To get the best, most accurate care, your doctor needs to know a few things about your training. – Christina Bonnington
As athletes, we’re pretty in tune with our bodies. But sometimes our bodies start sending signals that something is amiss. Maybe your occasionally achy knee is starting to hurt more often. Or perhaps your partner has complained about your constant grumpy mood.
Issues like those above might mean it’s time to make a doctor’s visit. But whether you’re heading in for a simple checkup or because of a nagging issue, there are certain things you should make sure your primary care practitioner knows. Your level of training can explain a lot about your health, and could affect the advice he or she gives you. That advice might include adding cross-training to your workouts to prevent repetitive stress injuries, or altering your diet to ensure you’re fueling properly. Particularly if you don’t have a coach to keep things in check, your doctor can make sure your training routine isn’t just effective—it’s healthy for you, personally.
We chatted with Aaron Mares, assistant professor at the University of Pittsburgh’s Department of Orthopaedic Surgery, and associate medical director of the Pittsburgh Marathon; and Kortney Parman, a cyclist and family nurse practitioner at the University of California San Francisco Medical Center; to find out what changes and observations athletes should always mention to their doctors for the best, most accurate care.
How Often You’re Working Out
Mares says it’s important to share how often you’re training, particularly if you’re seeing a new physician. And don’t just mention how many days per week you’re riding or running, but include how long each day, on average, and at what intensity levels. He says he also likes to know whether endurance athletes are complementing their workouts with other activities, like cross training and strength-training, and what those activities are. This is important for doctors to know because it can be a factor in your likelihood of repetitive stress injury.
What Medications You’re Taking
Your doctor will probably ask you this, but if not, be sure to bring up what medications you are currently taking or notable prescriptions you’ve had in the past. Your doctor needs to know the full picture in order to best help you: It will give them an idea about your current medical history, whether it is controlled, and your risk factors for injury or illness, Mares says.
Changes in Mood or Libido
Parman says you should tell your physician if you notice a change in mood. It could be related to overtraining or fatigue, or it could be indicative of an underlying mental health issue, which often go overlooked or unchecked. Similarly, changes in libido could signal ongoing under-fueling or overtraining, which can affect sex hormone levels.
Inability to Do Your Usual Exercises
If tasks that used to be easy are becoming increasingly difficult (and painful), that’s something to mention to your doctor. Parman says that if you’ve taken some time off or have exercised at a lighter intensity for at least a week or two and the pain persists without improvement, you should mention it. This will help your physician to know whether additional followup tests (such as an X-ray or MRI) are necessary to assess the extent of an injury, and better figure out what’s needed in order for proper recovery.
Changes in Weight
“Rapid weight change has many implications and impacts on the body, and the primary care provider can help to ensure these are explored,” Parman says. Unexplained weight loss could signal overtraining; if left unchecked, it could result in lowered athletic performance if you don’t have enough fuel to power your efforts. As a registered dietician, Parman also notes that eating disorders are common among athletes. Talking to your physician can be the first step in getting help.
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The Timing of an Injury
“If I’ve had wrist pain for four to five weeks, and it has gotten progressively worse, that progressive nature is important to know, versus, ‘Hey, I was going around a bend and my rear wheel kicked out and I fell down on my wrist,’” says Mares. That progressive versus acute distinction is important in helping the physician come to a diagnosis (a tendon rupture versus tendonitis or tendinopathy). You’ll also want to mention any bruising or swelling, and if there was any “popping” sound at the time of the injury—that is typically not a good sign. For example, a “popping” sound followed by acute pain in the Achilles tendon could mean that the tendon ruptured.
Chest Discomfort or Breathing Difficulties
Both Mares and Parman advise that if you’re feeling things such as a funny heartbeat—or if your chest feels weird, you feel a flutter, or feel shortness of breath—you should take it up with a professional. If you’ve felt any dizziness, or if you’ve ever passed out, those could be signs of something “more concerning,” Mares says. This could include signal anything from a stress fracture in your ribs, if you fell or crashed recently, to conditions such as exercise-induced asthma, an undiagnosed congenital heart condition, or angina.
And One Thing That’s Not So Important: Changes in Heart Rate
“Tracking heart rate is easy and can be enlightening—and a great training tool—but we can also read too much into numbers,” Parman says. A lot of factors can affect your heart rate: genetics, fitness, illness, sleep quality, stress, nutrition, mental wellbeing. Unless your resting heart rate is say, 20 bpm higher than normal on an ongoing basis, changes in heart rate are likely best directed to your coach. If you do want to bring it up with your physician, though, be prepared to provide additional context (and in the absence of other symptoms, be prepared for your doctor to feel that it doesn’t require further attention at the time).