Informed Advice Needed On The Question Of Whether It Is Safe To Play Golf With An Ascending Aortic Aneurysm

Is it safe to play golf with an ascending aortic aneurysm?

FitOldDog with his head on one side.

When we wonder we tend to tilt our head to one side (remember the Terminator in the robotic factory recognizing a long lost ancestor in a simple factory robot?). In this case, I’m working to put less stress on my outer right foot when running and cycling, based on lessons learned in Feldenkrais (but a little more subtle tilt than this demonstration for emphasis). It’s all part of body awareness training needed for my daily risk-benefit assessment.

Hi folks! Thanks for stopping by!

I have been working to answer a ‘simple’ question, whether it is safe to play golf with a 4.2 cm. diameter ascending aortic aneurysm, and it’s not so simple.

Since writing this post, I published a detailed approach to determining benefit/risk, for such a question. You want more benefit than risk, that’s for sure!

If you want to return to your sport, safely, with aortic disease.

My story, of returning to Ironman, is laid out in one of my ebooks!

FitOldDog with Deb at the Raleigh Autism 5k Run

FitOldDog is still competing in local, national and even international sports events with his AAA stent graft, so what about the golf guy?

I need information to help this avid golfer, and owner of the aforementioned aneurysm. He really needed a benefit-risk assessment, which only he can do at the end of the day. I carried out a risk-benefit assessment for my situation, Ironman distance triathlete with an abdominal aortic aneurysm stent graft, and decided to keep on trucking. I’m still training and competing with the help of Rupert, my Cook Zenith stent graft, combined with careful modifications of my training to protect Rupert from undue stress. I started by asking questions, such as: (1) Could I induce metal fatigue in the graft by cycling? (2) Which exercises should I avoid to reduce risk of displacing Rupert? (3) Which exercises induce dangerous lower abdominal pressure? It took a while, and it continues every day, especially when I’m undertaking challenging endurance events. But I’m still an Ironman distance triathlete! So what about the guy who wants to play golf?

bobby_jones_golf_swingFive doctors told him no problem, and another (very reputable) told him definitely “No way!” Which critical questions should he ask of the medical community, body movement experts, and himself, for his assessment of acceptable risk? You can’t just stop living your passion solely based on the recommendations of your doctor! You have to take this advice into account and then decide what is OK with you and those you love, especially when it comes to sports and aneurysms.

Here are some questions that came to mind as we (Rupert and I) were driving back from the Mountains of Misery 100-mile bike ride, with tired but happy legs:

  1. I lived in Scotland for five years, played a little, and I know what it means to be an avid golfer -these great people seemed to be obsessed with golf and whisky, so I don't underestimate the concerns of this golf guy.

    I lived in Scotland for five years, played a little golf, and I know what it means to be an avid golfer – these great people, the Scots, seemed to be obsessed with golf (and whisky), so I don’t underestimate the concerns of this golf guy.

    Can one induce dangerous displacement of the aorta during a golf swing, as it is known that movement of the aortic root (near heart) can play a role in dissection.

  2. What is the mechanism(s) of aortic dissection in an individual with a healthy cardiovascular system (apart from the aneurysm!)? A quick look at the literature provides a bunch of different proposed mechanisms for dissection, but I don’t see any clear answers.
  3. If the golf swing does induce aortic biomechanical stresses, can the swing be modified to reduce such risks? For instance, I cut out the rowing machine and squats in the gym, so what are the equivalent training modifications for a golfer?
  4. Have upper aortic biomechanics been examined during the golf swing using advanced techniques, such as cineMRI, with potential insights for our golfer friend?
  5. I read that weight lifters and golfers are at increased risk of sternal fractures, which is pretty close to the ascending aorta, but does this have relevance to aortic dissection in this site?
  6. Is there someone out there who really knows the answer, as it could save this guy and his family a great deal of time and heartache, and perhaps his passion, golf (which is number two to his family).

All help would be very much appreciated.

Knowledge provides power over one’s life.

-k @FitOldDog

 

Comments

  1. I also wish for answer for my 74 year old dad diagnosed yesterday, 9 jul 13 who plays golf vigorously 2-3 times a month. Currently 3 CM.
    Thanks

    • Sorry.
      Its an abdominal anurysm (AAA)

    • Alan Martins says:

      Hi,
      At 3.0 cm is very small. He may never need surgery at his age if he keeps fit and has normal BP. If not he needs to lower ASAP. I play golf with a 4.2 ascending aneurysm. I have a call to my guy and I have friendships with the top ten Aorta surgeons in the world. I have sent him the question on playing golf with an AAA. Look up Jason Sperling or got to the AAA forum in Facebook I listed a site to contact Dr Sperling with any questions as he has agreed to answer all questions that we post. As soon as I hear from him I will post his answer .
      If you contact him tell him Alan Martins sent you.
      Best of luck.

      Alan

  2. Hi Scrappy, I think that you need to talk to Alan, avid golfer with 4.2 ascending aortic aneurysm, to compare notes. Then I think there is a need for specific sport-related pages for people to discuss the affect of aortic aneurysms on their particular sport, and vice versa. Let me ask Alan to wade in, as we spent some time working on this, and he is becoming the expert. My skill lies in finding ways to work out what to do, and then each person has to decide for themselves how to approach it – it is a risk-benefit question, like many things that we enjoy in life. I’ll send this link to Alan, and we’ll see what he has to say. Please say ‘Hi!’ to your Dad, but at 3 cm. I would continue playing, whilst monitoring the size using ultrasound and staying in touch with a surgeon who actually understands the underlying biology, but we each have to make that call for ourselves. I’ll be back! Cheers, Kevin aka FitOldDog (for as long as I can be! Off for a run with a friend, which isn’t bad for 70, and my party was a blast.).

  3. Carol Belt says:

    Hi Kevin, I just found your site and have a question. I have been diagnosed with a 4.1 cm ascending thoracic aortic aneurysm. I have been continuing to use the rowing machine at the gym because I read it was safe. I read that you have stopped using the rowing machine. We’re you told this or did you find this through research? I just want to make sure that I am not doing anything to risk a dissection. Thanks . Carol

    • Hi Carol!
      When it comes to the rowing machine, the real concern is for AAA, as one wants to avoid excessive lower abdominal pressure. I found a reference to at least one person who had displaced their AAA stent graft through rowing, which I think is linked on my site – I’d have to hunt as it was several years ago. If I find it, I’ll post this link here.
      That said, for a thoracic aneurysm, I wouldn’t be too concerned about the rowing machine, as it doesn’t torque the chest. But remember, we are all guessing. Alan has had his for years, at 4.2 with no change, which makes me wonder if ascending aortic diameter is more variable than people realize.
      The trick, in your case, is to watch for growth, and live your life.
      Wish I could get back on the rowing machine, as it was my preferred way to warm up before weight training.
      I hope that helps, and if I can help in any way, just let me know.
      I’ll go look for that reference.
      Wishing you well.
      Kind Regards,
      Kevin
      PS I found the link to that article, which is embedded in this blog post
      http://athletewithstent.com/2010/11/12/training-for-older-people-with-or-without-an-aaa-stent/
      with the following anchor text: rowing

  4. Sam Cassandra says:

    I am 68 and have a thoracic aortic ascending aneurysm (4.8 cm). I used to run a lot but due to OA in both knees and back conditions, I’m now limited to walking. I walk 6-8 miles per day with a little running thrown in, averaging 18-20 minutes per mile. My question is, can I golf with my son? I haven’t golfed in over a year and then only occasionally. I know I can’t do any heavy lifting which isn’t a part of golf but I’m wondering about the torque created with the swing. Thanks.

    Sam Cassandra

    • Hi Sam, this isn’t a new question for me. It started with Alan a few years ago, who you need to talk to. He went ahead with golf and no problems. I forget his ascending aortic aneurysm diameter, but I think it was 4.5ish. He’ll talk to you I’m sure. For me it all comes down to benefit/risk assessment, about which I blogged a while ago at this link:
      http://athletewithstent.com/2013/08/15/rediscovering-your-sport-and-your-life-after-life-saving-surgery-recovery-using-semi-quantitative-benefitrisk-assessment-v1/
      When it comes to golf, the torque was the first thing I was concerned about. I wondered if it was possible to modify one’s swing, to move more from the hips than the thorax. Everyone is guessing, as there are no good data.
      Talk to Alan, and then get back to me. For me, with an ascending 4.8, I would probably go ahead, because I love to do Ironman races with my son.
      Let’s see if Alan responds, as he follows my stuff.
      I would suggest you also post the question on the AAA Awareness support site, as there are plenty of great people to talk to there, at:
      https://www.facebook.com/groups/2283898552/
      Read my benefit/risk article and get back to me, if I can help further.
      Kind Regards,
      Kevin

  5. Lhiz Fequiere says:

    Hello, I was first diagnose with aortic aneuresym last October 2014 at 3.8 cm and last February 2017 it went up to 4.2 cm, I am 41 years old and I am kind of concern about this because it looks like it gets bigger quickly. Is there any advise what should I do? I am scared really. Thank you.

    Lhiz

  6. Hi Lhiz,

    I’m sorry you’re going through this, but at least you know, before it becomes dangerously large.

    Mine was 6.9 cm when I found it in 2010. You need to double check the size, by getting scans/ultrasound, regularly, to be sure it’s really expanding. Some just sit around 4 cm for years.

    Did the same person make the measurements, as these numbers can be inaccurate, especially with ultrasound?

    If it is growing rapidly, you need to plan for surgery, when it hits 5 cm – the choices are minimally invasive stent (mine has caused problems twice since 2010, but I still live a very active life, but I’m 74), or a graft (best choice, if there aren’t serious side effects of open surgery, and more risky in men than women).

    It’s important to talk to people, and to develop a support group. The AAA Awareness page is the best place, at the following link, where you’ll receive support and advice:

    https://www.facebook.com/groups/2283898552/

    Stay in touch, keep talking, stay calm, fear doesn’t help, never does.

    Kindest regards,

    kev

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Disclaimer: As a veterinarian, I do not provide medical advice for human animals. If you undertake or modify an exercise program, consult your medical advisors before doing so. Undertaking activities pursued by the author does not mean that he endorses your undertaking such activities, which is clearly your decision and responsibility. Be careful and sensible, please.