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Back to the Gym: Tips for starting a safe exercise routine after COVID

July 08, 2021
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By Dr. Tara Futrell, Baystate Sports and Exercise Medicine

Whether you’re starting a health challenge with friends, starting a new sports season after a long break, or returning to the gym post-COVID, you should come up with a plan.

Jumping into an extreme workout after living a sedentary lifestyle can be jarring to your body. It can sometimes even lead to issues like knee pain, hamstring strains, and muscle soreness.

If you push yourself too hard at first, you may also become discouraged or burn out all your enthusiasm.

To set yourself up for success:

  • Don’t forget to warm up before exercising or playing sports
  • Come up with a plan in advance, making sure to take it slow at first
  • Give yourself rest/recovery days so you don’t overwork your body

For people who got infected with COVID-19, it’s especially important to be mindful about safely returning to physical activity.

We know that COVID -19 can have a wide range of severity from asymptomatic infections to severe life-threatening illness. We know the virus may cause long term damage to the heart, lungs and brain, but we know less about who is going to be affected. Some people may be able to return to activity right away. Some may suffer from extended period of fatigue, shortness of breath and, in severe cases, an inflammation of the heart called myocarditis.

While you have COVID-19

If you were diagnosed with COVID, you should have a period of isolation form others for at least 10 days. During this time the focus should be on rest, hydration and good nutrition.

It is important to follow the recommendations of your physician.

When to contact your doctor

Once you have recovered and have at least 7 days free of any symptoms, you may slowly begin to increase your activity.

Be careful to monitor any new symptoms that you notice.

If you feel fatigued easily, short of breath of feel a racing or irregular heartbeat you should stop and contact you doctor right away for further testing.

Meet with your doctor before returning to exercise if during your COVID illness you:

  • Had moderate or severe symptoms like fever, chest pain, or shortness of breath
  • Had to be hospitalized

It is recommended you have an EKG, blood test and echocardiogram to screen for any cardiac abnormality before you return to exercise. If any of these tests are abnormal you may require additional testing and a visit with a cardiologist.

These tests can help evaluate for myocarditis. Myocarditis is an inflammation of the heart that can follow viral infections and can lead to swelling of the heart that can be deadly.

Symptoms to look out for while exercising

Once you are ready to begin exercising again, begin slowly and gradually increase the intensity if you are not experiencing any symptoms.

A young athlete should be monitored by a parent, coach or athletic trainer.

If any of the following symptoms are experienced, stop exercising and rest:

  • Cough
  • Shortness of breath
  • Fatigue
  • Nausea/ vomiting
  • Racing heart or skipped beats
  • Fainting or feeling as if you might faint
  • Lightheaded or dizzy
  • Headaches

If the symptoms do not resolve after stopping exercise or continue during 1-2 days of rest, then you should contact you doctor.

Follow a multi-step process

The recommended return to exercise should be a multi-step process for those who had mild to moderate illness. Spend a couple of days to 1 week at each level depending on how you are feeling.

The following progression was adapted from an infographic in British Journal of Sports Medicine.

Stage 1

Day 1 and 2 - (2 days minimum)- 15 minutes or less: Light activity (walking, jogging, stationary bike), intensity no greater than 70% of maximum heart rate. NO resistance training.

Stage 2

Day 3 – (1 day minimum) – 30 minutes or less: Add simple movement activities (eg, running drills)- intensity no greater than 80% of maximum heart rate.

Stage 3

Day 4 – (1 day minimum) – 45 minutes or less – progress to more complex training – intensity no greater than 80% maximum heart rate. May add light resistance training.

Stage 4

Day 5 and 6 – (2 days minimum) – 60 minutes – Normal training activity – intensity no greater than 80% maximum heart rate.

Stage 5

Day 7 – Return to full activity/participation.

Progress takes time

Returning to your previous level of fitness and activity may feel slow and frustrating but be patient and listen to your body. Do not try to “power through” symptoms that you might be feeling.

Contact your doctor if you have concerns. Learn more about Baystate Sports and Exercise Medicine and how we can help you get back on track. 

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