As more people recover from Covid here in Brisbane, we’re getting asked a lot of questions about ‘what happens next’. We were wondering the same thing. So we dived into the research and melded that with our experience as practitioners. 

We hope you'll find the information useful. 

How do you return to exercise after Covid?

Liz (Dr. Liz Johns) caught Covid-19 over New Years and she’s been reflecting on the difficulties of returning to exercise. This is her personal story and some of the strategies she is using to return to exercise quickly, but safely. 
 
How it all began:
My whole family managed to catch Covid-19 over New Year (2021/2022) and I've only just started to feel ready to navigate my return to my current exercises of choice…. 12 round fitness. 
 
Even though I’ve recovered from the acute symptoms of Covid-19, what I’ve noticed in my body is: 
My exercise tolerance is down after Covid-19

• Walking up a slight incline will cause shortness of breath.

• I’m stiff and sore and have less flexibility, and this isn’t limited to my lungs and chest area

• To add to this, I’ve had a period of significant detraining (4 weeks of covid-19 recovery and 2 weeks of Xmas socializing). I have to remind myself that my body is less prepared for exercise than it was before, so I have an increased risk of injury.

Despite my usual New Year’s resolutions, this IS NOT the time to jump straight back into exercising at the same intensity as I was doing before.  

Below are our tips for returning to exercise post Covid-19: 

Remember: This is general advice only. Please see your healthcare provider if you are struggling to recover or would like an individual plan to help transition back into your chosen activity.

• Listen to your body. You may have tested negative but that doesn’t mean that your body has fully recovered. Take your time and be kind to your body. In your first session: Aim for LOW volume. Try <50% of what you did before, but remember to listen to your body. If this is too much, stop and allow your body to recover. If you feel good, that’s great! You can increase it at your next session. But there’s no point overdoing it in the first session.

• You may like to start with some walks. Try something short, such as a 10 - 15 min and build from there. Even with mild symptoms, the guidelines recommend sticking to walking in the week after your recovery and judging how you feel and how you recover before increasing your training.

• Move your body in a way that feels good. If you don't have the energy to walk or go to the gym, try some gentle mobility exercises.

• Prioritise sleep, nutrition, hydration. These are all essential for recovery and injury prevention.

• If you have persistent symptoms (such as fatigue, cough, breathlessness, fever), limit activity to 60% of your maximum heart rate until 2-3 weeks after symptoms resolve.

• Lower your expectations of what you can achieve in a single training session. And if you have a training buddy, teammates, or training coach / PT, let them know you have been sick and will need more rest.

• When you feel ready to progress into doing more than walking, start with a familiar form of exercise. Covid-19 can impact your mental capacity and concentration levels, so it may not be the best time to learn a new skill or activity. Stick with activities your body and brain are familiar with e.g. 12 round fitness and yoga for me. Doing something you know also makes it easier to monitor how you are doing when you compare to exercising before you got sick.

• Gradually increase your frequency (how many times in a week you exercise) and your volume (how long you exercise). Once again, listen to your body and any symptoms you may be experiencing. This is not the time to go hard.

• When should you increase your exercise intensity (how hard you push when you exercise)? That will be individual, but a good guide is when your frequency and volume are back to normal, i.e. you are training as often and for as long as you were previously, with no increase in symptoms and you're recovering well.

Remember that we are all Individuals and how we all recover is different. If you bounced right back, that’s great! But if you’re taking a little longer, that’s okay too. 

Fatigue is the most common post-Covid symptom, according to research from around the world. It has also found that when people don’t get enough rest in the early days of post-covid recovery, they’re more likely to suffer from fatigue for longer. So it's okay to start slow. 

If you are getting back into exercise after Covid -19 and you feel like you are stressing your body, the team at Pivot Osteopathy is here to help get your body moving so that you can return to exercise and daily life as quickly as possible. 

Yours in health

Sarah, Liz, Alison and Teleah

Bibliography:

Greenhalgh, T., Knight, M., Christine A’Court, Buxton, M. & Husain, L. 2020, "Management of post-acute covid-19 in primary care", British Medical Journal (Online), vol. 370.
Barker-Davies RM, O'Sullivan O, Senaratne KPP, et al. 2020, “The Stanford Hall consensus statement for post-COVID-19 rehabilitation,” British Journal of Sports Medicine 2020;54:949-959.
The Royal Australian College of General Practitioners, Patient resource: Managing post-Covid-19 symptoms. East Melbourne, Cic: RACGP, 2020
Australian national Covid—19 Clinical Evidence Taskforce (2022). Caring for people with COVID-19 [online]. Available at https://www.covid19evidence.net.au/#clinical-flowcharts/ (Accessed: 12 Feb 2022)

Disclaimer:

The information set out in this blog is current at the date of first publication and is intended for use as a guide of a general nature only and may or may not be relevant to your particular circumstances. Nor is the information on this blog exhaustive of the subject matter. People implementing any recommendations contained on this blog must exercise their own independent skill or judgement or seek appropriate professional advice relevant to their own particular circumstances when so doing.

The content is for informational purposes only and is not to be regarded as clinical advice and, in particular, is no substitute for a full examination and consideration of medical history in reaching a diagnosis and treatment based on accepted clinical practices.

Accordingly, Pivot Osteopathy and its employees and contractors shall have no liability (including without limitation liability by reason of negligence) to any users of the information contained in this publication for any loss or damage (consequential or otherwise), cost or expense incurred or arising by reason of any person using or relying on the information contained in this publication and whether caused by reason of any error, negligent act, omission or misrepresentation in the information