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Exercising After COVID-19: What Doctors Need To Know

The majority of physicians agree that regular physical activity is beneficial to one’s health. Exercising boosts immunity and can have immediate and long-term health benefits. However, for those who have or have just recovered from COVID-19, this may not be the case. So when is it safe to start working out again? The experts are now weighing in.


A recent study has concentrated on a number of health concerns that are linked to the return to exercise the following infection with COVID-19.

According to the authors of guidance published in the BMJ, COVID-19 can cause cardiac injury, including viral myocarditis, increasing the risk of disease and death.

Throwing clots is another risk factor, with pulmonary emboli being associated with COVID-19 in some cases as well. At this time, it is unclear what the long-term pulmonary consequences are, but data from the 2003 SARS-CoV epidemic showed that survivors had long-term impairments in pulmonary function and exercise capacity.

As the last risk, psychosis or other mental health problems could jeopardize the ability to function. Depression, anxiety, PTSD, suicide, psychological stress and somatic symptoms have been documented as a consequence of the COVID-19 pandemic. A few cases of new-onset psychosis have also been observed.


As a physician, it is critical to encourage your patients to return to physical activity when they are ready to do so. Patients with Covid-19 can avoid being fully sedentary by getting up to do light activities and moving around during the day, as long as they do not experience chest pain or exhaustion while doing so.

A narrative review published in the International Journal of Environmental Research and Public Health supports the idea of employing exercise to prevent the negative effects of long-haul symptoms.

As the authors put it, “there is sufficient data to suggest that personalized and supervised exercise training may be an effective multisystemic therapy for post-COVID-19 syndrome that is appropriate for the wide range of cases and symptoms.” The use of a multidisciplinary and integrative approach, which includes exercise sciences, is essential when treating clinical conditions. However, the approach must take into account neurocognitive and psychological aspects of the patient, as well as address the social consequences that this pathology entails.

Following a seven-day period of asymptomatic rest, the patient should be prepared to resume physical activity. Prior to returning to rigorous exercise, it is important to complete the activities of daily living as quickly as possible. There must also be no indications or symptoms of myocarditis or cardiac damage, such as chest pain or discomfort, shortness of breath, or heart failure.

If the patient is experiencing persistent symptoms, a primary care physician should review them and refer them to rehabilitation services if necessary. Studies suggest that those who have been hospitalized for COVID-19 will benefit from graduated rehabilitation. Physical examination and diagnostic evaluation, which may include an ECG, serum troponin levels, and echocardiography, may necessitate a referral to cardiology, however, some abnormalities, such as costochondritis, may be treated in primary care settings without requiring a referral. Additional heart sounds, edema, fibrosis, pleural effusion, and unusual arrhythmias are among the findings that should be of concern.

Symptoms such as coughing and shortness of breath should subside within a few weeks but persisting or worsening symptoms could indicate pulmonary embolism, pneumonia, or post-inflammatory bronchoconstriction, which are all treatable conditions. These patients should be directed to the appropriate care provider.

Although exercise has been shown to improve mood and well-being in certain people, the patient must be mentally prepared for the task at hand. The patient’s mood, sleep, inclination, and appetite should all be taken into consideration. In addition to traditional counseling and rehabilitation treatments, systems of support such as self-care resources and community programs, as well as peer support, may also be beneficial.

Should Physical Therapy Be Part of COVID-19 Recovery?

The most prevalent difficulties we see with clients after COVID-19 are fatigue and deconditioning. We can help with these issues. Our DPTs can set a target heart rate for a patient and then monitor the patient’s heart rate to ensure that they are exercising at a level that is within their tolerance. When someone is regaining their strength, it is quite simple for them to overdo it and end up injuring themselves. Cadence Physical Therapy can offer custom-tailored exercises and rep counts to ensure that patients are performing them within a range that is both safe and effective for them. When the patients have a physical therapist at their side, they can be confident that they are challenging themselves with effective and appropriate exercises and difficulties.

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