Skiing: Activity-Specific Guide for Cardiac Conditions & Heart-Healthy Exercise

Quick-Start Summary

Skiing can build aerobic fitness, leg and core strength, balance, coordination and confidence—while you enjoy fresh air and community. With the right preparation, pacing, and safety steps, many people in cardiac rehab can ski safely. Always agree timing with your cardiac rehabilitation (CR) team before you start.

Before you book: buy comprehensive travel insurance that includes winter-sports cover and declare all pre-existing medical conditions. GHIC/EHIC cards are useful but do not replace travel insurance or cover mountain rescue or repatriation.

“The mountains are calling and I must go.” — John Muir

Is Skiing Right for Me?

Your start date depends on your diagnosis, recovery stage, and any co-existing conditions. After open-heart surgery or an implantable device (e.g., pacemaker/ICD), you may be advised to wait until wounds are fully healed and you can safely tolerate knocks or falls. Plan with your CR team.

Altitude can raise cardiovascular load at rest and with exercise, and may especially affect people with heart failure, a recent heart attack, or lower fitness. If in doubt, choose lower resorts, add acclimatisation days, and speak to your CR or heart-failure team.

Benefits (Why Choose Skiing?)

• Improves aerobic fitness and cardiovascular health.

• Builds lower-body and core strength.

• Enhances balance and coordination.

• Supports psychological wellbeing and social connection.

“Small steps, great distances.” — Anonymous

Travel Insurance & Paperwork Essentials (Don’t Skip This)

• Buy winter-sports travel insurance for the full length of your trip. Ensure it covers medical care (state and private if needed), emergency transport, and medical repatriation.

• Declare all pre-existing medical conditions and medications. Non-disclosure can invalidate claims, even if unrelated to the condition. Specialist insurers exist if you need them.

• Check common exclusions and requirements: some policies exclude off-piste without a qualified guide and may require a helmet; many do not cover damage to rental gear unless specified.

• GHIC/EHIC: useful for medically necessary state care in the EEA (and a small number of other places) but not a substitute for insurance; does not cover ski or mountain rescue or repatriation. Each traveller needs their own card.

• Carry policy details and 24/7 emergency number, plus a medication list and brief medical summary (diagnosis, devices, meds, allergies, emergency contacts).

• Travelling with medicines: keep them in hand luggage, in original packaging. You can carry essential medicines; liquids over 100 ml require proof (e.g., prescription or GP letter) and extra screening. Check your airline.

“You don’t have to be extreme, just consistent.” — Unknown

Safety Fundamentals (Read Before You Go)

Aim for an effort that feels comfortable to moderate. If you use heart-rate training, many CR programmes target about 40–70% heart-rate reserve; if you’re on beta-blockers, use RPE and the talk test.

• Warm up ~15 minutes at light intensity; cool down ~10 minutes gradually.

• Cold increases energy demand—start gentler than usual and build gradually.

• Hydrate and avoid large meals immediately beforehand.

• Avoid breath-holding (no Valsalva).

• Some cardiac medications affect temperature regulation—dress in layers and monitor how you feel.

• Avoid alcohol when skiing; it impairs judgment and cold resistance.

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

Pre-Trip Conditioning (4–6 Weeks)

Frequency: 2–3 non-consecutive days/week for strength, plus 2–4 days/week of cardio.

Cardio (30–45 min): brisk walking, cycling, elliptical or Nordic walking—progress duration first, then gentle hills or short, easy intervals.

Strength & Balance (2–3 rounds):

• Sit-to-stand or light goblet squat × 8–12 (RPE 3–5)

• Step-ups (low box) × 8–10/leg

• Lateral lunges or banded side steps × 8–10/side

• Hip hinge (light deadlift pattern) × 8–10

• Calf raises × 12–15

• Core anti-rotation (Pallof press or short plank) 20–30 s

• Balance holds (single-leg) 20–30 s/side

Also practise ski-day tasks: getting up from a fall, using a manual lift, putting boots on/off, and carrying equipment. Consider resort buses to reduce long walks in heavy gear.

“Strength grows in the moments you think you can’t go on but you keep going anyway.” — Unknown

On-Mountain Technique Cues (Alpine/Downhill)

• Posture: soft knees/hips, tall torso, eyes up.

• Breathing: exhale through turns; avoid breath-holding.

• Turns before speed: link easy, rounded turns on green runs before progressing.

• Pacing: plan regular pauses for RPE/HR checks and hydration.

• Terrain: greens → easy blues as confidence allows; avoid crowded steeps early on.

• Off-piste only if your policy covers it and ideally with a qualified guide.

Sample Session Plans

Beginner (first days back)

• Warm-up (15 min): easy walk from the lodge plus ankle/hip/shoulder mobility.

• Main set (60–90 min total): 5–8 gentle green runs (5–8 min each) of relaxed linked turns; rest 3–5 min between runs and keep RPE around 3–4.

• Cool-down (10 min): very easy final glide or 10-minute walk; light stretches while warm.

Intermediate

• 1–2 warm-up greens, then 5–7 easy blues.

• Add 2–3 “focus blocks” (two longer, controlled runs with wide, rhythmic turns); keep most of the day at RPE 4–5.

Low-Impact Endurance Day (Nordic/Cross-Country)

• 45–75 minutes of continuous easy gliding on flat or gently undulating terrain; conversational breathing with short sip breaks each loop/lift.

Avalanche & Slope Etiquette (Awareness Level)

• Check the daily avalanche bulletin (European scale 1–5: low to very high) and obey closures. If the danger is “considerable” (3) or above, stay on open marked runs.

• Follow the FIS slope code (control speed, respect signs, assist after accidents, exchange details).

Environment & Kit Checklist

• Layer smart: moisture-wicking base, insulating mid-layer, wind/water-resistant shell; warm gloves, neck buff, helmet/liner.

• Helmet & goggles: fit and comfort matter for safety and pacing; some policies require helmet use.

• Footwear function: practise boots on/off without strain; get help or boot-tools if needed.

• Logistics: consider resort buses or easy-access lifts to reduce long, fatiguing walks in heavy equipment.

Warm-Up & Cool-Down (Why They Matter)

Begin and finish each day at low intensity to let heart rate and blood pressure rise and fall gradually. Cool down by skiing very gently or walking for 10 minutes; add light stretches while warm.

Red Flags — When to Stop

Stop and rest if you experience chest discomfort, palpitations, dizziness, or light-headedness. If symptoms don’t settle promptly with rest and/or your GTN spray/tablets, seek medical advice as soon as possible.

FAQs

Will the cold make skiing feel harder?

Yes. Cold increases energy demands and can make exercise feel tougher even at lighter workloads. Start gentle, build gradually, and shorten sessions on very cold or windy days.

What about medication effects?

Some cardiac medications make temperature regulation harder. Dress in layers, take more breaks, and monitor symptoms.

Can I ski after surgery or an implant?

Only once fully healed and cleared by your team—you need to tolerate knocks/falls safely. Your CR team can advise on timing.

Is altitude a problem?

It can be—especially with heart failure, recent MI, or lower fitness. Opt for lower resorts, add acclimatisation days, and speak to your CR/heart-failure team.

SMART Challenges

7-Day Mini Challenge (Pre-Trip)

Do the conditioning circuit twice this week, plus two 30–40-minute cardio sessions at RPE 3–4. Log RPE and any symptoms.

4-Week Build

Weeks 1–2: 2 strength + 2 cardio sessions/week.Weeks 3–4: 3 lighter-volume strength + 3 cardio (one longer steady session, one gentle hill/interval session).Outcome goal: enjoy a half-day of green runs at RPE ≤5 with steady, conversational breathing.

How My Movement Medicine Can Help

• Pre-trip screening and tailored programmes aligned with BACPR principles.

• Small-group classes to build the exact strength, balance and stamina skiing demands.

• Heart-rate–monitored sessions and clear home programmes (Polar-friendly).

• One-to-one coaching for return-to-sport and altitude preparation.

Get in touch

Written by Jamie Pickett, Clinical Exercise Physiologist (My Movement Medicine), with AI assistance.