Exercise after Covid is proving to be no easy task for many who have fought off the virus. Of course, getting moving again after recovering from any illness can be difficult – but anecdotal evidence suggests that many have found returning to the mat/road/bike/ after Covid particularly tough.
Francesca Menato, from Women's Health, is no different. She was well into marathon training when she contracted Covid-19 in March 2020. "I was without a doubt, the fittest and the fastest I’ve ever been in my life at that point," she says. She was on track for a sub-3:30 marathon when she started experiencing symptoms.
Thankfully, she recovered without needing any additional medical help. About a week and a half later, she was feeling well enough to attempt easing back into running – but it turned out to have been far too soon. "I was still in that marathon plan mentality, and I just couldn’t accept that I needed to take a longer break," she admits.
No matter how slowly she ran, her heart rate would skyrocket. "I slogged through a few runs, hating them until I made peace with the fact I was going to need more time out."
She took several more weeks off before she felt ready to begin a new running plan in July. While she feels better than before, it certainly hasn’t been easy going. "My body just felt like I had no energy – every new run felt like I was coming off that back of a really intense training week. It’s crazy."
As is the case with any infection, pushing yourself too far too soon may slow your recovery, says Dr Folusha Oluwajana, a GP and fitness instructor with a BSc. in Sports and Exercise Medicine.
"Deciding when to start exercising again after having Covid-19 can be tricky as the recovery period can be very variable between individuals," she says. "We are still learning about this novel virus and road to recovery is not always clear or straightforward."
If you’re anxious to get back, understand that your return to your former glory may take time as your overall health takes priority.
With that in mind, here are 5 things you need to know about returning to exercise after recovering from Covid-19.
Can you exercise with Covid?
First things first: what if you're still fighting off the virus? If your Covid symptoms are anything but very mild, chances are you won't feel like lacing up your trainers at all. But what about those with minimal symptoms or asymptomatic cases?
"Mild symptoms indicate that your body is experiencing only a low inflammatory response to the virus, so your exercise capacity is unlikely to be significantly affected," Dr Oluwajana says.
But – and this is a big but – just because you still feel up to that lunchtime live workout doesn't mean you should.
"As a sports' medic, I'd definitely advise resting, for a full week at least," says Dr Rebecca Robinson, consultant in sports and exercise medicine at the Centre for Health and Human Performance (CHHP).
"We do see even asymptomatic people with confirmed Covid getting Long Covid, so for a week of rest, it’s not worth the risk of pushing through."
If you've had a mild case, Dr Robinson advises at least 10 days off, or until all symptoms have gone.
Is exercise safe after Covid?
"Start slow and avoid the temptation to compete with your [pre-Covid] self. This is a vicious virus that affects major parts of your body. With that, it is still new in the medical field, and with that in mind, a slow and measured approach is certainly advised."
If you've battled with severe symptoms or were hospitalised with Covid, your doctor should be your first port of call when it comes to guidance on getting back to exercise.
How long should you wait until you start exercising after Covid?
An expert-consensus statement by pulmonologists published in The Lancet recommended that athletes rest completely for at least 10 days from the time they first experience symptoms and then take a further week off for symptoms to resolve.
"In elite sports, we set the first week after 10 days off as light aerobic walking or equivalent, regaining range of motion, and no more than bodyweight strength and conditioning," says Dr Robinson.
But don't feel pressured to jump back in – everyone is responding differently, and some need much more rest before making a return to exercise after Covid.
"We recommend listening to your body and ensuring you do rest when your body indicates that’s what you need," says Hewitt. If you have the means, help from a specialist is advisable, he adds.
What kind of exercise should you do after Covid?
As per Dr Robinson's recommendations, a walk or an easy cycle (provided you have self-isolated according to government guidelines before going outside) is a good place to start.
Now is a great time for some yoga, Dr Robinson adds. "Lots of people find breathing patterns alter after Covid, so breathing practice through yoga can really help."
"If you had niggles before Covid, attend to them now by focusing on rehab – reframe it as prehab for your return to sports," she says.
How do you know if you're not ready to exercise yet?
Dr Oluwajana suggests paying close attention to your body when you get going again. "As you recover and energy increases you will be able to slowly increase the intensity of exercise," she says.
Feel worse after exercising? You might be falling into that ‘too hard, too soon’ camp. "Reduce the intensity or take some time off, and ensure you are getting adequate rest, fluids and nutrition."
A fitness tracker or heart rate monitor can be useful here if you were using one before Covid, says Dr Robinson. "If your heart rate is more than 10 beats higher than normal, back off," she says.
Stop exercising and seek medical advice if you experience any of the following symptoms while exercising:
chest pain or tightness
shortness of breath on minimal activity
Why do I feel so much weaker, even though my symptoms have gone?
While it may down to the fact that you've been out of action while recovering (which, as we learned above, is the wise thing to do), the virus itself might be behind your drop in fitness and strength.
"Covid is overall a respiratory illness, affecting the lungs – a major player in aerobic fitness," says Dr Robinson. "Some people do see muscle loss too."
"To heal you might need more rest and lose some fitness, but resting harder in the initial phases can help minimise these losses and get you back to full health sooner."
How long will it take me to get back to my pre-Covid levels of fitness?
Unfortunately, this depends. Just as the effect Covid-19 has on people differs, so too will their rate of recovery.
"Some people may be able to get back to their pre-infection exercise intensity fairly quickly, but for others, it can be a long process," Dr Oluwajana.
If you’ve spent a few weeks resting – as you should have – you’re not going to return to the level of fitness and strength you were at beforehand.
"This can be frustrating but it is safest to be patient and avoid overexertion," Dr Oluwajana says.
Will going too hard too soon set my recovery back?
Even after symptoms have abated, your body is likely still dealing with inflammation in your lungs and other tissues.
"While exercise is still important for your health, it is also essential to avoid pushing yourself too far, too soon," Dr Oluwajana says. "Doing so could slow your recovery or possibly cause your symptoms to worsen by increasing levels of inflammation in the body."
How do I know if I need expert help?
"If you are concerned that your energy levels or breathing are not improving over time, particularly if your ability to complete simple daily activities is affected, speak to your GP," Dr Oluwajana.
If you've recovered but are battling to cope with light movement, Hewitt recommends getting help from an exercise physiologist.
"Exercise needs to be right for you and right for the particular phase of your journey to recovery. Having someone prescribe a bespoke plan knowing that the exercises are suitable and safe would be the gold standard approach."
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