Returning to exercise after any physical setback is tough. You trust yourself to listen to your body, but it’s also tempting to get back out there before you’ve fully recovered. However, jumping back into your fitness routine too soon can cause more harm than good—and this is especially true if you’re dealing with the longterm effects of COVID-19.
According to Michael Fredericson, MD in Everyday Health, “resuming physical activity after having COVID-19 has an extra layer of complexity because of the potential of complications, such as myocarditis,” which is inflammation of the heart muscle. And with all the uncertainties and complications surrounding “long COVID,” extra caution is needed.
After a positive case, it may not be possible to tell the difference between long COVID and a case of “regular” (yikes) COVID that is taking its sweet time to resolve. In addition to the toll on your body, there’s also the mental frustration of feeling like you’re being held back from your fitness goals. Below, we get into what we do and don’t know about long COVID, the current state of recommendations for post-COVID athletes, and how to mentally cope with the fitness setbacks.
We have a lot to learn about long COVID
Wether you’re a serious athlete or a casual gym-goer, no one wants to be a COVID “long hauler” experiencing prolonged symptoms of the virus. These lingering complications include blood clots in the arteries and inflammation of the heart. Some athletes have also reported fatigue and respiratory problems that persist after they have otherwise recovered from COVID-19.
Unfortunately, long COVID is still difficult to define, and more time is needed to properly study and understand it. Symptoms of long COVID overlap with those of other conditions, including what used to be called chronic fatigue syndrome. For the time being, we have general guidelines for exercising caution when exercising post-COVID.
Guidelines for returning to exercise after having COVID
The following guidelines for returning to exercise were created by a team of doctors from the Hospital for Special Surgery in New York. (One of the authors, Jordan Metzl, has also written about the reasoning behind these guidelines in the New York Times.) Among the recommendations:
- If you were healthy beforehand and had a mild case of the virus, you can consider returning to exercise after you’ve been symptom-free for seven days.
- Expect to take about a month after that before returning to your full training schedule.
- If you have a heart or lung condition, consult a doctor before returning to exercise.
- Stop exercising and see a doctor if your symptoms return, especially chest pain, fever, palpitations, or trouble breathing.
In our previous coverage of how to safely return to exercise after you’ve had COVID-19, Lifehacker senior health editor Beth Skwarecki explained that
The recommendation to ramp up gradually suggests starting with just half of your normal volume of conditioning activities (so, if you are a runner, this might be half your normal amount of running). The guidelines aren’t specific about lifting weights, but the authors point to a set of non-COVID-specific guidelines that likewise recommends starting out easy when you return to the weight room and ramping up gradually.
These guidelines were written before the emergence of the delta variant, but they still apply to cases caused by the various variants, says James N. Robinson, MD, a primary sports medicine doctor at HSS in New York City and a co-author of the paper.
Additional recommendations for athletes
In this synthesis of the current recommendations for athletes to safely return to physical activity after COVID-19, researchers found that the expert consensus is to refrain from any exercise until at least 10 days of rest from symptom onset, including a minimum of seven days of being symptom-free. At that point, a “graded return” to exercise can begin.
If you’re looking for some concrete benchmarks to ease back into your routine, here are some tips pulled from the American College of Sports Medicine:
- Make sure that you can easily perform activities of daily living and walk 500 meters on a flat surface without experiencing excessive fatigue or shortness of breath.
- Initial physical activity should consist of light exercise for 15 minutes.
- If post-COVID energy levels are achieved, activity time duration can be increased, followed by resumption of bodyweight exercise, such as yoga or resistance training with sufficient rest.
- Heavier resistance and sports-specific training can follow.
For more current information about returning to exercise, check out this site for the most recent study about returning to strenuous activity following COVID infection.
Coping with prolonged symptoms
Each person recovers from COVID-19 at a unique rate, and there is currently no formula to determine exactly how and when an individual should return to activity.
Long haulers experience the unique frustration of battling symptoms that simply won’t go away. You’ve heard advice to “listen to your body” and “trust your instincts,” but what about when your body refuses to return to peak performance?
While we wait for more research about dealing with long COVID, it can help to approach your invisible symptoms, like fatigue, as if they were a tangible injury—say, a broken ankle. You wouldn’t treat a broken ankle by “pushing through it” and pounding the pavement like always. Instead, you’d understand that allowing time for full recovery is necessary for your long term goals.
Similarly, it’s not going to help you to “push through” symptoms of COVID-19. The current medical consensus is to wait until all symptoms subside, but I understand that doesn’t sound realistic when your symptoms have no end in sight. So if you still suffer through prolonged issues with fatigue and headaches, try to practice the same gentleness and forced patience you would with a broken ankle. You need to recover now so you can get back to your old self over the long term.