Returning to physical activity after covid-19

March 14, 2022 Joe Brady
Posted by Joe Brady on

The health benefits of being physically active, from cardiovascular, pulmonary, digestive to mental health issues like depression and anxiety, are well established. Indeed in recent research, it has been demonstrated that physical activity improves the health and functioning of every cell in your body. Meanwhile not being active is a major risk factor for non-communicable disease worldwide, alongside others such as cigarette smoking or obesity. There is evidence that the covid-19 pandemic has made matters much worse. Physical activity levels have declined much further since the start of the pandemic. As we hopefully put the worst of the pandemic behind us people need to take up physical activity, with the associated lifelong positive health impacts. Even in those recovering from an illness from covid-19 returning to previous levels of physical activity or hopefully improving on previous levels is crucial to regaining strength and some semblance of normal healthy activity. People may feel unsure of how and when to return to physical activity after covid-19, and whether it is safe. Some may have tried to get back to a normal level of exercise and found they were unable to do so, scientist is finding that returning to active vigorous life after covid requires you to begin at whatever you are able to comfortably accomplish and slowly build back up to pre-covid conditioning levels.

Read more for specific exercise recommendations after covid and news from the CDC about the lack of physical activity being a major risk factor for severe illness from covid.

Once you have recovered from a bout with covid-19 there are some specific recommendations for getting back to an active lifestyle. It is important to note that recovering covid-19 patients should avoid overdoing it at first. It is essential to build up your conditioning slowly. In China, they begin recovering covid-19 patients with exercises like tai chi that can be done slowly and carefully. If a recovering covid-19 patient exercises too hard, too soon after covid-19 they become exhausted to the point that it takes many days to recover, It’s not like the normal tired you get after a good workout but a down to the bone tired. So if you are recovering from covid-19 it is wise to follow the advice of Woody Guthrie who once said “ take it easy, but take it”.

There is no proven procedure for a safe return to physical activity after covid-19, but a prudent approach is that it should be gradual, appropriate to the individual. The best way to measure how much is appropriate in yourself is the perceived level of exertion, in other words, stay within what feels comfortable yet also feels like you are working a little bit at it. Once someone has been symptom-free for at least seven days, a gradual approach can be used to increase physical activity levels a little more each day. If the person was not physically active before covid-19, this can be a great opportunity to improve your overall health by becoming more active. Any return, of symptoms—including cough, abnormal breathlessness, palpitations, fever, and anosmia—indicates the need to stop, seek medical advice if required. You can restart the process when you are symptom-free. People can expect to be a little shorter of breath for a given activity after a period of illness or inactivity. However, a degree of subjective assessment is needed to assess if this is consistent with the given activity and level of fitness and if it is improving. A graduated progression includes increases in volume (time doing the activity) and load (intensity).

See: Salman D, Vishnubala D, Le Feuvre P, Beaney T, Korgaonkar J, Majeed A et al. Returning to physical activity after covid-19 BMJ 2021; 372 :m4721 doi:10.1136/bmj.m4721https://www.bmj.com/content/372/bmj.m4721

For more tips from the American College of Sports Medicine, on exercising after COVID read:

Returning to Physical Activity After COVID-19

CDC rates physical inactivity as a major risk factor for severe illness from COVID – 19

People who do little or no physical activity, or exercise, are more likely to get very sick from COVID-19 than those who are physically active. Being physically active (or exercising regularly) is important to be healthy.

A study of 48 440 adult patients with a COVID-19 diagnosis compared hospitalization rates, intensive care unit (ICU) admissions, and mortality for patients with COVID-19 who were consistently inactive, doing some activity or consistently meeting physical activity guidelines.

The study found that consistently meeting physical activity guidelines was strongly associated with a reduced risk for severe COVID-19 outcomes among infected adults. 

In the journal, Nature Reviews, the lead author of the study Bob Sallis stated:

“These important findings show how critical it is to assess the level of physical activity in clinical practice. Indeed, the risk of adverse COVID-19 outcomes associated with being physically inactive was higher than that of smoking and most chronic conditions (obesity, diabetes mellitus, hypertension, CVD, and cancer) considered in the analyses. Thus, these results show the critical role of a sedentary lifestyle not only as a risk factor for chronic diseases but also for severe COVID-19 complications and death.”

Sallis R, Young DR, Tartof SY, et al Physical inactivity is associated with a higher risk for severe COVID-19 outcomes: a study in 48 440 adult patients British Journal of Sports Medicine 2021;55:1099-1105. https://bjsm.bmj.com/content/55/19/1099

Get more information on physical activity and health, physical activity recommendations, how to become more active, and how to create activity-friendly communities: