How to start exercising again after COVID

December 2, 2020
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Even after patients recover from COVID-19, many report feeling some long-lasting impacts well after the bulk of the illness has passed. And doctors fear that the disease could lead to other respiratory, cardiac or gastrointestinal illnesses that may last for months or years.

That is why physicians are now recommending that patients take their time before returning to their normal levels of exercise and activity.

“We’re recommending about seven to 10 days, and probably about 10 days of inactivity before they start getting back to activity,” said Dr. Jordan Metzl, a sports medicine physician at Hospital for Special Surgery in New York who has been researching the impact of exercise on COVID recovery.

Dr. Metzl says that while someone’s level of general health and fitness are known to correlate with the probability of a serious illness or death, the same does not appear to be true for long term symptoms.

“We’re seeing younger, healthier people getting some of these morbidities and ongoing issues: ongoing breathing problems, fatigue, some of these issues that are not necessarily correlated to either being in the high mortality group or necessarily relate to how sick they were when they got their disease.”

That is why Dr. Metzl and his colleagues recommend that everyone should take it slow when recovering.

“The main point I want to make to everybody listening is if you’ve had COVID or COVID-like symptoms, you have to really go slow,” he said. “It’s time to really step on the brakes, back off. This is a time to really go back and slowly get back into activity. Don’t rush back in, because of the risk of exacerbating some of these different conditions people are getting.”

Some patients have even seen a resurgence of symptoms after returning to their normal level of activity, which is why he advises everyone to listen to their body’s signals. If you are feeling more tired or out of breath during or after a workout than you normally do, back off and rest. While some patients are able to return to their pre-COVID routines somewhat quickly, others report feeling fatigued even months later.

When it is time to start working out again, start with something less intense than your usual exercise.

“Slowly build up your workload. As you start to get back to activity, for the first week you’re doing about half your normal activity, and then just by a percentage of about 15-20% a week, you slowly start to increase.”

The key, he says, is to monitor both the workload and intensity of your workout.

As a marathon runner and self-described exercise junkie, Dr. Metzl acknowledges that exercise is very beneficial to physical and mental health and generally recommended for everyone. But patients recovering from COVID are turning out to be the exception to the rule.

“I’ve been prescribing exercise to my patients for the past 20 years, and this is the first time I’m changing my recommendation.”

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