Day 27 of Covid - When to Restart Exercise?

[JumpyTheFrog]

Day is day 27 of Covid for me. A few days ago I finally leveled-up into just dragging myself through daily activities. I still have some congestion and a cough, although they are about 75% better than they were a week ago. Before Covid I was playing soccer 3-4 days per week and lifiting weights twice a week. Right now my pulse still zips up to about 120-125 going up one flight of stairs. I have an Oura ring, so I can see that my heart rate variability is about back to normal, although my pulse is still about 3-5 bpm higher at night than before Covid.

The brain fog has mostly lifted, although as I said, although I no longer need to bum around all day, my energy is still low. I'd say I can do things like laundry, pay bills, dishes, and cook for maybe about 1-2 hours spread throughout the day. 

How do I know when it's time to try some light exercise? I thought another Hive member said something about if people try to return to normal too quickly they can end up with long Covid. Online searches suggested the Return to Play protocol, which has about 7 stages of returning to normal training once a person has  gone 7 days without symptoms. I'm not sure if this would be a week with zero cough, or a week of feeling totally normal except for a bit of a lingering cough. (For example, I was sick about 4-5 days at Thanksgiving, but I was able to play in a tournament the following weekend, even though I had a lingering cough that was finally about gone when I caught Covid.)

DH caught Covid about five days after me and is similarly slow to recover. The last two nights his fever at night was only about 0.5 degrees F after having a real fever almost every night since Christmas. Even DS1, who is never more than mildly sick more than 2-3 days, took 2 weeks to totally recover.

[Ali in OR]

My Covid was very mild--mostly felt like a head cold. I had fatigue and napped more than usual even when I was negative and feeling mostly fine. At a doctor's appointment a couple of weeks later for something else, I had high blood pressure--high enough to re-check at another appointment 3 weeks later and it was still high. I bought a home monitor and it went back to normal (was always normal before or even low). I've been thinking it was due to Covid as I don't have another explanation for it.

Anyway, I would go slow as you return to normal activity. I was doing gentle yoga when I still tested positive (like days 8,9,10) and that actually felt good. I would think short walks would be an ok way to ramp up a bit. But think of the recovery period as months instead of days or weeks and go easy on yourself. Give in to any urge to nap if you can.

[KSera]

25 minutes ago, JumpyTheFrog said:

How do I know when it's time to try some light exercise? I thought another Hive member said something about if people try to return to normal too quickly they can end up with long Covid.

This is what I have read everywhere as well. I know there are some pacing guides online. I will see if I can find a link.

This one looks pretty good. Some of the ones I’ve seen make it sound more confusing than this does:

Managing Fatigue in Post COVID-19 Recovery with Pacing

It has links to a few other helpful documents, including how to undertake exercise.

 

Edited January 15, 2023 by KSera

[Harriet Vane]

I don't have an official answer, but I will share what a dear friend told me. My friend is an exceptionally talented physical therapy assistant and athletic trainer. She put me back together after deconditioning from sepsis coupled with chronic conditions left me in terrible shape. She also worked with me throughout the pandemic and most notably in the months after my own, first covid infection. 

My friend has, at this point, suffered covid herself and she has trained many people after their covid infections. Her strongest advice is "LOW AND SLOW." This is apparently the catch phrase all the trainers are using. 

My off-the-cuff guess as to why low and slow is the only way is because covid causes a lot of damage a lot of places at a cellular level. The damage has to actually heal. Pushing too hard before healing is exactly the same as walking on a broken leg before the bone is set--the only thing that happens is more damage. 

So hold on to the principles you know as an athlete--that moving is better than not moving--but take it low and slow. For myself, in the months after my infection, I found that I was horribly breathless and would end up gasping for air while working out. We moved to lower weights, fewer repetitions, and almost no pushing aerobically until I could manage simple weight rotations without all the heavy breathing. I also took walks as much as I wanted--I was slower for a little while but able to put in good distance. In my case, it took only a few months to work back up to normal. 

[HomeAgain]

Yep, keep it light.  We've had 3 come down with Covid here:

A. Hockey player, on the ice 4-8 hours a week and off ice training.

B. Multi-sport/military, running and basketball preferred

C. Avid bike rider doing 30-40 miles at a time with hills and speed.

We learned with the hockey player to monitor hard.  He had to start slow, keep his heart rate low, and work his way up. It took months for him to work back out. It made the other two realize they had to go just as gentle on their bodies.  A walk every day.  Yoga to help with breathing.  Working back up to flat jogs and short bike rides.  It meant the summer was shot, but it was so worth it. They're all (mostly) fine now. 

[skimomma]

I had an uncomfortable but likely not terrible case on Covid last May and I learned the hard way what happens if one does not follow the low and slow advice.  I did not have brain fog and I'm not sure you could call my lingering symptoms "long covid," but I had a relapse that lasted for weeks that I believe was due to jumping back into exercise too quickly.  I run, bike, swim, lift, hike, and ski at least one hour a day, often much more.  I was training for my annual half marathon when I got sick.  I took two full weeks off until the cough went away and I felt mostly normal.  Having missed the two weeks, I was eager to get back on my training plan to make up some ground.  I did a couple of short, slow runs.  They went ok but I did notice, and should have heeded, that my heart rate was much higher than normal.  So then I tried my first on-plan run and not only felt terrible fatigue after 30 minutes despite an uncharacteristically slow pace, but managed to fall (this was a trail run) and ended up taking myself out for weeks due to the resulting leg injury.  I think that was a blessing in disguise.  I did not enjoy the pain but it kept me from making the situation worse.  The fall happened far from the car and like a lot of fresh injuries, it was not obvious right away just how bad it was.  So, I ran the 30 minutes back and was alarmed at my heart rate and difficulty breathing even though I was running much slower due to the injury.  The next day, in addition to the injury, the covid cough came back worse than ever and my resting heart rate spiked.  This all lingered for WEEKS.  I have to say that it made me feel super low.  I was able to do some very mild exercise in the pool and that was about it.  I still didn't learn my lesson and insisted on doing the race I was training for....except I dropped to the 5 mile event.  That went terrible and it was way too early.  Again, I was red-lining it with heart rate and still running at a slow pace.  I believe that set me back even further.  I am *still* not back to any of my pre-covid metrics, my heart rate is still running high, and I feel like my lungs have been compromised.  I have had two colds since covid and in both cases the cough was out of control and lingered for weeks.

All that to say that I think low and slow is for sure the way to go and to make sure you are keeping it low and slow enough, wear a heart rate monitor and pay attention to how you feel on all levels.  I should have started with a solid two weeks of walking only.  Sadly, I am not sure I have the discipline to follow my own advice should I come down with covid again, but I sure hope dh would tackle me, hide all my equipment, and threaten to lock me up if I don't.  Exercise is my best anxiety mitigator so it is very hard for me to leave it, even when I should!

[stephanier.1765]

On 1/15/2023 at 2:18 PM, Ali in OR said:

My Covid was very mild--mostly felt like a head cold. I had fatigue and napped more than usual even when I was negative and feeling mostly fine. At a doctor's appointment a couple of weeks later for something else, I had high blood pressure--high enough to re-check at another appointment 3 weeks later and it was still high. I bought a home monitor and it went back to normal (was always normal before or even low). I've been thinking it was due to Covid as I don't have another explanation for it.

Anyway, I would go slow as you return to normal activity. I was doing gentle yoga when I still tested positive (like days 8,9,10) and that actually felt good. I would think short walks would be an ok way to ramp up a bit. But think of the recovery period as months instead of days or weeks and go easy on yourself. Give in to any urge to nap if you can.

I also had what I consider a mild case of Covid. I just finally tested negative yesterday. Oddly, I was having problems with my BP dipping too low, such as 85/65. It's so strange the way this disease affects people in so many different ways.
 

JumpytheFrog, I also agree with low and slow. Because my case was mild, I thought I would use the time to get some spring cleaning done. 🤦‍♀️ Whew, it was so easy to wipe myself out that I would just about fall asleep any where. So please, take it easy. Your body needs you to really take good care of it right now. Good luck!

[KeriJ]

Agreeing with what has been said so far. Right now I am trying to decide if I have a new cold or if it's a covid relapse because I have done too much too soon.

[Laura Corin]

I waited about two months to go back to previous levels of exercise.  I didn't have any lingering symptoms, but I wanted to be cautious - my brother has had a terrible time with LC. 

It has gone fine - a bit frustrating, but I'm glad I was cautious.

[lmrich]

It took me a long time. I started to feel better after three weeks and could walk around my block (very small block) and then I could do it twice a day. But then I broke (shattered really) my toe so I went back to resting while that healed. 

Take your time and listen to your body. 

[Spy Car]

My concern is that there seems to be a cohort of people who have Long Covid who experience what is called "Post Exertional Malaise" aka "PEM," which is an odd way of saying that these people "crash" (or experience an exacerbation of their symptoms, such as extreme fatigue and brain fog) if they exceed their somewhat narrow energy reserves. They pay dearly for overdoing it.

This group (that experiences PEM) exactly mirrors what people with ME/CFS describe. Those with myalgic encephalomyelitis/chronic fatigue syndrome (which is also a post-viral illness) caution people that the worst thing a person can do for their well-being is to exert themselves to the point where they repeatedly go into PEM crashes, as that seems to be a downward spiral. And PEM can happen a day or two post-exertion.

So my advice would be to be "mindful." Go slow. If you feel better, keep going. But if (and hopefully it is not the case) you "crash" after exertion, then operate with great care. That is when you do not want to "push through."  

Listen to you body.

Bill

[busymama7]

51 minutes ago, Spy Car said:

My concern is that there seems to be a cohort of people who have Long Covid who experience what is called "Post Exertional Malaise" aka "PEM," which is an odd way of saying that these people "crash" (or experience an exacerbation of their symptoms, such as extreme fatigue and brain fog) if they exceed their somewhat narrow energy reserves. They pay dearly for overdoing it.

This group (that experiences PEM) exactly mirrors what people with ME/CFS describe. Those with myalgic encephalomyelitis/chronic fatigue syndrome (which is also a post-viral illness) caution people that the worst thing a person can do for their well-being is to exert themselves to the point where they repeatedly go into PEM crashes, as that seems to be a downward spiral. And PEM can happen a day or two post-exertion.

So my advice would be to be "mindful." Go slow. If you feel better, keep going. But if (and hopefully it is not the case) you "crash" after exertion, then operate with great care. That is when you do not want to "push through."  

Listen to you body.

Bill

THIS!!!!!!

Please just don't exercise for quite awhile and certainly not if you are having any elevated heart rate.   It was 18 months for me before I could even climb stairs without spiking my HR.   It takes time.  Take it easy 

[JumpyTheFrog]

On 1/17/2023 at 10:29 AM, Spy Car said:

This group (that experiences PEM) exactly mirrors what people with ME/CFS describe. Those with myalgic encephalomyelitis/chronic fatigue syndrome (which is also a post-viral illness) caution people that the worst thing a person can do for their well-being is to exert themselves to the point where they repeatedly go into PEM crashes, as that seems to be a downward spiral. And PEM can happen a day or two post-exertion.

I actually had CFS from about 2008-2011 and eventually recovered from it, so I know exactly what you're talking about. I NEVER want to go back to that, which is why I was asking for suggestions here. Thankfully I have tech to help me avoid it. DH and I both have Oura rings, which track our nighttime average and lowest heart rates, as well as heart rate variability. I also have a smart watch for fitness purposes, as well as a chest strap heart rate monitor I can dig out for more accurate readings. We are both looking at all our numbers carefully each day, which is what has prompted us to take things very easy.

[JumpyTheFrog]

On Monday I went for my first walk and went 0.5 miles. Today I went 0.8 miles. Both days I started to feel slightly more tired after about 3-4 minutes, but then it went away. The first day I felt like resting in a chair for a while after I got, but then I was fine the rest of the day (coughing fits aside). Today I didn't feel like I needed to rest after my walk.