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As we approach the one-year mark of living with COVID-19, we are understanding more about the coronavirus and how to resume normalcy after recovery—including getting back into the swing of our regular fitness routines.
In previous years, when you caught a cold or the flu, you likely didn’t overthink it when it came to returning to the gym or your exercise routine—in some cases, it’s even been encouraged by doctors as a great way to strengthen your immune system. But for COVID-19, doctors say not so fast.
COVID-19 causes inflammation throughout the body and can lead to myocarditis, an inflammation of the heart muscle, even in asymptomatic cases. Working out with myocarditis or before the heart is fully recovered can cause an irregular heartbeat and even sudden death. So even if you think you’ve fully recovered, but you have pre-existing cardiovascular conditions, you should still seek a cardiology evaluation before rushing back to intense workouts.
What the Experts Say
Karen M. Sutton, MD and her colleagues at the Hospital for Special Surgery (HSS) have released a guideline for returning to exercise for recreational athletes following mild to moderate cases of COVID-19. Doctors suggest resting for 10 full days after symptom onset and seven days after symptom resolution. While most mild to moderate cases see recovery in 5-7 days, doctors say there is “an apparent heightened risk of deterioration in respiratory status between days 7 and 14.”
Once fully recovered, HSS doctors agree to the 50/30/20/10 four-week strategy developed by the National Strength and Conditioning Association and Collegiate Strength and Conditioning Coaches Association Joint committee.
For the first week back to activity, exercise load should be reduced by 50 percent. If that level of activity feels comfortable, spend the next week exercising at a 30 percent reduction of your normal exercise intensity. In the following two weeks, continue to a 20 percent reduction, then 10 percent reduction before returning to training at 100 percent capacity.
“If athletes struggle to return to play due to chest pain or shortness of breath after a COVID-19 infection, a comprehensive cardiac evaluation should occur,” suggests Dr. Sutton.
Modifications are necessary depending on the severity of the virus, and it could take months rather than weeks to work out at your full intensity. “I think the key is being mindful of your body and paying attention to cues that either your body is recovering well, or that you may need more time to progress with the intensity of typical exercises and sports,” says Dr. Sutton. “Oftentimes, keeping a log of how difficult daily training was is helpful in following trends.”
Even Olympians Take It Slow
Doctors advise that listening to your body has never been more important—something Olympic rower Emily Regan knows very well.
Regan was one of the 12 women of the United States national rowing team who contracted COVID-19 in late March of 2020. At the time, testing wasn’t readily available, but she knew she had been exposed to a positive case and the entire team was instructed to quarantine. “When obvious symptoms started arising, I tried to convince myself that these symptoms were due to other things than COVID,” Regan says.
With three days of sleeping 15 hours a day, having a fever of 102 degrees, and pain while breathing, the coronavirus was impossible to deny. “I had three days where I wasn't able to get off of the couch at all,” says Regan. “Getting up from the couch was exhausting and took all of my energy.”
Eager to get back to her training, Regan only took those three days off completely. “In hindsight, I wish that I had taken more days off,” she says, adding that it was when she wasn’t training that her body spoke the loudest that it wasn’t fully recovered. “I had to really listen to my body and do what was best for it,” she says. “If I needed to cut a workout short, I would.”
Then one day, she felt like herself again. “It was like a flick of the switch overnight,” she says. “I went from feeling ‘off’ and not like myself one day, to feeling like myself again.” Emily has been training at her normal capacity since May, focusing on the 2020 Tokyo Olympics, which have been postponed to later this year, but continues to share her COVID-19 story. “So often athletes want to push through discomfort,” says Emily. “But if I felt too tired or off in any way, I would listen to my body and stop.”
Quick Tips for Returning to Exercise After COVID-19
- Do not return to your workouts if you still have symptoms. You should be one week symptom-free before exercising.
- Take it slow, only increasing intensity gradually and when completely comfortable.
- If your condition worsens during exercise, stop.
- Those with pre-existing cardiac conditions should consult their physician before returning to any physical activity.
Disclaimer: This article is not intended to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider with your specific questions regarding returning to exercise after COVID-19.