Returning to Exercise Post COVID-19

Exercising can be hard at the best of times. Fitting training into a busy schedule is difficult, and this can be made even harder when you experience setbacks.  

You probably know the feeling – you’ve made the commitment and after four weeks of really knuckling down and staying super consistent with training, you’re starting to see the benefits. You start to feel stronger and fitter, you recover from your workouts faster and maybe those jeans slide up just a little easier. But then, a minor injury or an illness prevents you training for a week or so, and suddenly the routine slips. It’s easy to feel like you’re back where you started, but all it really takes is consistency and care to bring it all back.  

But what about if you’ve had COVID-19? There’s so much misinformation and media hype around the virus that it can be difficult to know the right path to take. Due to the recency of its spread, there is still a lot of research to be done, but this blog can help you navigate a return to exercise using the best scientific advice that’s available so far.  

The most common symptoms of COVID-19 include fever, cough, fatigue and loss of taste or smell. Other symptoms include sore throat, muscle aches and pains, headache, diarrhoea and rashes, while severe symptoms might include shortness of breath or difficulty breathing, confusion or loss of speech or mobility or chest pain. 

There is a wealth of evidence showing that being physically active and having cardiovascular fitness can either prevent or minimise the severity of infections. As with many other diseases, COVID-19 has been shown to manifest with more severe symptoms in those who are physically inactive. On the other side of the spectrum, people with high levels of cardiorespiratory fitness have had lower rates of hospitilisation due to COVID-19 infection. 

Despite this, there are many things to consider when continuing or resuming exercise after infection. A return to exercise after a COVID-19 infection needs to be cautiously introduced. Due to the comparative recency of the pandemic, definitive data is difficult to find however, many exercise physiologists are concerned about the potential risks of high intensity physical activity or exercise following the contraction of the virus. 

While some people have experienced little to no symptoms and have been able to continue most of their exercise routine throughout the course of their illness, others have had very severe symptoms and been affected by fatigue for weeks after the initial infection has passed. Some have also been affected by persistent symptoms after infection, mainly consisting of breathlessness, headaches, coughs, chest pains and muscle pains. Although there is still not conclusive evidence around this phenomenon, researchers have termed it “long COVID syndrome”, and the full effects of it are yet to be determined. People who have experienced long CoVid often report much lower tolerance to intensity while exercising. There are several potential causes for this, including a lower peak aerobic capacity, feelings of breathlessness, low blood pressure and fatigue. 

So where does this leave you when you’re attempting to return to your usual level of activity after a COVID-19 infection? Most advice recommends a very slow, graded return to exercise. Even walking should be reintroduced slowly to assess tolerance. It is important to avoid over-reaching during the early stages of return to activity, as this may prompt relapse or delay recovery. 

Depending on your previous level of physical fitness and activity, it is also important to consider the musculoskeletal system during your return. While it may have taken a long time to build strength, stability and coordination through the muscles, tendons, ligaments and bones, this strength can become de-conditioned quite rapidly and especially after a serious illness. 

Some recommendations for beginning the process of returning to exercise include: 

1. Begin gradually, with only 15 minutes of light intensity walking or cycling. Be attuned to how your body feels and stop if you feel weak, dizzy or faint.  
2. Try to only train every second day to begin with, allowing you to fully recognise how your body responds and recovers. 
3. When beginning strength training again, drop volume, load and intensity right down. Increase rest periods between sets and between sessions. 
4. Mentally, the process of rebuilding can be very frustrating. Especially if exercise is an outlet for you, it is important to be kind and patient with yourself as you build back up. 
5. Because of this frustration, try to find an alternative outlet for stress and anxiety. Try some meditation or gentle stretching, reading, baths or drawing. 
6. Consider seeking advice from professionals like an exercise physiologist or experienced personal trainer during your journey back to peak performance, and if you are struggling consult a GP or mental health practitioner too. 

So, in summary, like any fitness experience, the return to exercise after having COVID is a really individual journey. It’s important to celebrate small wins and try to enjoy the process as much as possible, because it may seem very daunting at first. Always err on the side of caution rather than risking a setback, and always seek professional help if you need it.