Common Conditions & Injuries
We’ve compiled some of the most common conditions and injuries reported in our assessments to help you offer appropriate modifications and support in your class. This is not an exhaustive list and isn’t a replacement for regular CPR & First Aid training. If you’re not sure whether or not someones behaviour or symptoms requires a 911 call, the default action is always to call 911.
Hypertension
Hypertension is more commonly known as “high blood pressure” in everyday language. It means that the pressure in the body’s blood vessels is too high, and it causes the heart to pump harder to make sure blood reaches the organs. It can be caused by many factors, such as genetics, age, and lifestyle. Regular exercise can help regulate blood pressure.
Most people don’t experience many symptoms, if at all.
Often, there will not be any symptoms of hypertension during exercise. However, those with very high blood pressure may experience:
- Severe headaches
- Chest pain
- Dizziness
- Difficulty breathing
- Nausea and/or vomiting
- Vision changes, like blurry vision
- Confusion
- “Buzzing” in the ears
Without a blood pressure measurement, it is impossible to tell in class if these symptoms are due to hypertension. Stop the participant and seek immediate medical care.
Red flags to watch out for include:
- Complaints of chest/neck/jaw/arm pain or tightness
- Dizziness or faintness
- Severe shortness of breath
- Irregular heartbeat (“racing”, “fluttering”, etc.)
These could indicate a possible heart problem. Stop the participant and seek immediate medical care.
Hypotension
Hypotension is more commonly known as “low blood pressure” in everyday language. This means that the force of blood pushing against the blood vessel walls is too low, so it is more difficult for the body to ensure blood reaches the organs. This can be caused by many factors, like PD, dehydration, medications, age, and others.
Some may not have any symptoms. Others may experience:
- Dizziness or light-headedness
- Blurry or fading vision
- Fainting
- Fatigue or weakness
- Difficulty concentrating
- Upset stomach
Help the participant into a sitting or lying position until the symptoms pass. Ensure they have access to water/fluids. The participant may feel weak.
Orthostatic/postural hypotension is a sharp drop in blood pressure upon standing/being upright. This happens because not enough blood in the lower extremities can make it to the heart and brain, which can be caused by PD, medications, dehydration, and in some cases, hot temperatures.
Symptoms can be disorientating, but this rarely causes long-term issues. The main concern is falls because of these symptoms. Symptoms may include:
- Dizziness
- Light-headedness
- Fainting
- Generalized weakness
- Visual changes, like blurry vision
- Leg buckling
- Cognitive slowing
- Angina (chest pain)
Encourage participants to move more slowly into a standing or upright position. Ensure everyone has access to water/fluids. Having something nearby to hold onto is also helpful. If symptoms occur, help the participant move slowly into a sitting or lying position. They should feel better.
Arthritis
Arthritis refers to any disorder that causes damage in the joints. This damage can be because of normal wear and tear due to aging, or disease processes.
Osteoarthritis is a gradual and progressive condition, and it occurs when the cartilage at the ends of your bones deteriorates. Normally, that cartilage is protective, and allows for frictionless movement in the joint. Once it begins to wear down completely, the resulting bone-on-bone contact is painful. Osteoarthritis also causes changes and inflammation in the bones and connective tissues surrounding the joint. It can occur in any joint, but it most commonly occurs in the hands, knees, hips, and spine.
Movement can help promote healthy cartilage. Movement through a full range of motion can help slow the deterioration of cartilage.
Low-impact exercise, as well as tai chi, can help lessen symptoms. Slow and gentle movements of the joints in warm-ups can help ease participants into more strenuous exercise. High-impact exercises are advised to be avoided.
Symptoms include:
- Joint pain, stiffness, and/or tenderness
- Loss of flexibility
- “Grating” sensation in the joint
- Swelling
Encourage participants to take breaks and know their limits.
Rheumatoid arthritis (RA) is an autoimmune disease that causes chronic inflammation. The immune system attacks the joints and affects the joint lining, which can cause pain, swelling, and eventually deform the joints and erode the bone. The immune system can also attack other parts of the body.
Resistance training combined with aerobic exercise can help strengthen and maintain muscles to better support joints.
The main symptoms are joint pain and swelling. This usually starts with the joints in the fingers, the wrists, and the balls of the feet, and progresses from there. Symptoms vary, but may include:
- Joint warmth
- Joint stiffness in the mornings, for a few hours
- Aching muscles
- Fatigue
Avoid extreme neck movements and pressure on the back of the neck. Avoid overstretching or applying too much force over joints—especially knees and fingers. Modifications may be needed for exercises on hands and knees.
Diabetes
Diabetes affects the way the body uses glucose, a sugar. Normally, for your cells to bring in and use glucose, they need a hormone called insulin. If there is a deficiency in insulin, or if your cells don’t respond to insulin, glucose can’t enter the cells and will build up in the blood. This leads to the high blood sugar seen in those with diabetes. Having too much sugar in the blood can lead to long-term consequences, such as nerve damage, kidney disease, heart issues, and vision problems.
Exercise can help lower blood sugar and increase the body’s sensitivity to insulin.
There are two types of diabetes, which differ in cause and severity of symptoms.
In type 1 diabetes, the pancreas, which is the organ that makes insulin, does not make enough insulin—or any at all.
Symptoms may occur when blood sugar is very high, which may include:
- Intense thirst
- Fatigue
- Blurry vision
- Needing to go to the bathroom often
In type 2 diabetes, the pancreas makes insulin, but the cells in the body do not respond to insulin well enough. The pancreas may try to increase production of insulin to force a response, but eventually it will not be able to keep up.
Usually, type 2 diabetes does not cause any symptoms. However, if symptoms occur, they will be similar to the symptoms of type 1 diabetes.
If blood sugar is too high, the participant will likely need to take measures to lower their blood sugar. However, the more pressing concern is hypoglycemia (low blood sugar), which can occur due to diabetes medications or exercise. Symptoms include:
- Feeling shaky, weak, dizzy, or confused
- Sweating
- Fainting
The participant may need to eat or drink something to raise their blood sugar, such as fruit juice, soda, hard candy, etc. Hard candy can be found in the U-Turn Parkinson’s first aid kit. Once the blood sugar is at a safe level, and the participant feels good and wishes to continue, it is okay for them to continue exercise.
Stroke
Stroke refers to brain damage as a result of an issue with blood flow supplying the brain. The cause could be a blocked artery leading into the brain, or an artery breaking open and bleeding around the brain. For some, a stroke may not leave behind any long-term issues. For others, however, a stroke can lead to the loss of brain functions, like speaking or certain motor movements.
FAST is a mnemonic that is used for the symptoms of stroke:
- Face: the face droops on one side or looks uneven
- Arm: weakness or numbness in one or both arms, or having one arm drift downwards when holding both arms out
- Speech: odd-sounding speech or having trouble speaking
- Time: call for an ambulance—time is of the essence
Other symptoms may include a sudden, severe headache.
If you notice symptoms of a stroke, seek immediate medical care. The faster someone is treated, the better.
Anxiety
Anxiety is an umbrella term referring to a variety of anxiety disorders. Generalized anxiety disorder is a type of anxiety disorder that refers to a persistent anxious or worried feeling in day-to-day life for 6 months or more. This can interfere with daily life.
Exercise can help ease anxiety and its symptoms. Physical activity incorporating mindfulness, like yoga or tai chi, can help as well.
Symptoms include:
- Feeling anxious about normal activities in life, and/or feeling more anxious than normal over small things
- Trouble focusing
- Feeling tired or tense
- Stomach aches
- Chest tightness
Depression
Depression is a mood disorder that causes persistent feelings of sadness, and can impact daily life. It is caused by issues with neurotransmitters in the brain, which are chemicals that are used as messengers in the brain.
Exercise can help ease symptoms of depression.
Symptoms may include:
- Loss of interest
- Feelings of sadness/emptiness/hopelessness for most of the day and nearly everyday
- Memory issues
- Physical aches/pain
- Fatigue
- Loss of appetite
- Slowed thinking, speaking, or movement
Atrial Fibrillation
Atrial fibrillation (otherwise known as A-fib) is an issue with the rhythm of the heart. Normally, two chambers of the heart, called the atria, pump blood into the rest of the heart and the body. In A-fib, the atria do not pump as strongly, which can result in some blood remaining stagnant inside the atria and forming clots. These clots can end up other places in the body, like the brain, and cause a stroke.
Exercise can help lower the chances of recurrent A-fib.
For some, they may not experience any symptoms. For others, symptoms may include:
- Feeling the heart is “racing”
- Chest tightness or pain
- Lightheaded-ness or dizziness
- Trouble breathing, especially during exercise
The above symptoms may also occur during physical activity. Stopping and resting may help alleviate symptoms.
Red flags to watch out for are the symptoms of a stroke.
Parkinson’s Disease Dementia
Dementia refers to a set of symptoms that affect memory, cognitive, and/or social abilities of the brain to the extent that these symptoms interfere with daily life. Dementia is caused by nerve cell damage or loss.
There are many diseases linked to dementia. Parkinson’s Disease dementia is dementia that develops in the context of PD. Those with PD are at higher risk of dementia, although not every person with PD will develop dementia.
Exercise can help lower the risk of cognitive decline and reduce symptoms.
Symptoms may include:
- Visual hallucinations
- Changes in concentration, attention, alertness, wakefulness
- Disorganized or unclear ideas
- Poor judgement
- Confusion
- Changes in mood and behaviour
- There may also be changes in the nervous system, resulting in problems with blood pressure, body temperature, dizziness, fainting, falls, and others.
Heart Disease + Heart Attack + Angina
Cardiovascular disease is an umbrella term used to describe medical conditions that affect the heart, which can include coronary artery disease, arrhythmias (irregular heartbeats), congenital heart defects, and diseases of the heart muscle or heart valves.
Coronary artery disease is a disease of the blood vessels. The most common cause is when fatty deposits build up in the arteries, which narrow the arteries and can cause damage to surrounding tissues. These fatty deposits can also break off and block blood vessels supplying the heart, which can cause a heart attack.
Arrhythmias are irregular heartbeats, caused by an issue with the electrical system in the heart that directs heartbeats. Someone with an arrhythmia may have a heartbeat that is too fast or too slow, or one that is inconsistent. Some people may not experience any issues, but some types of arrhythmias can be life-threatening.
Diseases of the heart muscle are called cardiomyopathies, and these can affect how well the heart can pump blood. The heart relies on its heart muscle to pump blood efficiently, and cardiomyopathies make it more difficult for the heart to do its job properly. These diseases can lead, eventually, to heart failure because the heart is working much harder.
Heart valve disease affects the blood flow through the heart. If one or more of the valves are affected, this can change the normal direction of blood flow (for example, blood may flow backwards if a valve does not close properly) and thus decrease the amount of blood pumped out of the heart.
Exercise helps maintain heart health.
Symptoms depend on the type of cardiovascular disease. Common symptoms include:
- Chest pain
- Fainting, dizziness, or lightheaded-ness
- Fatigue
- Irregular heartbeats
- Shortness of breath
Red flags to watch out for are the symptoms of a heart attack or stroke. Seek immediate medical care.
A heart attack is when blood vessels supplying the heart are blocked, resulting in a lack of blood flow. Any heart tissue that has lost this supply of blood can die.
For some, there may be mild symptoms, or perhaps no symptoms at all. For others, they may experience severe symptoms. Common symptoms include:
- Chest pain, often described as “an elephant sitting on your chest”, or chest tightness/pressure/ache
- Pain/discomfort located in the shoulder/arm/jaw
- Sweating
- Fatigue
- Nausea
- Shortness of breath
- In females, other symptoms may include a brief/sharp pain located in the neck/arm/back
Seek immediate medical care.
Angina is a temporary loss or reduction of blood flow to the heart. Symptoms will only last for a few minutes. For someone who has stable angina, symptoms usually happen during activity/exertion, and will go away with medication or rest.
For someone who has unstable angina, symptoms may occur at rest, or symptoms may worsen or last for a longer period. In these cases, seek medical care, as this may be an emergency.
Symptoms may include:
- Chest pain/discomfort for a few minutes
- Pain in the arms, neck, jaw, shoulder, or back
- Nausea
- Dizziness
- Fatigue
- Shortness of breath
- Sweating
Red flags to watch out for are the signs of a heart attack.
Knee/Hip Replacements
Knee and hip replacement surgeries will replace parts of or the entire joint. This is often done to relieve pain and improve mobility and quality of life.
High impact exercises are advised to be avoided. Low impact activities are recommended. The participant should move at their own pace, especially if they are still recovering.
Cancer
Cancer refers to a disease that is caused by the development and uncontrolled proliferation of abnormal cells. These cells can invade normal tissue, form tumours, cause damage, and they can also spread to multiple areas of the body. Normally, cells have checks and regulations that control their growth and proliferation. However, if something goes wrong, like a mutation that removes those checks and regulations, cells can grow and divide uncontrollably.
Exercise can help lower the risk of cancer.
Symptoms and complications of treatment may include:
- Pain
- Fatigue
- Unexplained weight loss