American Medical Society for Sports Medicine

View all recommendations from this society

Released March 29, 2022

Do not forget to routinely assess activity levels and recommend appropriate physical activity to your patients.

Leading an active lifestyle has wide-ranging health benefits for people of all ages. Specifically, studies have shown a decrease in all-cause mortality associated with increasing levels of energy expenditure (Kcal/week). It has also been shown to decrease risk of coronary artery disease, diabetes, hypertension, many types of cancers, and a host of other medical conditions with strong, consistent epidemiologic evidence and moderately strong supporting evidence from clinical trials. Benefits on bone health and mental health have also been demonstrated. In the United States, cardiovascular disease alone accounts for an estimated $214 billion per year in healthcare expenses and causes $138 billion in lost productivity at work according to the Centers for Disease Control. Preventing cardiovascular disease, as well as other conditions, can potentially decrease both the use of healthcare resources and the associated cost.

Practitioners should routinely assess physical activity levels and recommend safe and appropriate activity to patients. The potential risks associated with a well-designed exercise program that accounts for age, baseline fitness level and medical history/co-morbidities are low, and far exceeded by the potential benefits. Some studies have also shown that exercise prescriptions increase physical activity levels and quality of life

These items are provided solely for informational purposes and are not intended as a substitute for consultation with a medical professional. Patients with any specific questions about the items on this list or their individual situation should consult their physician.

How The List Was Created

The American Medical Society for Sports Medicine (AMSSM) has identified this list of clinical recommendations for the Choosing Wisely® campaign. The goal was to identify common topics in the practice of sports medicine that, supported by a review of the literature, would lead to significant health benefits and a reduction of common procedures that can be unnecessary or cause harm. For each item, evidence was reviewed from peer-reviewed literature and several sports medicine consensus statements. The list was initially generated and drafted by AMSSM’s Quality Measures Subcommittee. It was then edited and approved by AMSSM’s Practice and Policy Committee and the Board of Directors.

The American Medical Society for Sports Medicine’s disclosure and conflict of interest policy can be found at


See The benefits and risks of aerobic exercise. Authors: Peterson D, MD, MBA, FACP, FACSM. Section Editors: Aronson M, MD. O’Connor F, MD. MPH. FACSM. Deputy Editor: Kunins L, MD. This topic last edited: January 15th, 2021.

See Exercise prescription and guidance for adults. Authors: Franklin B, PhD. Sallis R, MD, FAAFP, FACSM. O’Connor F, MD, MPH, FACSM. Section Editor: Fields K, MD. This topic last edited: July 22nd, 2020.

Sui X, Lamonte M, Laditka J, et al: Cardiorespiratory Fitness and Adiposity as Mortality Predictors in Older Adults. JAMA 2007 ;298(21):2507-2516.

JANSSEN, I, JOLLIFFE, CJ. Influence of Physical Activity on Mortality in Elderly with Coronary Artery Disease. Medicine & Science in Sports & Exercise: March 2006; 38:418.

Hoffmann TC, Maher CG, Briffa T, Sherrington C, Bennell K, Alison J, et al. Prescribing exercise interventions for patients with chronic conditions. CMAJ. 2016 Apr 19. 188 (7):510-8.

Proper KI, Singh AS, van Mechelen W, Chinapaw MJ. Sedentary behaviors and health outcomes among adults: a systematic review of prospective studies. Am J Prev Med. 2011;40(2):174.

Lemaitre RN, Siscovick DS, Raghunathan TE, Weinmann S, Arbogast P, Lin DY. Leisure-time physical activity and the risk of primary cardiac arrest. Arch Intern Med. 1999;159(7):686.

Mandsager K, Harb S, Cremer P, Phelan D, Nissen S, Jaber W. Association of Cardiorespiratory Fitness with Long-term Mortality. Among Adults Undergoing Exercise Treadmill Testing. JAMA Network Open. 2018;1(6):e183605.

Grandes G, Sanchez A, Ortega R, et al. Effectiveness of Physical Activity Advice and Prescription by Physicians in Routine Primary Care. Arch Intern Med. 2009;169(7):694-701.

Yaman H, Atay E. The effect of exercise prescription of primary care physician on the quality of life in patients. London J Prim Care (Abingdon). 2018; 10(4): 93–98. 

Lobelo F, Muth N, Hanson S, Nemeth B. Physical activity assessment and counseling in pediatric clinical settings. Pediatrics volume 145. number 3, March 2020:e20193992.