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Exercising After COVID-19? Experts Say Take It Easy

Woman exercising wearing a face mask.

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Key Takeaways

  • Experts say a phased and slow approach to resuming exercise after contracting COVID-19 is best.
  • Regaining your pre-COVID-19 fitness level may take time.
  • Slowly introducing walking, weight training, and rib and chest expansion exercises can be helpful in your recovery.

As the number of people in the United States who have contracted COVID-19 approaches 30 million, many who recover may be wondering how to ease back into physical activity. Is it safe to exercise? How much is enough and how much is too much?

A recent guide for exercising post-COVID-19 published in the BMJ looks to answer some of those questions.

The report, led by David Salman, PhD, an academic clinical fellow in primary care at the Imperial College London, recommends waiting for seven days after major symptoms have stopped before starting to slowly build up physical activity by phases. Relying on the Borg Rating of Perceived Exertion (RPE) scale, they offer four phases of activity, starting with light intensity exercises such as walking, yoga, or stretching—activities that can be completed with no shortness of breath.

Phases two through four should present more challenging activities, such as brisk walking, light resistance training, or swimming. Each phase should be maintained for seven days. If the patient ever feels like activity is too strenuous, they should drop back down a phase and stay there until they feel confident in their abilities.

While there are some risks associated with exercising post-COVID-19, especially after a particularly severe case, easing into exercise after a mild case will likely be beneficial.

Long-term risks of cardiac injury such as myocarditis (inflammation of the heart muscle) and pulmonary embolism are associated with severe cases of COVID-19. There's little research about the risk of these severe conditions after mild cases of COVID-19.

"A balance is needed between obstructing an already inactive population from undertaking physical activity at recommended levels beneficial for their health, and the potential risk of cardiac or other consequences for a small minority," the authors wrote.

Why It's Best to Take It Easy

Anthony S. Lubinsky, MD, clinical associate professor in the department of medicine at New York University Grossman School of Medicine, says that approaching recovery in this way offers plenty of room for accommodation.

"If a patient comes in for an evaluation and their vital signs look good, and there's no acute or chronic condition, they could probably start back to their prior level of activity," Lubinsky tells Verywell. "Usually, I would recommend that they take it easy. If you're a runner, maybe walk part of your route for a while and if that feels good, then increase your efforts."

In a few weeks, Lubinsky says, most people with mild cases of COVID-19 should be back to their normal fitness routine. That routine is important for staving off other potential problems related to inactivity after COVID-19, such as blood clots. Regular motion can help deter blood clots from forming.

"I would put out a plea for normalcy," Lubinsky says. "Most people recovering from COVID-19 are not going to be able to do what they did before immediately, but they should try to get there. It's a mistake to be immobile for long periods of time. It's also a mistake to go out and do really intense activity before you're ready."

What This Means For You

Exercise is essential for ongoing well-being, so people that have recovered from COVID-19 should pursue getting back into their normal routine after major symptoms have ceased. Remember to take it slow. You may not continually progress forward. Work with your doctor if you're concerned with how much activity is safe for you. In general, both aerobic and weight training will help your recovery efforts down the road.

Rehabilitation Takes an Unpredictable Path

James Dunleavy, PT, DPT, spokesperson for the American Physical Therapy Association and director of rehabilitation services at Trinitas Regional Medical Center in New Jersey, has found that even extremely healthy people with relatively mild cases have had to slowly ease back into their fitness routine.

"The best way I can say it is that whether they've had a mild, moderate, or severe case of COVID, there's no linear progression for their recovery," Dunleavy tells Verywell.

Dunleavy says that many of his patients report feeling additional COVID-19 related effects such as coughing or shortness of breath while actively exercising. Still, after they are done, their regular breathing is much better. However, their breathing clarity and oxygenation's progression resemble two steps forward and one step back rather than an ever progressing climb.

"It's enormously frustrating that we can't say to these patients that they will feel better in six months," Dunleavy says. "Because I would just be lying. I don't know that."

How to Increase Lung Capacity 

Although the BMJ report advises that patients start their exercise plan only after seven days without symptoms, Dunleavy says that some symptoms can remain, such as coughing or fatigue. More acute symptoms such as fever or extreme shortness of breath should be indicators that patients are not ready to resume exercising.

Once patients are ready, Dunleavy recommends a combination of exercises intended to increase lung capacity. If the patient was an athlete before COVID-19, their routine might look slightly different, as their activity level was likely higher pre-infection.

He recommends starting slow and allowing for setbacks for those that are typically sedentary or work in a low activity environment.

Walking

Dunleavy recommends adding walking to your routine post-COVID. Start at a pace that can be maintained without getting winded.

If you feel good, increase that to a normal walking speed or increase the incline if walking on a treadmill. Dunleavy says that five-pound weights on each leg can also help reasonably increase resistance.

Weights

Adding weights to your routine can also be beneficial. Start with low weights such as 5 to 10 pounds for both arms and legs. Any resistance exercise is beneficial since muscle atrophy can set in quickly.

Rib and Chest Expansion Exercises

Dunleavy specifically focuses on rib and chest expansion exercises since many patients have lost their ability to use their respiratory muscles fully. He says that the more you can expand your lungs, the more progress you will make.

Overall, Dunleavy emphasizes that you may experience setbacks along the way and should be accommodating to your body. Recovery looks different for every patient.

The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit our coronavirus news page.

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2 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Centers for Disease Control and Prevention. COVID Data Tracker. Updated March 19, 2021.

  2. Salman D, Vishnubala D, Le Feuvre P, et al. Returning to physical activity after covid-19. BMJ. 2021;372:m4721. doi:10.1136/bmj.m4721