If you like to exercise outside, it’s tempting to just soldier through colder weather without changing your routine too much. However, cooler temperatures can greatly affect everything from your muscles to certain medical conditions.

“Extreme cold weather can cause a person’s airways to tighten, making breathing more difficult,” said Jennifer Blevins, a nurse practitioner with Novant Health Primary Care Salisbury . “The body works harder to keep warm, requiring more energy to do so. The muscles require more energy as well to regulate your body’s core temperature.”

Here are a few things to consider, courtesy of Blevins, before you head outside for that long walk or winter training run.

Layer up

Wear lightweight, synthetic material closest to your body. “This allows you to stay dry better when you are working out,” Blevins said. “Keeping moisture away from your skin helps you to stay dry and warm at the same time.”

Consider fleece or wool as a second layer to help insulate if you will be outside for some time. Your third outer layer should be a breathable, waterproof, wind-repellant item.

“Most of the body’s heat is lost through the skin, and the most heat is lost through the head, so wearing a hat is a good idea. Be sure to cover your ears, which are susceptible to frostbite in extreme cold,” Blevins said. In addition, wear gloves to protect your fingertips, and ensure your feet stay warm and dry with proper footwear and wicking socks, not cotton, and are specially designed to keep feet dry.

Stand out

Visibility in the winter months can easily be overlooked. “Dress in light-colored, reflective clothing,” she said. “It gets darker earlier, and you want to ensure you are seen while you are outside exercising.”

Stay stable

This may seem like a no-brainer, but be sure your footwear is up to the task. “You need to plan on wearing good shoes that are sturdy and slip resistant,” Blevins said. This also may mean adding traction to everyday running shoes if you plan on running on areas at risk for ice.

Warm up

“Not warming up before a chilly run or exercising in the cold can actually be a shock to your body, causing your muscles to feel tighter,” Blevins said. “This can lead to an increased incidence of injury due to sprains and strains.” Be sure to stretch indoors and perform some dynamic stretching movements to raise your heart rate to warm your muscles before you head outside.

Special considerations

“Medical conditions that can be aggravated by cold weather include asthma, hypertension, heart disease, diabetes and COPD, just to name a few,” Blevins said. “People with health issues need to discuss their exercise plan with their primary care doctor.”

If you have asthma: It’s important to always carry your rescue inhaler with you, Blevins emphasized. “The cold air can make your body work overtime, especially the heart and lungs, because these organs work together to keep you warm,” she said. “This can cause blood pressure to rise as the blood vessels constrict, making breathing more difficult and leading to an acute exacerbation of asthma symptoms.” Caution should be exercised with any strenuous activity, from running to shoveling heavy, wet snow.

If you have diabetes: “It’s important to dress appropriately to minimize frostbite and wear sturdy, slip-resistant shoes to protect feet and circulation,” Blevins said.

If you have a heart condition: “Discuss your exercise plans with your primary care doctor to customize a plan that’s safe for you,” she said.

If you are elderly: “Take precaution to stay warm but not to overdress. Layering is key,” Blevins said. “Wearing good, sturdy shoes that are slip resistant can help reduce falls. The elderly also need to exercise in a familiar area with good lighting to reduce the risk of falls.” She added that the elderly also should discuss exercise plans with a health care provider to establish what is safe for them individually.

Head inside if temps get too low

“If the windchill is negative, skip the outdoors and stay inside,” Blevins said. “Exposed skin has an increased risk of frostbite in less than 30 minutes in extreme cold. Definitely opt for an alternative to being outside in these conditions.”

Know your limits

“It’s important to know your limits when temperatures dip,” Blevins said. “Discuss your exercise plan with your doctor. Be prepared to enter the cold. Watch for skin numbness or tingling, trouble breathing or muscle soreness. Be smart and proactive and stay safe!”