If you’ve just started life with a pacemaker, it might feel like everything has changed. The idea of getting back to normal routines, including exercising, can feel daunting or even impossible. However, it’s absolutely possible in most cases to adjust and get back to a good routine—pacemaker patients are often able to resume most exercises eventually, depending on the condition of their heart. Exercise is a great way to build strength, lower cholesterol, and reduce risk for heart disease, so it’s something you should prioritize as soon as you can. If you’re not sure where to start on getting back in shape, here are some guidelines to help you get moving.

First Steps: Talk to Your Doctor

Before you start exercising, it’s important to talk to your doctor about what they believe is safe. You may need an ECG before you embark on a new exercise program, to determine your individual tolerance for exercise with a pacemaker. Every case is different, and your doctors know your specific situation better than anyone. They might advise you to avoid certain activities, take precautions, or just give you the green light to start gradually building up your fitness. Regardless, you don’t want to take chances with a new pacemaker or risk your health, and utilizing integrative care to address your concerns should be the first step before you step out for a jog.

Start Slow

As with any exercise program, it’s important to start slow. Ramping up too quickly could be hard on your heart, and could also cause other injuries as well. With this in mind, try to begin with gentle to moderate activity. You might want to start off with just a brisk walk or push once or twice a day, gradually increasing distance and/or pace. If your doctor approves strength training or jogging/hand-cycling, start with just a few reps or a few short intervals. If you have just had your pacemaker put in, you will need to wait at least 6 weeks before beginning any serious exercise program.

Don’t Give Up

This piece of advice applies to everyone who is beginning a new fitness regimen—don’t give up! Because it’s best to start slow, it can feel like you’re not making any progress, when in reality, you’re building up both strength and endurance. If you’re having trouble working toward your goals, getting a personal trainer or accountability buddy to exercise with can be helpful. Just make sure they’re not pushing you harder than your pacemaker can take.

Avoid Some Sports

After the first 6 weeks, it’s generally safe to start low to moderate intensity exercise. However, people with pacemakers should take care when swimming, playing golf, or participating in other sports that require a large range of motion in the shoulders, as it’s easy to crush the pacemaker wire. Contact sports are also not a good idea for pacemaker patients.

When in Doubt, Ask

Keep in close contact with your doctor about your activity levels. You should let them know immediately if you experience any negative symptoms due to exercise, such as pain or shortness of breath. Using a mobile health app while exercising and can help you log any symptoms or health data that may be important for your doctor visits as well. Make sure you have everything you need before getting started, such as any equipment you may want to use. And remember—when in doubt, ask. You’ve got this!