Exercise And Covid 19 Recovery

Runners are a hardy breed and typically are anxious to run through whatever ailments come their way. Conventional wisdom tells runners that if symptoms of sickness are in your head, it’s okay to run. However, if the symptoms you are experiencing are below the neck, you should rest. Typically, as people recover from an illness a physician will just tell them to listen to their body. Being smart and coming back gradually from illness makes a whole lot of sense. But what if the illness is a brand new virus that scientists are still learning about? Today we discuss exercise and covid 19 recovery.

Can You Workout With Covid?

The simple answer is no, you should not. Even if you are asymptomatic, the recommendation from the Infectious Disease Advisor states if you have a positive test you should not exercise for two weeks. This recommendation comes because many individuals with Coronavirus experience heart problems.

Due to Covid being such a new virus, the long term impact on a patient’s body is unclear. Until more data can be collected athletes should err on the side of caution.

Tips From an Average Joe:

exercise and covid 19
Jeff Galloway

Jeff Galloway of Alvaton, Kentucky is one month out from Covid. Like many people, his return to running has been a rollercoaster ride. Galloway started out walking a mile a day, working his way up to 2.5 miles. After that he decided to run a 5K which actually went well while running it; however, after he was sore and experienced head and chest congestion, chills and felt feverish without actually having a fever. After resting a few days he headed out for another 5K and had none of the symptoms from the run before. 

Although Galloway and his physician did discuss some post covid testing, they did not do any. Like most athletes, he is just working his way through this via trial and error. 

Resuming Activity Post Covid

The very first thing to remember is to take it slowly when you return to physical activity after Covid. Although some people seem to bounce right back into their normal routine, there are others for whom this is not true.  While you might get lucky and be able to return to your workouts exactly how you left them, you should not make that assumption.

Asymptomatic Covid Positive – If you are Covid positive but have absolutely zero symptoms, you can return after 14 days at 50% of your normal level of activity. For a runner this is multifaceted. First, think what 50% of your base mileage would be. If you normally run 20-25 miles a week, taper that down to 10-12 for the first week back to activity.

The next thing to consider is your effort. Because many people find Covid impacting their heart, you should exercise at about 50% effort. Even though it may be hard for you to slow your roll, you need to be smart. If your normal run is 8:30 minute miles, consider slowing down to somewhere from 10:00 to 11:00 minute per mile pace.

After a week of this type of activity, you can dial it up just a little bit, trying 75% of normal level of activity and increase your effort to 65-75%. If at any time you experience shortness of breath and/or chest pain – STOP IMMEDIATELY.

Covid Positive with Mild to Moderate Symptoms – Your symptomatology during Covid will dictate your return to activity as it is not a one size fits all approach.

If you experienced respiratory symptoms such as pneumonia, the guidelines say to rest an additional week after symptoms have passed. Then, you can try and return to activity as described above. You should be very aware of your breathing while exercising and maintain a conversational pace. If it gets difficult to breathe and/or results in any kind of chest pain, stop immediately.

Some people have gastrointestinal symptoms while still experiencing Covid, and many others get them after their infectious period. The important thing here is to be sure you are adequately hydrated and fueled if you plan to exercise. If you are experiencing nausea, vomiting and/or diarrhea, you should probably be resting.

If you had joint or muscle pain that likely can return after your infectious period, you should try no or low impact exercise first. If that does not cause you discomfort, you can try the protocols outlined for asymptomatic Covid positive people.

For those with cardiac symptoms, you should rest an additional two to three weeks longer than those without. In fact, many physicians are encouraging anyone who is an endurance athlete to have an EKG prior to resuming activities. If it is found you have myocarditis (inflammation of the heart), you should not engage in any cardiovascular activity for three to six months. If this is you, please follow the recommendations of your primary care physician.

Danger Of Blood Clots

When contemplating exercise and Covid 19, we would be remiss if we neglected to discuss blood clots. After a healthy college student in Indiana with Covid died from blood clots, it caused people to take note of this danger in particular. If you are experiencing any unusual type of pain during or after Covid, you should contact your physician.

Signs and symptoms of a possible blood clot include pain, swelling, redness, tenderness and/or a warm sensation. Knowing a blood clot can potentially be fatal, they are nothing to mess with.

Tips From An Average Jane:

Coronavirus recovery and running
Peggy Marlar

Peggy Marlar of Oklahoma City has run 15-20 miles per week for roughly 10 years. She had what her physician called a mild case of Covid, in which she had chest congestion, a cough, muscle aches, headache, low grade fever, loss of taste and smell as well as fatigue. Advice from her doctor was just to be smart and take it slowly. Three weeks post covid, Marlar is running a full 2-3 minutes per mile slower than before and experiencing post workout body ache and fatigue. 

When It’s Safe To Run Again

Running and Coronavirus does not have to be scary as you resume activity, but you should respect the process. One word of advice besides “take it easy” is to use heart rate training as you get back into your groove.

You will probably notice that you are struggling with keeping your heart rate where it was pre-covid. Keeping your breathing and heart under control is an important aspect of fitness after experiencing this virus.

Tips From An Average Joe:

Coronavirus and exercise
Binyamin Lipsky

Binyamin Lipsky of Long Island was training for a sub 2 hour half marathon in March when Covid hit. His first indication that something was wrong was that his heart rate was creeping up on 170 while exercising, and normal for him was around 150. Lipsky eased back into exercise by jogging for one minute and walking for three. Over several months he built his way up to 30 minutes of straight running. 

Finally able to run for an hour, his pace is about 25% slower than before Covid. Although frustrated, this New Yorker saw first hand how devastating covid can be and is grateful to be here to run. 

COVID 19 rand running
Photo Credit: Pam Berg

My Story: On Thursday, November 5, 2020, I met a close friend for a workout. We ran a smooth and solid 5K. Notice the statistics to the left side of the image. My heart rate averaged 156 beats per minute and that was running an 8:33 pace (minutes per mile). This was one day before my covid symptoms started and two days before I tested covid positive in a rapid test. 

My symptoms included a terrible headache, ear pain, sore throat and cough. By the second day, the fatigue was terrible. My heart raced doing a simple task like walking up the stairs from our rec room. Because I am kind of twitchy and have a need for movement, I was anxious to get back to physical activity after covid.

I knew I needed to ease into things and did some purpose walking, then run/walk intervals before attempting to run a solid few miles. The statistics at the right show my first real run back. Notice my average heart rate was 178, and that is running a full :30 seconds per mile slower than on the 5th. This run was on day 17 of covid for me (one full week after I had returned to work). 

Since I am struggling with my heart rate while exercising, my physician has ordered an EKG for me. Until that happens I will happily be running slowly with walking intermixed. 

Heart Rate Training

If you have a heart rate monitor, consider running by heart rate instead of pace for a while. Based on advice from my doctor I am trying to keep my heart rate below 160. This has me running slower than I am accustomed to. Just remember: slow is better than not at all.

A New Normal?

Hopefully, after allowing your body some grace and time to heal you will find yourself back to your normal running machine-self and this will not be a new normal for you. Since the virus is still so new, it is unknown what (if any) long term impact the virus will have on the average endurance athlete.

Just remember to respect the virus, take it slow and be grateful for every moment you can be outside enjoying the fresh air. Movement, and the ability to do so, should never be taken for granted.

Sources:
Returning to Exercise After Recovery From Covid
Exercise After Covid-19

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