30–60 seconds) to maintain a steady effort rather than pushing through long stretches.

  
  

Equipment, Footwear, and Simple Packing List

Having the right gear can make a significant difference:

• Footwear: Supportive hiking shoes or boots with grippy soles; wear them in gradually.

• Clothing: Layered clothing, waterproof shell, hat, and light gloves; bring a spare warm layer.

• Pack Essentials: Small pack, water (0.5–1 L per hour depending on heat), and light snacks.

• Safety Items: Charged phone, trail map/app, ID/medical info, and any rescue or location app used locally.

• First Aid: Simple first-aid items, blister care, and any personal medications (carry GTN if prescribed).

  
  

Weather, Environment, and Altitude

Weather conditions can greatly impact your hiking experience:

• Heat: Start early, seek shade when possible, hydrate little and often, and slow your pace.

• Cold/Wet/Windy: Insulate properly, wear waterproof gear, keep moving gently, and avoid exposed ridges.

• Altitude: If hiking above ~1,500–2,000 m and you’re new to it, progress gradually. Keep RPE lower than usual, avoid rapid ascents, and seek clinical advice for higher treks.

  
  

Medication and Condition-Specific Notes

If you are on medication, consider these important notes:

• Beta-blockers: Expect a lower heart rate at a given effort; rely on RPE and breathing.

• Nitrates/GTN: Carry as directed; if you need it, stop and follow your plan.

• Anticoagulants: Prioritise stable footing, use poles, and take gentler descents to reduce fall risk.

• Diabetes: Bring snacks and a testing kit; check glucose before, possibly during, and after longer hikes. Be cautious of hypoglycaemia on longer or colder days.

• Pacemaker/ICD: Carry your device card; hike with a partner or group and choose routes with mobile coverage when possible.

  
  

Trail Nutrition and Hydration

Proper nutrition and hydration are key to a successful hike:

• Drink regularly from the start; clear or pale-straw urine is a good indicator of hydration.

• Bring easy carbs for hikes longer than 60–90 minutes (fruit, oat bars, sandwiches).

• Add electrolytes on warmer days or during longer efforts.

  
  

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

A Simple Session Template (30–60 Minutes)

Here’s a basic session template to follow:

• Warm-up: 8–10 minutes of easy walking on flat ground.

• Main Section: 15–35 minutes at RPE 11–13. Include 3–6 short hills or stair bouts of 1–3 minutes at RPE 13–14, separated by easy walking.

• Cool-down: 8–10 minutes of very easy walking and stretches.

  
  

Progressive 12-Week Hiking Plan (Choose Your Level)

General Notes: Aim for 2–3 hikes per week on non-consecutive days. Keep most work at RPE 11–13, with short hills to RPE 13–14. If a week feels too hard, repeat it before progressing.

Beginner (From Regular Flat Walks)

• Weeks 1–2: 30–35 min per hike, ≤ 50 m total ascent, 1–2 short hills.

• Weeks 3–4: 35–40 min, ≤ 75 m ascent, 2–3 hills or steps.

• Weeks 5–6: 40–45 min, ≤ 100 m ascent, add one slightly longer hill (2–3 min).

• Weeks 7–8: 45–50 min, ≤ 150 m ascent, introduce poles if helpful.

• Weeks 9–10: 50–55 min, ≤ 200 m ascent, include one gentle, longer trail.

• Weeks 11–12: 55–60 min, ≤ 250 m ascent, practice pacing on undulating routes.

  
  

Intermediate (Already Doing 45–60 Min Walks)

• Weeks 1–2: 60 min, ≤ 200 m ascent, 3–4 hill repeats of 2–3 min.

• Weeks 3–4: 60–70 min, ≤ 250–300 m ascent, add one steady 10-min climb at RPE 12–13.

• Weeks 5–6: 70–80 min, ≤ 350 m ascent, add short technical sections carefully.

• Weeks 7–8: 75–90 min, ≤ 400 m ascent, include a back-to-back easy day (30–40 min).

• Weeks 9–10: 90 min, ≤ 500 m ascent, practice downhill control.

• Weeks 11–12: 90–105 min, ≤ 600 m ascent, choose one scenic “goal” route.

  
  

Advanced (Comfortable Hill Walkers Building Robustness)

• Weeks 1–2: 90 min with 500–600 m ascent, controlled descents, poles optional.

• Weeks 3–4: 2 hours, 600–700 m ascent, add one sustained 15-minute climb at RPE 12–13.

• Weeks 5–6: 2–2.5 hours, 700–800 m ascent, include rough ground sections at an easy pace.

• Weeks 7–8: 2.5 hours, 800–900 m ascent, practice nutrition/hydration strategy.

• Weeks 9–10: 3 hours, 900–1,000 m ascent, focus on steady pacing all day.

• Weeks 11–12: 3–4 hours, 1,000–1,200 m ascent, target a summit or ridge day in fair weather.

  
  

Pre-Hike Checklist

Before heading out, ensure you have:

• A planned route suited to your current level (distance, ascent, terrain, escape points).

• Checked the weather, layered clothing, and broken-in footwear.

• A fully charged phone, downloaded map/app for offline use, and someone who knows your plan.

• Water, snacks, medications, ID/medical card, simple first aid, and blister care.

• Poles if they help with balance or knee support, and a small emergency layer.

  
  

Travel and Insurance (For Hikes Away from Home)

If you are travelling, ensure your travel insurance covers hiking and declares pre-existing conditions. Some policies limit altitude, distance from roads, or “guided vs unguided” hiking—choose appropriately. Know local emergency numbers and how to share your location. In remote areas, consider a group hike or qualified guide.

SMART Challenges

This Week (Short-Term): Choose an easy, local circular trail (≤ 3 km, ≤ 75 m ascent). Hike at RPE 11–13, maintain a steady rhythm, and write down three positives you noticed about your pacing or breathing.

Next 8–12 Weeks (Long-Term): Select a scenic “goal” route that is realistic for your level (e.g., 8–12 km coastal or hill walk). Plan your progression using the 12-week outline above, book a date, and invite a friend or group for accountability.

How Can My Movement Medicine Help?

Our Online & Face-to-Face classes aren’t hiking-specific, but they’re excellent cross-training for the trail. You’ll build cardiovascular endurance (Borg RPE 9–13), leg and core strength, balance and stability, and confidence—skills that carry over to uneven terrain, hills, and longer days out. Regular training with us can help lower blood pressure, improve cholesterol and insulin sensitivity, support weight management, and lift mood and sleep.

Book a class

If you’d like extra guidance, our premium personalised programme turns your health status and goals into a tailored 12-week plan with weekly check-ins—so you progress steadily and safely toward the adventures you have in mind.

Online Programme

Book a free trial class or enquire at www.mymovementmedicine.co.uk.

FAQs

What if my heart rate jumps on hills?

Shorten your stride, slow down a bit, and use poles. Keep effort at RPE 13–14 max on steeper sections, then return to RPE 11–13.

Can I hike alone?

Preferably start with a partner or group. If hiking solo, choose well-used routes with reception, leave your plan with someone, and carry essentials.

What about knee or back discomfort?

Poles, softer trails, and controlled descents can help. Keep your hips under you on downhills. If pain persists, seek individual guidance.

This health guide was written by Jamie Pickett, Clinical Exercise Physiologist, Health Facilitator, & Founder of My Movement Medicine.

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