When is it safe to resume exercise after contracting Covid-19?

The benefits for those who practice physical activity are incomparable. Not only because of the six pack abs or the butt on the back of the neck, but because the list of daily improvements promoted by the exercises ranges from a greater disposition when you wake up to the incomparable quality of sleep when you go to sleep.

If the famous doses of endorphins are sorely missed, social isolation as a way to prevent Covid-19 may seem like a sign of sedentary lifestyle. Imagine having to take a break from the training rhythm at home, so sweaty and built on the basis of willpower, to see a drop in your fitness due to a coronavirus infection. But, believe me, it is necessary.

As a recent disease, the effects of Covid-19 on the body are in the process of continuous discovery by science. However, experts have already revealed that the possible impacts of the coronavirus on the respiratory system and, especially, on the heart, can affect sports practice.

It is natural to feel a little unwell during recovery from the disease and it is even recommended to avoid physical exercise while the viral load is still high in the body. But, after all, when is it safe to resume the physical activity routine after beating Covid?

The key, when talking about the post-infection period of Covid-19, is the ability to transmit the disease. Even with the end of the symptoms, it is possible that a viral load capable of infecting others remains. Therefore, it is essential to wait 14 days before considering engaging in a sports activity in public – and isolation also applies to living with other people.

In addition, even at home, exercising can make it difficult for you to recover. Even in cases of mild symptoms, physical activities increase the circulation of the virus – from the blood circulation – and can cause an increase in the viral load in the heart, resulting in more serious complications.

But then, when is it recommended to go back?

In an interview with Metropolises, a cardiologista Clea Colombo, president of the sports cardiology study group, points out that the return to physical activity, as well as the recommendation of the medical evaluation, depends on the clinical condition that the person had.

Serious cases usually have greater consequences, and the body requires more time to recover. Each of the particular complications will require a professional assessment to see how much these problems interfere with physical exercise.

However, “the return would be, at least, after two weeks of resolving the disease”, explains the doctor. Wait 14 days after the symptoms are completely gone, then start with lighter activities.

The return should be gradual. Don’t even try to achieve the same performance as before the infection in the first gym session. That is, nothing of a heavy routine in the crossfit, a hectic class of spinning or run like you used to.

physical activity

Coronavirus impacts may affect physical activityGetty Images

Close Up Of Woman Stretching Before Run

It is essential to wait at least 14 days after the end of the symptoms before resuming the exercises

people practicing physical activityphysical activity

Some warning signs may mean the need to see a doctorGetty Images


What is the frequency and frequency of exercises recommended?

After treatment, the recommendation of the World Health Organization (WHO) takes effect again. There are at least 150 minutes of light to moderate aerobic exercise per week or 75 minutes of intense activity. And two weekly strength training sessions.

Recommendations for each frame
  • For those who tested positive, but remained asymptomatic: avoid physical exercise for at least two weeks after the positive test result. Remembering that it is essential to wait 14 days to leave the house, following strict isolation guidelines.
  • For those who have developed mild or moderate symptoms: a minimum interruption of two weeks of any physical training is also recommended, but this pause should start at the end of the symptoms. It is important to consider the possibility of cardiac injury in these cases, requiring cardiological examinations.
  • For recovered individuals: the ideal is to perform a careful clinical cardiovascular evaluation in combination with cardiac biomarkers and images. With no symptoms and no objective evidence of cardiac involvement, the return to physical activities, with clinical follow-up, can be done. If the test suggests heart problems, the return patient must wait for the treatment period.
  • For those who have been hospitalized, but whose cardiac biomarkers and imaging studies are normal: minimum rest of two weeks after resolution of symptoms, always taking into account cardiac tests, followed by a gradual resumption of exercise.
  • For patients who were hospitalized, becoming more seriously ill, and had cardiac injuries associated with Covid-19: it is recommended to return to physical practice according to the treatment of myocarditis, even though it is not the only possibility resulting from cardiovascular changes.
Medical follow-up

From the experts’ point of view, it is recommended that all people undergo a medical evaluation before returning to exercise, “since we have seen that individuals with mild and asymptomatic conditions may have heart involvement in the future”, advises Clea Colombo.

However, due to the disparate socioeconomic situation, “many people are unable to see a doctor in the short term, and we do not want to inhibit anyone from returning to exercise”, ponders the cardiologist.

Therefore, if possible, make a medical evaluation before increasing the intensity of the exercise, for the sake of safety. “It is essential to know if this heart is good for doing high intensity activities”, he guarantees.


Warning signs

It is very common for people who have had Covid-19, regardless of the severity of the condition, to have some sequelae. Some may even interfere with the possibility of practicing physical activities or not.

According to physical educator Mônica Marques, in front of the Cia. Athletica academy in São José dos Campos, in São Paulo, there are more common signs. Myocarditis, a myocardial inflammation of cardiac origin, is an example of a contraindication to physical activity. Signs like chest pain, palpitation or difficulty breathing can be symptoms, according to cardiologist Clea.

“Other conditions, more common, are excessive tiredness and body pain”, points out Mônica. These are called myopathies, which cause muscle discomfort. There are also respiratory symptoms, such as shortness of breath.

women practicing yoga
Yoga exercises are great alternatives to restore breathing capacity

There is also a greater possibility of thrombosis as a post-Covid sequela, whose main symptom is severe pain in the calf. When identifying this significant discomfort in the region, it is necessary to stop the activity and seek medical attention.

Health issue

Talking about physical activity is also about treating a healthy pillar of life. Although the pandemic and confinement have significantly increased the rates of physical inactivity, “exercise is essential for health, because it is able to help prevent various diseases and even minimize the risks of severe Covid-19 conditions”, he explains Clea Colombo.

To bring the first epidemiological and clinical metrics necessary to facilitate a fresh start after contamination by the virus, the Brazilian Society of Exercise and Sport Medicine (SBMEE) and the Brazilian Society of Cardiology (SBC) published a document with guidelines for safe return the practice of exercises.

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