How to safely resume your exercise routine after recovering from COVID-19
Original article published via ABC News
Getting moving again after recovering from COVID-19 is no walk in the park for some people and experts warn that pushing yourself too hard, too soon, can be detrimental to your recovery.
Even those with peak levels of fitness who only suffer mild COVID-19 symptoms can be overcome with exhaustion and struggle to get moving after their infection.
For Sydney personal trainer Matt Hunt, getting back to the gym after days of fevers, aches, headaches and night sweats from COVID-19 was more tiring than he imagined. "It's just the energy levels, it really knocks you … they take a while to come back and there's no easy fix," he said.
"I've never lied down on the couch for five days in a row, so that was a novelty for me."
When can I start exercising again?
The general consensus among exercise physicians is to wait at least seven days after you first experience symptoms to resume any form of exercise.
But don't jump back in like you're qualifying for the Olympics. Instead, start with low- or light-intensity activities.
"This might be things like everyday activities — for example, housework, light garden tasks or gentle walking — for the first couple of weeks," says Selina Parry, senior lecturer at the University of Melbourne's department of physiotherapy.
You should be able to do tasks such as these while holding a full conversation.
From there, gradually increase the time you're doing these tasks, perhaps by 10 to 15 minutes per day, until you get to the point where you can complete a 30-minute walk at a light intensity, suggests Dr Parry, who specialises in intensive care patient recovery.
What if I am completely asymptomatic?
There's no evidence to definitively say you should or should not exercise before day seven of your infection if you're experiencing no symptoms. But, Dr Parry says, even if you feel perfectly well after testing positive, monitor how you are feeling very closely if you engage in exercise.
How do I progress?
The most important thing to remember is to implement a gradual, slow return to physical activity. After a week or more of gentle movement, you can progress to moderate exercises — such as brisk walking or swimming — for a week.
"You might be breathing a bit harder than normal, but you shouldn't be out of breath and you should be able to hold a conversation," Dr Parry says.
Following this, Dr Salman advises levelling up to some more complex movements that use coordination, strength and balance, such as running with changes in direction or circuits of bodyweight exercises.
"Again, without it feeling hard," Dr Salman says. When you're able to complete these activities, you should be ready to return to your pre-COVID level of activity or more.
When to stop
It's likely you may be more breathless than usual when restarting your regime but be alert to the return of or development of COVID-19 symptoms.
"Things I'd be looking out for include abnormal levels of fatigue or exhaustion, breathlessness, racing heart, dizziness, cough… any increased signs or symptoms or new symptoms," Dr Parry says.
Chest pain should also ring alarm bells and at least a visit to a doctor because some people with COVID-19 can develop myocarditis (heart inflammation), however, this is thought to be rare in those with mild to moderate COVID-19.
Monitor how you feel one hour after exercise and the day after.
"It's just about making sure you're not flaring up your symptoms," Dr Parry advises. "You should be able to feel recovered an hour later and the next day you shouldn't be going, 'Oh my goodness I can't even think about doing what I did yesterday."
Research is still evolving, Dr Parry says, it is critical to minimise something called "post-exertion symptom exacerbation", which could cause prolonged symptoms, commonly referred to as "long COVID" and, if you are struggling getting back into some physical activity due to weeks of fatigue, seek individualised support from a GP, physiotherapist or exercise physiologist.
What to expect
Dr Parry says that, for some people, it will take weeks to get back to their pre-COVID level of fitness but others will bounce back a lot quicker. "If you have a more prolonged time when you're not active, you will lose some of your fitness. Recognise what you have been through."
Will exercise help me?
As long as you slowly, gently build up your routine, yes.
The physical and health benefits of being physically active significantly outweigh the risks of not engaging in exercise, post-COVID, for many people. If you're not feeling motivated though, the smallest of steps can help.
"If you are lying down and feeling like you have no energy if you just get up and move a little bit … reach down and touch your toes, or any sort of mobility moves, even just five minutes of a yoga flow, you will feel so much better," Mr Hunt says.
"If you're moving the body and breathing, then the blood flow and oxygen rush through your whole entire body, which makes you feel a lot better, so your endorphins are flying."
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