• Luke Nelson

Returning to exercise after COVID-19

With COVID now running rampant in Australia (& elsewhere around the globe), many are facing time spent laid up at home, too sick to exercise. So once able, how should you return to exercise?

Whilst there have been many elite athletes that have bounced back from COVID to record historical performances in the weeks & months following, there have also been some that have continued to suffer persistent symptoms for months post-infection. Plus a recent study showed that runners who had suffered COVID went on to suffer more injuries than their infection-free counterparts, but more on this later. (Toresdahl 2021)

So here are our 4 key tips on returning to exercise post COVID:

1. Wait until symptoms have cleared

Firstly, avoid performing strenuous exercise whilst still experiencing COVID symptoms (i.e breathlessness, cough or fever). It's recommended to wait 10 days from onset of symptoms or 7 days AFTER cessation of symptoms (whichever comes later) before starting a return to exercise. Plus you should be able to do all your daily activities & be able to walk 500m without excessive fatigue.


2. Start easy

This might seem obvious, but some feel that because they've missed all this training, they need to play catch up & start with a tough session. Not only can your body take time to recover from the illness, but there will be a loss of fitness after 1-2 weeks off training. Initially limit intensity to 70% max heart rate, & keep the duration short around 15-30mins. Repeat 2 of these sessions before performing at an intensity of 80% max heart rate.

Anecdotally we've seen a number of people returning to exercise & experiencing a higher than usual heart rate, so keep the effort low.


3. Avoid loading "spikes"

As mentioned above, unfortunately with time away from training, there will be de-training & a loss of fitness. Caution must be taken when increasing training loads to avoid creating loading "spikes". This is one of the possible explanations for the increase in running injuries in those who had been infected with COVID in the Toresdahl study mentioned earlier: runners coming off a break may have ramped up their training too quickly, which then caused an injury.

Generally speaking, if there have been 2 weeks of no training, it can take 4 weeks to safely rebuild to pre-infection levels. As a guideline:

  • In the first week back of training, aim for 25% of pre-illness volume.

  • Second-week increase to 50% of the pre-illness volume

  • Third-week increase to 75% of pre-illness volume.

As an example, our runner was consistently running 3 times, in total 50km (approx 250mins) per week before becoming unwell with COVID. They waited 7 days post-cessation of symptoms before their first run.

  • Week 1: 25% of pre-illness volume (Total 60mins): All easy runs, limiting to 70% max HR. 15mins, 15mins & 30mins

  • Week 2: 50% of pre-illness volume (Total 125mins): All easy runs, intensity can increase to 80% max HR but no speed work. 30mins, 35mins & 60mins

  • Week 3: 75% of pre-illness volume (Total 185mins): Light speed work can be introduced on 1 session, 2 other runs easy pace. 60mins easy, 45mins with some faster efforts, 80mins easy


4. Listen to your body

Lastly, if something is not feeling right when you've returned to exercise, get checked by your health professional! There have been many cases of persistent fatigue, heart & lung issues post COVID, so if in doubt get it checked!


If you need guidance in your return to exercise, please don't hesitate to contact us at www.healthhp.com.au


References

  • Elliott N, Martin R, Heron N, et alInfographic. Graduated return to play guidance following COVID-19 infection British Journal of Sports Medicine 2020;54:1174-1175

  • Salman D, Vishnubala D, LeFeuvre P, Beaney T, Korgaonkar J, Majeed A et al. Returning to physical activity after covid-19 BMJ 2021; 372 :m4721 doi:10.1136/bmj.m4721

  • Siopis, G. (2022). "Elite athletes maintain peak performance after testing positive for SARS-CoV-2." Journal of Science and Medicine in Sport 25(2): 195-196.

  • Toresdahl BG, Robinson JN, Kliethermes SA, et al. Increased Incidence of Injury Among Runners With COVID-19 [published online ahead of print, 2021 Dec 14]. Sports Health. 2021;19417381211061144.

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