Competitive Sports?  Recreational Sports?

What Is the Difference?

"For the purpose of this discussion, recreational sports activities are defined in juxtaposition to competitive sports. A competitive athlete is one who participates in an organized team or individual sport that requires systematic training and regular competition against others and that places a high premium on athletic excellence and achievement.³³ Characteristic of competitive athletes is the strong inclination to extend themselves to extremely high levels of exertion, often exceeding their native physical limits and sometimes for prolonged periods of time, regardless of other considerations.

Conversely, individuals participating in a variety of informal recreational sports and circumstances engage in a range of exercise levels from modest to vigorous on either a regular or an inconsistent basis, which do not require systematic training or the pursuit of excellence and are without the same pressure to excel against others that characterizes competitive sports. The lack of systematic athletic conditioning in the definition of recreational sports is expected to decrease the risk of cardiovascular events.

Sudden cardiac death is usually the result of an interaction between acute triggers and the underlying heart disease (ie, substrate). Triggers for life-threatening ventricular tachyarrhythmias and sudden death during sports include emotional stress, environmental factors, myocardial ischemia, sympathetic-vagal imbalance, and hemodynamic changes. Intensive and systematic athletic training itself may increase the risk of sudden death in the presence of heart disease by promoting disease progression or worsening of the arrhythmogenic substrate (either structurally or electrically) over time. For example, in patients with HCM, recurrent episodes of exercise-induced myocardial ischemia during intensive training may result in cell death and myocardial replacement fibrosis, which in turn enhances ventricular electrical instability.³⁴ In patients with ARVC, regular and intense physical activity may provoke right ventricular volume overload and cavity enlargement, which in turn may accelerate fibrofatty atrophy.³⁵ ..."

"The panel also recognizes that in formulating this definition, some individuals participating in recreational sports nevertheless train systematically (similar to, and as a surrogate for, competitive athletics). Indeed, it is far easier to formulate recommendations for competitive sports, which are easily defined forms of exercise, than for recreational sports, which may include a multitude of physical activities that are part of ordinary daily life. We have not included recommendations for physical activity associated with performing art forms such as dance and ballet."

What is a GCVD?

"A group of relatively uncommon but important genetic cardiovascular diseases (GCVDs) are associated with increased risk for sudden cardiac death during exercise, including hypertrophic cardiomyopathy, long-QT syndrome, Marfan syndrome, and arrhythmogenic right ventricular cardiomyopathy."

"*Recreational sports are categorized with regard to high, moderate, and low levels of exercise and graded on a relative scale (from 0 to 5) for eligibility with 0 to 1 indicating generally not advised or strongly discouraged; 4 to 5 indicating probably permitted; and 2 to 3 indicating intermediate and to be assessed clinically on an individual basis. The designations of high, moderate, and low levels of exercise are equivalent to an estimated >6, 4 to 6, and <4 metabolic equivalents, respectively."

Footnote A:  These sports involve the potential for traumatic injury, which should be taken into consideration for individuals with a risk for impaired consciousness.

Footnote B:  The possibility of impaired consciousness occurring during water-related activities should be taken into account with respect to the clinical profile of the individual patient. Barotrauma is a primary risk associated with the use of the scuba apparatus in Marfan syndrome.⁷³

Footnote C:  Recommendations generally differ from those for weight-training machines (non–free weights), based largely on the potential risks of traumatic injury associated with episodes of impaired consciousness during bench-press maneuvers; otherwise, the physiological effects of all weight-training activities are regarded as similar with respect to the present recommendations.

Footnote D:  Individual sporting activity not associated with the team sport of ice hockey