To exercise, or not to exercise: When to start exercising post-COVID?

Research has also shown that if post-COVID patients do not do breathing exercises and physical rehabilitation, there can be permanent lung injury and muscle weakness that never recovers to normal.

By Dr Ravi Andrews  Published on  27 Jun 2021 7:04 AM GMT
To exercise, or not to exercise: When to start exercising post-COVID?

If I ever had to write a book on the different excuses people give for avoiding exercise, the title of the book would be: "I cannot find the time". Post the COVID-19 pandemic, this excuse has lost its validity because we all now have time and more time on our hands. This is particularly true in the case of those who have suffered and overcome COVID-19 infection themselves. This group is isolated at home or elsewhere and has plenty of time on their hands.

The important question is, when can people start exercising post-COVID infection and what kind of exercise is suitable for them. There is a fair amount of confusion regarding this. On the one hand, there are reports of people having heart attacks and brain strokes after exercising and on the other hand, there are reports of lung damage in people who remain totally sedentary post-COVID. There has to be a sensible middle ground and common sense will show this to us.

Post mortem studies of people who died from COVID-19 have shown us that the most common cause of death is blood clots in the circulation which leads to lung damage. Other organs can also be damaged by this same mechanism. Excessive exercise started too early post-COVID facilitates blood clot formation by dehydration. Also, existing blood clots can be dislodged during vigorous exercise and travel to critical areas in the body.

Research has also shown that if post-COVID patients do not do breathing exercises and physical rehabilitation, there can be permanent lung injury and muscle weakness that never recovers to normal.

So what is the solution?

Most doctors are in agreement that for the first month post-COVID infection, strenuous physical exercise must not be attempted. However, light exercise can be done provided the patient does not feel fatigued or tired. Light exercise should start only when the patient has no symptoms for at least a week. There should be no fever, cough, breathlessness, muscle pains, joint pains or diarrhoea. Oxygen saturation must be over 95% on room air.

Exercise should start slow, with just slow walking for five to 10 minutes at a time. No weight lifting is permitted. Gentle breathing exercises are allowed. If there is any discomfort at any time, the exercise must be discontinued. The intensity and duration of exercise can be slowly increased once in three to four days. After one month, if everything is going well, the individual can be allowed 150 minutes of moderate exercise per week. For those individuals who had high fitness levels before COVID infection and had an intense exercise regime, 60-70% of pre-COVID exercise intensity is permitted after one month. Again, the key is to listen to the body and reduce or stop the exercise if there is any discomfort.

Now, a few tricks to make exercise more appealing and effective:

· Always club exercise with another activity like watching TV, listening to music, preparing a speech or presentation mentally, etc. So never think of it as "exercise time" but think of it as "TV time", or "music time", or "preparation time" and so on.

· One of the most demotivating factors during exercise is the sound of your heavy breathing. Hearing your fast breathing while doing cardio or hearing your grunting while lifting heavy weights tells your brain that you are tired. This auditory stimulus can be removed by listening to music or watching TV. You will find you can do more exercise if you cannot hear yourself struggling.

· While doing cardio, do not do it while chatting with a friend or while on the phone. You will automatically slow down to save your breath and the cardio session will be ineffective.

· While doing weights, do it with a friend. This will help you do more as you can motivate each other.

· Try and regularise your schedule so that you do exercise at the same time every day. This fits it into your schedule and you are less likely to miss a session.

· Do not keep a target of five days a week because you will invariably end up exercising for four days. Keep a target of 25 days a month then you will end up exercising 22- 23 days. That would make it five days a week. There might be times when you even exercise for seven days at a stretch. That is fine. Most of us do recreational exercise which is not too intense. So the body doesn't get so tired that it needs to rest for two whole days every week. Of course, if you are an elite athlete doing intense exercise daily, you will need that kind of rest for your body.

Then again, if you are an elite athlete, you will not need to resort to any tricks or gimmicks to motivate yourself!

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