Safely returning to exercise post Covid

Now that COVID-19 has well and truly arrived in WA, it is important we are all as prepared as possible, not just for when sick and symptomatic, but also for the best recovery over the following weeks so that we can safely return to exercise without long term ill-effect.

A positive test not only means seven days isolation, but for the active ones amongst us it also means time off training which is never ideal. However, once through the worst of it, what is the best way to re-introduce training to ensure a quick return to fitness and recreation without delaying recovery?

The best evidence that we have at this stage suggests that we should is to slowly re-introduce exercise in a graded fashion whilst monitoring for any symptom exacerbation. This extends beyond the flu-like symptoms experienced in the acute phase, but also includes exercise induced shortness of breath, chest pain or excessive fatigue beyond what you’d expect from that level of exertion.

COVID-19 is a systemic virus, meaning it attacks multiple different systems in the body. Despite resolution of the acute symptoms, for some people the fight is continuing internally and in particular for the cardiovascular and nervous systems. The risks of pushing too hard too fast when returning to exercise are cardiac overload, resulting in myocarditis or pericarditis, chronic central nervous system fatigue, resulting in undue exhaustion or lethargy, or even mood disturbances such as anxiety or depression. These are the symptoms of “long-COVID”.

While pushing through fatigue is usually a sign of mental fortitude, when recovering from COVID-19, it will place greater stress on the body, worsen symptoms and ultimately lengthen recovery. This is not something you should push through!

So what should you do?

  • Rest up for a week
    • For the seven days directly after testing positive, rest, recover and do no physical exercise. Even if only mildly symptomatic, the body is fighting a completely new and foreign infection and needs energy to do so. The risk of deconditioning does not outweigh the risks of “Long Covid”.
  • Test the waters
    • Once out of isolation and acute symptom-free, it is recommended taking another seven days to only do light exercise. Trial a 500m walk at a slightly faster pace than causal walking. This is a good way to screen for lingering illness. If you develop any of the above symptoms, this is a good sign that you are not yet ready to attempt more vigorous exercise.
  • Build it up slowly
    • Once able to walk 500m easily you can begin to reintroduce higher levels of exercise, but still being careful to gradually build up to pre-covid intensity and monitor for symptoms for four weeks after originally testing positive.

Ultimately, taking your time to ensure you are at full health is the safest way to prepare the body for high intensity exercise again and avoid a prolonged recovery.

Best of luck!

The team at Subiaco Physiotherapy