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Returning to Exercise Post Covid

With the new Omicron Covid-19 variant having arrived on our doorstep, many of you (and us) have now contracted the virus. Not the start to 2022 that we had been hoping for!

With rising case numbers epidemiologists are predicting 60% of the population will have had Covid in the next few weeks. So we thought it was a good time to discuss returning to exercise post Covid. Especially given that many of you have set yourselves New Year’s health and fitness resolutions and are likely to be hankering to get stuck into them.

 

Current Research

Currently there isn’t huge amounts of research and evidence out there on exercising safely post covid. Nor do we know all the potential long term effects for those who have contracted the virus. But what we do know is that rest and recovery should be your number 1 priority. This is especially so while you are positive, even if you are asymptomatic.

David Salman and colleagues at the BMJ have written a guideline article on returning to physical activity after Covid-19. We have highlighted their points below. They suggest a phased approach to returning to exercise, and recommencing only once asymptomatic for 7 days.

 

Why should I wait 7 days post symptoms before returning to exercise?

With mild respiratory illnesses some light exercise is usually fine. However Covid is a whole new ball game, even if you were essentially asymptomatic.  Apart from potentially prolonging the illness, the main concern is the risk of exacerbating Covid associated myocarditis. Increasing cardiac output could also increase viral load transfer to other parts of the body.

Myocarditis is an inflammation of the heart muscle. It can be associated with even asymptomatic Covid-19 infections (more likely with severe disease though).  Reassuringly most people make a full recovery from myocarditis. However it’s important that a return to physical activity is done slowly and with rest days in between.

 

Gradual return to exercise

A phased return to exercise is recommended, spending at least 7 days in each phase. If symptoms return or exercise feels too hard then drop back a phase. It’s important to remember to listen to your body, stop when something doesn’t feel right. Also pay attention to how you recover post exercise. Seek medical advice if you develop any abnormal shortness of breath, chest pain or fever.

Phase 1: Preparation for return to exercise

Examples: breathing exercises, light stretching, gentle walking.

Phase 2: Low Intensity activity

Examples: walking, light yoga, light household/gardening.

Progress: when can walk 30 minutes with minimal perceived exertion.

Phase 3: Moderate Intensity aerobic activity and strength

Examples: Pilates, body weight exercises, 2 short intervals of aerobic exercise with a rest in between. This could include cycling/swimming/stairs/jogging/brisk walking. You should not feel out of breath and should be able to hold a conversation.

Progress: when can achieve 30 minute session and recover within 1 hour.

Phase 4: Moderate intensity aerobic activity and strength with coordination and functional skills

Examples: add weights, light HIIT, running. 

Progress: when fatigue levels feel back to normal.

Phase 5: Baseline Exercise

Examples: Return to your regular routine.

Forgo the guilt

Try to remember that this virus is out of your control, and Omicron in particular is a highly infectious strain. So even with the best safety precautions in place, it is likely most of us will be infected at some stage. If you have contracted the virus, or do so in the future, there’s nothing you can do but be kind to yourself and focus primarily on resting and recovering. Forgo the guilt of “not exercising enough”, or not meeting your smartwatch or fitness App guidelines. Switch them off, switch netflix on and focus on getting yourself well.

Further advice

If you need more advice on your return to exercise please book in to see one of our physios for a personalized plan. We also work closely with a team of Exercise Physiologists upstairs in our building who can tailor and supervise a return to gym program. If you have had severe Covid-19 symptoms or you have been hospitalized with Covid-19, please ensure you follow up with your medical team before returning to exercise.

Salman D, Vishnubala D, Le Feuvre P, Beaney T, Korgaonkar J, Majeed A et al. Returning to physical activity after covid-19 BMJ 2021; 372 :m4721 doi:10.1136/bmj.m4721

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