Can Kids with Heart Transplant Exercise and Play Sports?

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With summer approaching, most parents are trying to figure out how their kids are going to spend the time off. Here’s one of the most common questions we get from our patients’ families:

“Can my child play sports or exercise after a heart transplant?”

Many parents are nervous about whether their kids will get hurt during rigorous physical activity. Or if their child will be able to keep up.

Still, my answer is simple: Yes, your child absolutely can—and should—play sports and exercise after a heart transplant. The key is to be safe about it.

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“But are there certain sports he can’t play?”

We encourage our heart kids to play any sport that interests them, but of course talk to your cardiologist to find out if your child has any limitations.

Some cardiologists might say there are no restrictions on what your kid can play. Others might give more “do this, not that” instructions.

Either way, there are certain sports you should be cautious of early after surgery — like any that could result in a direct blow to the chest. Those include football or mixed martial arts.

Here’s why: During the heart transplant surgery, your child’s breastbone was cut in half. Then, after her new heart was put in place, it was fastened back together with wires (or sutures in infants). That’s why sometimes your child might feel or hear a grating sensation in her chest.

Even after the breastbone has healed, some doctors may prefer that your child NOT participate in activities that could mean taking a hard blow to that area.

“What if my kid can’t keep up?”

The way the heart functions is directly linked to endurance. But for the most part, heart kids keep up just fine.

Just ask Shaun White, a 2006 Olympic Gold Medalist who had 2 surgeries for a congenital heart defect as an infant, or Erik Compton, the professional golfer who had 2 heart transplants, including his first at age 12.

Also, if your child is older, his ability to keep up depends on his activity level before the heart transplant. If he ran track before the surgery, then his endurance will bounce back much more quickly than a kid who was not physically active.

Warming Up and Cooling Down

Additional advice I’d offer to help kids keep up is warming up and cooling down. That’s a really important part of any physical activity, but most people skip it, especially kids.  They want to dart out there and get going; then plop on the bench when they’re tired. But, warming up and cooling down are especially important for kids who have had heart transplants.

They’ve had new hearts put in. So the nerves that controlled their old hearts have been severed. Now, they rely on hormones like adrenaline to let their hearts know that they’re speeding up or slowing down. It can take a little bit longer for their hearts to get the message.

We usually recommend at least 5 minutes of warming up and 5 to 10 minutes of cooling down. They could walk briskly, ride a stationary bike or go for a slow jog.

“I’m still not comfortable with my kid playing sports.”

If competitive sports still make you nervous, it’s important to be honest. If your child asks, try not to tell her, “You can’t.” Because that’s not true. She probably can; it’s just that you’re not comfortable, and explain why.

Then, think about getting your child involved in some other type of regular exercise, like dancing, biking or swimming.

Physical activity is key because there are a couple of bigger issues at stake. One is the national obesity epidemic.

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Kids who have had heart transplants already have more strain on their hearts than non-transplant kids. Not keeping their weight in check could cause issues with blood pressure, diabetes and other health troubles down the line.

Then, there’s the confidence issue. Some heart transplant kids may already struggle with self-esteem because they’ve been through things that are foreign to other kids, and they have different needs than their peers.

Consider how isolating them from group activities like sports could affect how they see themselves.

The interesting thing is that I’ve seen kids pull through medical crises with the grace and resilience of little lions. When they were most vulnerable, their strength was tested. And they passed. Because of that, they can do anything. When it comes to playing sports, I say let them.

FYI: Feel free to share this post with your child’s summer camp counselor or summer school teacher if they plan on being active this summer.

Barb Roessner

Hi, I'm Barb, and I'm a Physician Assistant and coordinator of the Heart Failure and Transplant Program at Children's Hospital & Medical Center in Omaha. I work with patients and families at every step of the journey, from diagnosing their child's heart condition to my favorite part—calling them to say "We have a heart."