Heart Health and Movement: What Your Doctor Isn’t Telling You (But Your Physical Therapist Will)

When we talk about heart health, most conversations stop at cholesterol numbers, blood pressure readings, and maybe a reminder to “exercise more.” While those things matter, they barely scratch the surface of how movement truly supports cardiovascular health—and how to do it safely, effectively, and sustainably.

This is where physical therapy plays a bigger role than most people realize.

Heart Health and Movement: What Your Doctor Isn’t Telling You (But Your Physical Therapist Will):

Heart Health Is More Than Cardio

Walking, cycling, and running are often prescribed as the gold standard for heart health. While aerobic exercise is important, it’s only one piece of the puzzle.

True cardiovascular resilience depends on:

• Strength to support efficient movement

• Mobility to allow full, pain-free joint motion

• Circulation driven by muscle activity

• Recovery capacity to handle stress without overloading the system
  

Neglecting these areas can limit your progress—or worse, lead to injury that stops you from exercising altogether.

The Exercise Sweet Spot: Intensity + Consistency

Research consistently shows that moderate-to-vigorous physical activity performed regularly improves cardiovascular outcomes, lowers resting blood pressure, and reduces all-cause mortality (Piercy et al., 2018). But “more” is not always better.

Many people fall into one of two traps:

• Doing too little because movement feels intimidating or uncomfortable

• Doing too much, too fast, leading to pain, fatigue, or burnout
  

Physical therapists help find the sweet spot—where exercise challenges your heart without overwhelming your joints, muscles, or nervous system.

Why Strength and Mobility Matter for Your Heart

It may surprise you, but limited mobility and poor strength can directly impact heart health.

• Strength training improves insulin sensitivity, reduces visceral fat, and lowers cardiovascular disease risk.

• Joint mobility allows for efficient gait mechanics and better oxygen utilization.

• Muscle mass acts as a metabolic reservoir that supports endurance and recovery.
  

If pain or stiffness limits how you move, your cardiovascular system never gets the stimulus it needs to adapt.

Red Flags: When to See a PT vs. a Physician

Some symptoms should always be evaluated by a physician first, including:

• Chest pain

• Shortness of breath at rest

• Dizziness or fainting

• Sudden, unexplained fatigue
  

However, many movement-related barriers to exercise—such as joint pain, stiffness, fear of injury, or prior orthopedic issues—are squarely within a physical therapist’s scope.

You don’t need imaging, referrals, or medications to address:

• Knee or hip pain limiting walking

• Back pain during exercise

• Shoulder pain with lifting or rowing

• Balance issues affecting confidence
  

How Physical Therapy Supports Heart Health

At Nashville Physical Therapy & Performance, we approach heart health through the lens of movement capacity.

A PT-guided program may include:

• Exercise prescription tailored to your cardiovascular tolerance

• Strength training to improve efficiency and reduce joint stress

• Mobility work to allow fuller, safer movement

• Education on pacing, recovery, and progression

• Confidence-building strategies for returning to activity after setbacks

  
  

This is especially valuable for adults who want to move more—but feel held back by pain, fear, or uncertainty.

Heart Health and Movement: What Your Doctor Isn’t Telling You (But Your Physical Therapist Will): Movement Is Medicine—When It’s Done Well

Loving your heart means more than logging steps. It means choosing movement that supports your body instead of breaking it down.

Physical therapy helps bridge the gap between knowing exercise is important and actually being able to do it consistently, comfortably, and confidently.

If heart health is one of your goals this year, a PT-guided movement plan may be the missing piece that keeps you active for the long haul.

References

Piercy, K.L., et al. (2018). The Physical Activity Guidelines for Americans. JAMA, 320(19), 2020–2028. https://doi.org/10.1001/jama.2018.14854

Lear, S.A., et al. (2017). The effect of physical activity on mortality and cardiovascular disease in 130,000 people from 17 high-income, middle-income, and low-income countries. The Lancet, 390(10113), 2643–2654. https://doi.org/10.1016/S0140-6736(17)31634-3

Williams, M.A., et al. (2007). Resistance exercise in individuals with and without cardiovascular disease. Circulation, 116(5), 572–584. https://doi.org/10.1161/CIRCULATIONAHA.107.185214