Everyday Activities
Learn about everyday activities and cavernoma, including exercise, flying, travel, weight lifting, smoking and alcohol. Understand what current evidence says about bleed risk and when to seek advice from your doctor.
Overview
This information is a general guide and does not replace medical advice. Decisions about activities should be made with your doctor, as advice may vary depending on your symptoms, recent bleeds, seizures, and overall health.
People often ask whether it is safe to do certain activities if they have a cavernoma.
Having a symptomatic cavernoma is rare, and there is still a lot that is not fully understood about why cavernomas form and why some bleed. This means everyday questions, such as about exercise, travel or other activities, have not been studied directly.
For many activities, we cannot say that research has proved they are safe, but equally there is little or no evidence that they increase the risk of a cavernoma bleed. Advice is therefore often based on the available evidence, current medical understanding, clinical experience and expert opinion where evidence is limited.
While it is natural to feel cautious, it is also important to recognise the wider benefits of staying active and continuing with everyday life. Physical activity is important for wellbeing, and many people living with cavernoma continue to take part in a wide range of activities.
Everyday Activities
The following are not known to raise bleed risk, and based on current understanding are not usually thought to be a particular concern:
- flying in a commercial, pressurised aircraft
- aerobic physical activity (e.g. walking, running or cycling)
- sexual activity
- giving blood
- consuming caffeine in moderation
- dental treatment, including drilling
- everyday devices (e.g. hearing aids, Bluetooth devices, TENS machines)
That does not mean each of these has been proven safe by research. It means there is little or no direct evidence that they increase risk, and current evidence and clinical understanding do not suggest that they make cavernoma bleeding more likely.
Having a cavernoma does not, by itself, mean that you cannot give blood. However, the usual blood donation eligibility criteria still apply. This includes considerations such as previous surgery, including neurosurgery. Further NHS guidance is available here.
TENS machines are not known to increase cavernoma bleed risk. However, they are not recommended for people with epilepsy. If you have a history of seizures, seek advice from your healthcare professional. Further NHS guidance is available here.
Some activities are less well understood. They have not been shown to cause cavernoma bleeds, but there is not enough research to give a firm answer:
- contact sports (see our head injury page)
- flying without cabin pressure control (e.g. small aircraft)
- high altitude mountain climbing
- heavy or very strenuous weight lifting
- certain yoga positions (e.g. head stands)
- scuba diving
- rollercoasters
- trampolining
This information is based on current research and the CCM Care Guidelines.
High altitude refers to much greater elevations than those found in the UK (for example, mountain ranges such as the Himalayas), so activities such as walking in the UK, including climbing Snowdon (Yr Wyddfa), are not considered high altitude.
If you are a professional athlete, you should seek advice from your relevant sporting regulatory body, as individual sports may have their own rules or requirements. Gyms and other organisations may also have their own policies regarding participation
For weight lifting, available research has not shown an increased bleed risk with typical lifting, but there is less certainty around very heavy or strenuous lifting.
Smoking and drinking
Smoking and heavy alcohol use (binge drinking) are best avoided. This is based on general health, but also on what we know about cavernoma.
For smoking, higher lifetime exposure has been linked with increased bleeding risk in people with familial cavernoma, and smoking is also known to increase the risk of stroke more generally. Clinical guidelines therefore advise avoiding smoking.
For alcohol, the main concern is binge drinking. Some people who had a cavernoma bleed reported recent binge alcohol use. For this reason it is advised that binge alcohol drinking should be avoided in patients with cavernoma.
There is no clear evidence that occasional or moderate alcohol increases bleed risk.