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Returning to Physical Activity after COVID-19

This may not have been the start to 2022 that we had hoped for. Pretty quickly the new Omicron variant of COVID-19 was knocking on our doors. Many of you may have already contracted the virus, but there is still a large population of people who haven’t. We thought it would be the right time to discuss returning to physical activity and exercise after COVID-19. 

It’s not as simple as just being able to jump back into your pre-COVID routine or performance. Overtaxing your body whilst still fighting an active infection, or right after recovering from your symptoms, can do more harm than good. Let’s break down all the factors of returning to physical activity after COVID-19.

What happens to your body when you get COVID-19?

Everyone’s experience with contracting COVID-19 is different. Some people show no symptoms at all, while others can feel ill and lethargic, and some experience life-threatening situations. After contracting the infection via the mouth, eyes or nose, the virus sets up shop by attaching to your cells and quickly hijacking them to generate more of the virus which spreads to other nearby cells.  

This is how all viruses work, even the common cold. However, in most cases, it only spreads to the nose and throat, which is why you only ever get a sore throat or runny nose. COVID-19 on the other hand can be more aggressive and target the lungs and respiratory system. It is usually a mild respiratory disease, but as we know, it can cause severe illness and long term complications such as ongoing fatigue, myocarditis and airway hypersensitivity.

After COVID-19

Even those with peak fitness levels who contract COVID-19 and only experience mild symptoms can be overcome with exhaustion and tiredness to get up and move. Health practitioners are constantly determining the most medically appropriate return to play protocols for the resumption of recreational activities and competitive sport. 

You want to minimise your risk of succumbing to ‘post-exterion symptom exacerbation’ also known as ‘long COVID’. It refers to when you continue to have COVID-19 symptoms for months post your diagnosis, which can occur for 3 – 9 months. Even those who had mild COVID-19 symptoms, and were not hospitalised, can still develop long COVID.

Returning to Physical Activity

Returning to physical activity is important for patients recovering from COVID-19, but it must be done gradually and safely. A cautious re-entry approach to exercise is recommended and the most appropriate.

What to expect

Do not expect to be able to jump straight back into your pre-covid level of fitness. Recovery is different for each individual, so try not to compare yourself with others. Some people will bounce back quite quickly while others will take longer to recover and return to their pre-infection performance and routines. When you start to return to physical activities you may find that you’re breathing harder than normal, but you shouldn’t be out of breath. Be honest with yourself after each session about how you’re feeling. If you’re returning to group classes, explain to the trainer or instructor that you’ve just recovered from the virus as they will be able to assist you in variations of exercises to aid in your recovery.

Assessing your return to physical activity

The Australiasian College of Sport and Exercise Physicians has released a framework for assessing your return to physical activity post-COVID-19. First, you need to identify whether you’re classed as a low, intermediate or high risk. Let’s break these down:

Low risk

  • You experienced mild or no symptoms
  • You only experienced upper respiratory symptoms only 
  • You are a younger patient
  • You have recreational exercise goals (you’re not an elite athlete) 

Suggested return to physical activity after:

From your diagnosis of COVID-19, you should have had 10 days of deliberate rest from the onset of symptoms. You should then at least have 7 days symptom-free and are no longer taking medications such as paracetamol or ibuprofen.

Intermediate risk

  • You experienced symptoms for 7 days
  • You had any chest pain contributing to your symptoms 
  • You are an elite or an endurance athlete 
  • If you have a history of asthma or chronic fatigue

High risk

  • You were hospitalised or in ICU due to COVID-19 
  • If you experience prolonged chest pain with rest with minimal energy exertion
  • If you have a history of cardiac arrest

Suggested return to physical activity after: 

If you are categorised as either an intermediate or high risk, we highly recommend and encourage seeking medical clearance from a doctor before you begin resuming physical activities. If you’re high risk, you’re more than likely going to receive a referral to see a sports and exercise physician.

Guided step-by-step program

Here we provide you with a step-by-step guide to returning to physical activity. Each stage must be completed comfortably before progressing to the next. Timeframes might vary from person to person depending on pre-COVID fitness level and the severity of your symptoms from the virus.

Red flags – when to stop

Before we take you through the steps, take note of these ‘red’ flag symptoms and seek medical advice if you experience any of the following: 

  • Chest pain or palpitations 
  • Breathlessness – out of proportion with the expected recovery, or more than usual 
  • Features of thrombosis, e.g. swollen calf or sinus tachycardia and breathlessness 
  • Abnormal levels of fatigue or exhaustion, racing heart, dizziness or cough 
  • If you experience an increase in symptoms or new symptoms

Returning to Physical Activity after COVID-19

Here are the steps you should take to return to physical activity post recovering from COVID-19. 

Step 1: Return to work or school
Return to normal routines and wake up times 
Reintroduce physical and cognitive loads 
You can introduce these through housework or gardening activities

Step 2: Light activity
Start with 15 minutes and monitor your symptoms 
Increase your heart rate and breathing rate
Start to clear brain fog
Try these activities: 
Stationary bike
Light jogging

Step 3: Increase training progressively
Increase the duration of a familiar, light activity first
Introduce bodyweight resistance exercises but keep reps low
Remind muscles they can work
Pay careful attention to recovery in this post viral period

Step 4: Steady, continual increase in training
Introduce sport-specific training, higher intensity drills, eg running skills/ball skills
Increase resistance, add weight or return to gym sessions
Pay attention to coordination and skills/tactics
Restore confidence in pre-COVID skills and exercise tolerance
Check-in on recovery

Step 5: Return to pre-COVID exercise
Enjoy pre-COVID exercise habits and start to set new goals
If you experience any red flag symptoms (as listed above) or if you have concerns about your exercise tolerance, a medical review is required as soon as possible
An Exercise Physiologist may help guide specific cases and provide guidance

Keep in mind that if you’re struggling to get back into physical activity and are suffering from weeks of fatigue, seek support from one of our Accredited Exercise Physiologists.

Be kind to yourself

It’s important to remember that we have no control over this virus, and more specifically the spread of the higher infectious strains. Even with the best social distancing, mask-wearing and hand sanitising protocols, it is likely that most of us will become infected. If you’ve already contracted COVID-19, or do so in the future, the best thing you can do to yourself is be kind to your mind and body by focusing on resting and recovering. Try to avoid feeling guilty for not exercising enough or being productive with your time in isolation. If you want to hear our professional advice, switch off your Apple Watch or other fitness apps and instead switch on Netflix and enjoy taking time for yourself.

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