I spent the first two weeks of January 2022 in bed and isolating in my room after testing positive for Covid. On day 11, I put on my sneakers and decided to celebrate my new found freedom with a jog at my local park.
Before Christmas I had built my stamina through the Couch to 5k app. But on my first post-Covid jog, within 10 minutes I was out of breath and more than a little tempted to pack it up and go home. All my progress, it seemed, was gone. “You decondition much faster than you think,” explains Dr. David Salman, Primary Care Academic Clinical Associate at Imperial College.
Excessive exercise after bed rest can also affect your breathing and musculoskeletal system – which can lead to a sprain, for example. It’s one of the reasons why post-Covid-19 experts are recommending a “gradual” return to exercise, literally suggesting you walk before you can run. However, this is not just to protect against a sprained ankle.
“This approach is intended to ensure that the body’s immune system is not overtaxed too early,” says Dr. Manoj Sivan, Associate Clinical Professor of Rehabilitation Medicine at the University of Leeds. If you’ve had symptoms while you’ve had Covid, “it means your immune system has been struggling a little bit to cope with this infection,” says Dr. Sivan. You need to keep this in mind during recovery—even if you’re feeling well now. “Even though the person no longer shows any symptoms, we don’t know whether the immune system resets completely or not,” explains Dr. Sivan.
He recommends gradually increasing activity levels. If you overdo it too soon, you could delay your recovery. “When a person goes straight into it [pre-Covid] activity level, they run the risk of actually getting new symptoms and making their existing symptoms worse,” says Dr. Sivan. “We think it’s because your immune system isn’t ready for this kind of challenge.”
Returning to your usual exercise regimen before a full recovery also increases your risk of developing more serious illnesses like post-exertional malaise (PEM), according to recommendations published by the World Health Organization. PEM can affect your energy levels, concentration, sleep and memory, and cause muscle and joint pain. If you experience it, you must avoid strenuous activities and aim to conserve your energy.
Continuing to overexert yourself carries other risks as well. “After an illness there is a time when you have to be very careful not to over-challenge your immune system because if you keep doing it and keep crashing it can become permanently dysfunctional – and that can be what happens in the long-term Problems like chronic fatigue syndrome,” says Dr. Sivan.
How should we move safely after Covid-19?
Ideally, before you start exercising, you should aim to be asymptomatic for a week, according to the Return to Physical Activity After Covid-19 study published in January 2021. British Medical Journal. If you still have symptoms, Dr. Sivan for waiting until your symptoms are stable for seven days.
Once you’re ready to start exercising again, follow the WHO’s five-week plan, which includes sample exercises to help you build strength and gradually recover. WHO guidelines recommend using the Borg Rating of Perceived Exertion (RPE) scale – a rating of how hard you feel at work, on a scale from 0 (no exertion at all) to 10 (maximum exertion). “It may be about staging your return to activity based on how you feel — and only increasing it gently so you don’t push yourself too hard,” says Dr. Salman.
The WHO recommends that you stay seven days in each of the five phases and only move on to the next phase if you don’t experience worsening symptoms or “crashes”. If you experience excessive fatigue or shortness of breath, Dr. Salman to push back a phase and take it slow.
Watch out for any “red flag” symptoms, such as B.: shortness of breath when resting, chest pain, palpitations, dizziness, worsening brain fog or confusion, weakness in your face, arm or leg, or mental health problems. If you experience any of these symptoms, the WHO recommends consulting a doctor.
How strictly should you follow the rules?
The WHO guidelines are just that: guidelines. Both Dr. Sivan as well as Dr. Salman agree that following them is useful, however they acknowledge that they will not be for everyone. “There will be many people who have minimal or no symptoms and who can maintain the same level of activity as before, and this may not be as beneficial to them,” admits Dr. Salman a. If you’ve been asymptomatic, says Dr. Sivan that you may be able to return to basic training.
“If you’ve been completely asymptomatic, I don’t see the point in changing anything — just keep doing what you were doing because you never had any symptoms,” he says.
Even if you had Covid-19 symptoms when you had the virus, you may not need to follow a five-week recovery program. Whether you choose to follow WHO guidelines or not, “the key message is don’t push yourself too hard and take that gradual pace,” says Dr. Sivan. “Pick up the pace and self-monitor your symptoms, and then take it easy and slowly get back to what you were doing.
Should you exercise if you have been ill with Covid for a long time?
If you have had Covid symptoms for more than four weeks, you may have post-acute Covid (aka long Covid). In this case, it is even more important to accelerate yourself.
The Centers for Disease Control recently released its interim clinical guidance on long Covid, emphasizing the importance of rest and pace. Pacing in this context refers to the prioritization of certain activities.
“I think pacing is a very sensible approach,” says Dr. Sally Singh, Professor of Pulmonary and Cardiac Rehabilitation at the University of Leicester. “That’s not to say that you might not get some exercise into your day, but it’s about picking the activities that are important to you, paying attention to the time of day you do them, and building adequate rest into your day and so forth.”
Exercise can also play a role. “I think for now, the limited research studies show it’s of value,” says Dr. Singh, lead author of a May 2021 study that suggested regular exercise could help recovery for people with long Covid. The study, conducted by the National Institute for Health Research Leicester Biomedical Research Centre, followed 30 patients who participated in exercise twice a week over a period of six weeks. The six-week program turned out to help patients with breathing problems, fatigue and brain fog.
dr Singh emphasizes that this isn’t the same as “stepped exercise therapy” — a controversial method involving large increments of exercise that the National Institute for Health and Care Excellence no longer recommends for treating chronic fatigue syndrome. The results of dr. Singh suggest a much more step-by-step approach.
“You wouldn’t run 10 minutes a day, think, ‘Actually, I feel fine,’ and then think, ‘I’ll do 20 tomorrow,’ because that’s a huge percentage increase. So people have to remember that if they can only walk 10 minutes, even walking an extra minute is a 10 percent improvement,” she says. However, it is not a one-size-fits-all and stimulation needs to be individualized for long Covid patients.
© Telegraph Media Group Ltd. 2022
https://www.independent.ie/life/health-wellbeing/health-features/have-you-had-covid-recently-heres-an-expert-guide-to-getting-back-to-exercise-safely-41516851.html Have you recently had Covid? Here’s an expert guide to getting back into exercise safely