Fit and fine by Kamal Singh CSCS: Return to working out, post Covid-19

I was recently asked how to go about exercising after recovering from Covid-19. Before I answer this question, let me preface it by a huge disclaimer – Anything I say in this column is from a training point of view and if your doctor advises you to wait or not to exercise then you should listen to him or her. So, before starting any physical activity, speak to your doctor and if they say you can go ahead then you can use this column to restart your journey to fitness.

After effects of Covid: lungs or more?

Since this virus is so new, initially the doctors and experts thought the virus only attacked the respiratory system – the lungs seemed to be the only organ, which the virus targeted. The doctors also did not know what could be the after effects on the lungs once the virus is gone. Now they do know that if you have had the severe form of the disease then scarring of the lungs is possible. Long term lung issues are more likely if hospitalised with mechanical ventilation. Thus if you had the mild or moderate form, then chances of scarring or fibrotic lungs are less.

We know that other viruses can trigger adult onset Asthma and Covid could do the same for people with the milder infections. Thus you could get chest tightness, wheezing or shortness of breath, especially while exercising. Doctors do feel that most people will get back their normal lung function but it could take a while and exercising in this time could be harder than usual.

And the heart?

From a study published in the Journal of American Medical Association, Cardiology, heart problems can occur in hospitalised Covid patients. The Journal mentions cardiac injury, which is a very wide term and can include a whole bunch of conditions. But one thing is clear that cardiac injury can cause extreme shortness of breath out of proportion to the activity you’re doing, racing or irregular heartbeat, chest tightness, lightheadedness, or even fainting. Currently there is no data of cardiac issues with people who were mildly sick but seeing such issues with the serious cases raises valid concerns about those who had the mild or moderate version of the disease.

The current recommendations for return to exercise

•For the mild and moderately ill, the experts advice waiting at least seven to nine days before starting to exercise after getting cured.

•For those who had to be hospitalised, the recommendation is to wait at least six weeks before starting to exercise after getting cured.

•The emphasis should be on slowly easing in to an exercise routine. Assume that you are a total beginner and proceed from there.

Spread your workout over two or three sessions in a day
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•Increase intensity and volume of the exercises very slowly. If you get tired after walking for five minutes, then next time increase the time to six minutes and not to 10 minutes.

•Always have a partner with you if exercising outdoors, in case you feel faint while exercising.

•Start with low-intensity exercises like walking rather than running etc.

•A good way to improve would be spread your workout over two or three sessions in a day. So, walk for 10 minutes three times rather than wanting to do a full 30-minute session and feeling completely wiped out.

•Frequent short dosing helps build capacity faster.

The Covid-19 virus is a fairly new virus and most of the doctors do not really know the long- term effects on the body. In these uncertain circumstances, it is a good idea to take things slow. Now go out and do it!

Kamal Singh is a Certified Strength and Conditioning Specialist who has been coaching for 15 years

From HT Brunch, August 23, 2020