After recovering from COVID-19, many patients want to get back to their pre-illness exercise program.

Doing so should be a gradual process that starts with a visit to your primary care provider for a physical exam and tests. Patients who dealt with severe illness might also need physical therapy.

While a cautious approach is key, patients are strongly encouraged to resume exercising for its many health benefits.

If you’ve recovered from COVID-19 and want to resume strenuous exercise, put safety first by checking with a health provider, taking it slow, and monitoring how you feel.

Regional One Health’s Ambrosia Scott, DPT, LAT, CCI, Manager of Rehabilitative Services, and Omobonike Olowosuko, DO, a physician who specializes in rehabilitative medicine, said patients can gradually resume aerobic exercise post-COVID.

First, consult with your provider. They can do a physical exam and run tests to make sure your heart, lungs, muscles and other body systems are healthy enough for exercise.

“Most patients who had COVID have persistent respiratory and cardiac complications even after recovery,” Scott said. “They may have an elevated resting heart rate, fatigue, and difficulty maintaining a healthy blood oxygen level.” This can last over six months.

Scott said the process of resuming exercise differs for patients with mild symptoms vs. moderate to severe symptoms. If you had mild symptoms, once you feel better you can likely start light exercise like stretching, strength exercises, walking, swimming and biking.

Ambrosia Scott, Manager of Rehabilitation Services, recommends a cautious approach to resuming exercise after COVID-19. “If you talk to your provider, take it slow, and listen to how your body responds, you’ll benefit from resuming exercise after recovery,” she said.

“Running or other strenuous activities are going to be more difficult, but we’ve seen patients ease back into running in a month or so. Talk to your provider about a process to graduate back to what you were doing,” she said.

Dr. Olowosuko added patients who had severe symptoms need to be even more careful. “Patients with breathing discomfort might need a tailored physical therapy program that teaches oxygen management, energy conservation and pacing. This can be done two to three times a week for three months.”

It’s essential to make sure your oxygen saturation, heart rate and blood pressure stay in a normal range. Along with talking to your provider, Scott suggests using a pulse oximeter, smartwatch or app for monitoring.

“Listen to your body,” she said. “If you exercise and then can’t get out of bed for two days, or your heart rate spikes well above the normal range, slow down.”

She suggests starting with one exercise session per week focusing on gentle cardiovascular activity with plenty of rest breaks. You might try more lower-body strength training, which is less taxing to the heart than upper-body strength training.

“Maybe start with one 30-minute session of walking and graduate to two days of walking, then three,” she said. “When you can do a little more each day comfortably, you can gradually start incorporating some higher intensity exercise.”

While Dr. Olowosuko and Scott urge caution, they encourage patients to make the effort. Scott noted cardiovascular exercise keeps the heart strong, maintains a healthy weight, boosts immunity, reduces chronic diseases, etc. “There are health and quality of life benefits to keeping the heart in shape. If you talk to your provider, take it slow, and listen to how your body responds, you’ll benefit from resuming exercise after recovery.”

Dr. Olowosuko added patients with cognitive impairment, ranging from brain fog to difficulty concentrating, might need formal speech therapy to enhance cognitive skills.

For more, call the Center for Rehabilitative Medicine at 901-515-5900.