You have a doctor’s appointment to check out your heart. He’s making you do what’s called “The Stress Test” (also known as “the treadmill test” or the “treadmill stress test”). If you’ve had it done, you know what it is. If you’ve never had it done, it goes like this:
Your doctor or cardiologist puts you on a treadmill, and looks at how your heart is behaving. Then, he raises both the speed and the incline, and continues monitoring how the heart is behaving. Eventually, they cut off the test, and tell you what’s going on.
Original source: here.
So if you want to wipe off that smug smirk off your cardiologist’s face, or you want to see his jaw all the way on the ground, pay attention to this article. Or if it doesn’t apply to you, send it to a friend or family member who would benefit from this.
The Protocol
Depending on your age and shape you can have one of two separate tests:
Test 1:
For 3 minutes, you walk at a pace of 1.7 miles per hour, and no incline.
If everything goes well, the cardiologist then raises the speed to 2.5 miles per hour, and an incline of 5 degrees.
The next stage is a speed of 3.4 miles per hour and an incline of 10 degrees.
Then a speed of 4.2 miles per hour and an incline of 12 degrees.
Then a speed of 5.0 miles per hour (at this point, you’re running) and an incline of 14 degrees.
Test 2:
If you’re younger and/or more fit, the cardiologist may just skip the first stage of walking at 1.7 miles per hour, and no incline, and put you straight into stage 2.
So if you’ve done any workouts on a treadmill, you’ll notice that the speeds are not crazy. They’re not exactly breakneck speeds. The real challenge of the stress test is the incline. That’s why in the past, we’ve had clients who were very fit in the cardiovascular sense, but they failed the stress test. Miserably. Why? Because they only run on flat surfaces, or on only a slight incline (or they bike, or use the elliptical, or swim, etc.). To really hit this one out of the ballpark, you need to train for it with an incline.
In exercise, there is a principle called the SAID principle, which is “specific adaptations to imposed demands.” The emphasis is on “specific.” If you practice running on flat surfaces, you’ll get good at running on flat surfaces. If you lift weights, you’ll get good at lifting weights, but not so good at swimming. If you practice yoga, you’ll be good at yoga, but not gymnastics.
So you want to know how to pass the stress test? Train with an incline. A steep one. And don’t do one of the dumbest things I see in the gym: cranking up the incline, but holding on to the treadmill as you’re walking. That negates the incline. And also, it makes you look dumb.
Original source: here.
Of course, that is grossly oversimplified, because people have different starting points. A program that prepares an already fit person for a stress test will be very different than a program that prepares an unfit person for a stress test. Also, the amount of time you have to prepare for the test would determine how you would exercise. So below, I’ll give you a few principles, but in the meantime, if you want a program designed that’s less generic, and more tailored to you, just fill out this questionnaire to see if you qualify to work with us.
How to Train for the Stress Test
The first step in preparing for the stress test is actually doing the test on your own. So follow the protocol I mentioned earlier in this article on your own.
And when doing it on your own, you’ll want to measure and write down your heart rate every minute. You can do that either by wearing a heart rate monitor, or by holding on to the heart rate sensors on the treadmill. I prefer the heart rate monitor, because you don’t have to wait the 15 or so seconds that it takes the treadmill to figure out your heart rate.
The test is over for you as soon as you reach your theoretical maximal heart rate. What’s your theoretical maximal heart rate? It’s 220 minus your age. So if you’re 60, your theoretical maximal heart rate is 160 beats per minute. Once you reach that mark, the test is over.
From your self-test, you want to note:
- Your pre-exercise heart rate: what was your heart rate right before you stepped on the treadmill?
- The amount of time it took to reach your maximal heart rate.
- Any points along the test where the increase in heart rate accelerated.
- Your heart rate 1 minute after the test is over. This is called your “recovery heart rate.” The larger the drop, the better. It means that you recover faster.
I just want to point out a HUGE caveat: The stress test is called “The Stress Test” for a reason: it’s stressful. It puts stress on the heart. If you’re not a regular exerciser, don’t do this exercise on your own. If you haven’t gotten clearance from your doctor to exercise, don’t do this test. If you have high blood pressure, and you’re sedentary, don’t do this your very first time in the gym.
Proper Progression
And now, ladies and gentlemen, once you have the data from your own test, here is how you craft your own program to pass the stress test. You ready? You excited? I’m excited!
So ask yourself: how much time do you have to get ready for the stress test?
If it’s just about 2 months or less, then just practice the test protocol 2-3 times per week.
But if you have more time than that, then here’s a generic program:
- Warm up for 3-5 minutes at a speed of 3.0-4.0 mph.
- Walk at a speed of 3.5 and an incline of 5.0 for 2 minutes.
- Walk at a speed of 3.5 and no incline for another 2 minutes.
- Repeat steps 2 and 3 six times.
- Cool down for 5 minutes by first walking at 3.5 mph with no incline for 2 minutes, then 3.0 mph (no incline) for another 2 minutes, and finally, 2.5 mph (no incline) for the final minute.
Once you can do this workout, with your top heart rate (the highest heart rate of the entire workout) not going above 90% of your maximal heart rate (so again, if you’re 60 years old, your maximal heart rate is 160. 90% of that is 144), you move on to the next step. This may take 1-5 workouts.
The next step is repeating that same workout, but this time, with an incline of 6.0 (same speed: 3.5 mph). And then, you continue with that, until your top heart rate doesn’t exceed 90% of your maximal heart rate. Which again, can take between 1-5 workouts.
After that, raise the duration to 3 minutes at an incline of 6.0 and a speed of 3.5. But when you’re walking without an incline, it’s still 2 minutes.
Next step: raise the incline to 7.0, then 8.0, then 9.0, then 10.0, then 11.0, then 12.0.
Once you’re doing 3 minutes at a speed of 3.5 mph, and an incline of 12.0, start decreasing the time without an incline.
So next workout, you would walk for 3 minutes at a speed of 3.5 mph, incline 12.0, but then it will be followed with only 1 minute and 50 seconds at a speed of 3.5 mph and no incline. Then, once you can do that without your top heart rate exceeding 90% of your maximal, you would again decrease that interval of no incline to 1:40. Continue reducing it until it gets to 0.
Once you get to that point, start raising the speed. So all along, you’ve been walking at 3.5 mph. Now, go up to 3.7 mph. Once you can do that without your top heart rate exceeding 90% of your maximal, increase further to 3.9 mph, and continue with this progression.
So for now, you have about 4-8 months’ worth of progressions.
Real Life Example
So you got a bunch of the methodology of how to pass the stress test. Let’s look at a real-life example from one of our clients, Jack. When he started working with us, he was 68.
Here is a record of his very first workout, on October 17, 2014:
| Minute | Speed | Incline | Heart Rate |
| 0 (resting) | 0 | 0 | 74 |
| 3 | 3.5 | 0 | 89 |
| 5 | 3.5 | 5 | 112 |
| 7 | 3.5 | 0 | 103 |
| 9 | 3.5 | 5 | 124 |
| 11 | 3.5 | 0 | 116 |
| 13 | 3.5 | 5 | 131 |
| 15 | 3.5 | 0 | 124 |
| 17 | 3.5 | 5 | 135 |
| 19 | 3.5 | 0 | 128 |
| 21 | 3.5 | 5 | 141 |
| 23 | 3.5 | 0 | 135 |
| 25 | 3.5 | 5 | 145 |
| 27 (cool down) | 3.5 | 0 | 139 |
| 29 | 3 | 0 | 126 |
| 30 | 2.5 | 0 | 118 |
Here is a record of his last workout before the stress test, 6 months later, on April 15, 2015:
| Minute | Speed | Incline | Heart Rate |
| 0 (resting) | 0 | 0 | 68 |
| 3 | 3.5 | 0 | 86 |
| 6 | 3.5 | 10 | 109 |
| 8 | 3.5 | 0 | 99 |
| 11 | 3.5 | 10 | 115 |
| 13 | 3.5 | 0 | 103 |
| 16 | 3.5 | 10 | 120 |
| 18 | 3.5 | 0 | 108 |
| 21 | 3.5 | 10 | 124 |
| 23 | 3.5 | 0 | 111 |
| 26 | 3.5 | 10 | 128 |
| 28 | 3.5 | 0 | 116 |
| 31 | 3.5 | 10 | 134 |
| 33 | 3.5 | 0 | 121 |
| 35 | 3 | 0 | 110 |
| 36 | 2.5 | 0 | 104 |
Here are a few things you should pay attention to:
- In the first workout, Jack’s highest heart rate throughout the whole workout reached 145. Well above 90% of his maximal heart rate (which was 152). In his last workout, his highest heart rate was 134.
- In the first workout, Jack’s resting heart rate was 74. In his last workout, it was 68. A sign of better heart function.
- In the first workout, Jack’s recovery heart rate (the amount of beats his heart rate decreased between the intervals with an incline and the intervals without an incline) was between 6-9 beats per 2 minutes). That’s really bad. The greater the drop, the better. By his last workout, Jack’s recovery was 10-13 beats every 2 minutes. I’d like to have seen this number get even better (closer to the 20-25 range), but still, a pretty good improvement.
- And of course, even though objectively the last workout was much harder (incline increased from 5 to 10, and time of the intervals with incline increased from 2 minutes to 3), perceived difficulty was much lower (again, despite an objectively easier workout the first time, his heart rate was higher at every interval, compared to the last workout).
Overall, Jack’s cardiologist was very impressed with the results.
Of course, with every client, we analyze the results afterwards, and think what could have been done better, and now, our methodology is even more refined, and we get results even better than this.
So if you want help with your own stress test, you can see if you qualify to work with us by filling out this quick, 1-minute questionnaire.