4 Steps to getting your active life back after an episode of Covid or flu
Physio ‘How-To’ Tips:
Physical activity keeps us healthy – not just physically, but also emotionally and mentally. It reduces the risk of developing heart conditions, diabetes, and cancer, just to name a few. It also boosts our immune system to help us fight viruses. In fact, research has shown that people who are less active before they get Covid can have worse symptoms when they have Covid, including increased risk of hospitalisation and ongoing symptoms1. So, it is vital after we’ve had a virus such as the flu or Covid, that we return to physical activity as soon as is safe to do so for the sake of our long-term health, and to avoid another viral attack too soon. But how do we do that?
The first research about returning to sport after Covid was published in October 2020 when vaccinations weren’t around and there was a concern about the development of serious cardiac conditions if the return to sport was too rushed2. This information was updated in 2022 once Omicron became the dominant variant and vaccinations were widespread3.
The key strategy is to let the symptoms guide you to gradually return to your previous level of physical activity. In very simple terms, initially rest, then once the symptoms have gone (a mild runny nose or slight sore throat are safe to still have) gradually do more and more, giving yourself 3 days at each step to make sure it’s safe to progress. We can assume that these same strategies will also help us get our normal life back again after other viruses, such as a nasty cold or the flu.
If all goes smoothly, full return to activity may only take 2-3 weeks3. But don’t push it! If you develop fatigue or any other Covid symptoms as you gradually return to your normal sporting activities, rest until you’ve had 24-48 hours without the symptoms, then recommence at an earlier step. If the symptoms persist or are significant (such as chest pain, shortness of breath, or extreme fatigue), ring Healthline on 0800 611 116, or see your GP. If you have other issues such as joint pain or general weakness, then see a physiotherapist for help.
So, here are the steps:
1: Rest, rest, rest.
It’s really important when you have acute symptomatic Covid or flu that you rest, rest, rest! Don’t attempt to continue your usual physical activities and exercises at this step – no matter how frustrating or against your usual nature that is! It’s best to rest whilst the virus is at its worst so your recovery isn’t delayed by lingering symptoms or the development of complications.
2: Light exercise.
Start doing light exercises for 15-30 minutes at 50% of the intensity you were doing before you got Covid. Let’s say you usually go for an hour-long fast walk, go for a 15-30 minute walk at a gentle, slower pace instead.
Repeat this step for at least 3 days. Then, if no symptoms have developed, including fatigue, progress to step 3. If symptoms develop, rest until you’ve had 24-48 hours symptom-free then try this step again.
Note: If you’re symptom-free whilst you’re in the initial 5 days after testing positive for Covid and can start this step, please be aware that you could still pass the virus onto others. Therefore, continue to isolate yourself from close contact with others and ensure there’s plenty of ventilation if other people are nearby. For example, go for a walk outside rather than the gym.
3: Moderate exercise.
Increase your exercise intensity to 75% of your usual routine for 30+ minutes per day. For instance, if you usually do a weights circuit in the gym for an hour, reduce the weights to 75% of the usual weight and only do 45 minutes.
Repeat this level of exercise for at least 3 days.
If no symptoms develop, including fatigue, progress to step 4. If symptoms develop, rest until you’ve had 24-48 hours symptom-free then begin step 2 for 3 days before re-attempting step 3.
4: Back to normal.
Return to your normal routine, duration and intensity. Again, if you notice fatigue or other symptoms developing, rest until you’ve had 24-48 hours symptom-free then resume step 3 again for 3 days.
Hopefully by following that routine you’ll not only return to your previous level of physical activity safely, you’ll also avoid the deconditioning that prolonged rest can cause. If you’re noticing that you have lost strength and conditioning, have some joint pain, or are generally finding it difficult to return to what you were doing previously, then please contact me or your local physio to help, It’s what we do!
Enjoy getting your life back again,
Celia
Celia Monk Physiotherapy
E: celia@cmphysio.co.nz
P: 03 9433475
Please note, this blog is not about Long Covid as the return to activity strategies for that are very different and require personal, individualised guidance from a health professional.
References:
1. Palstam A, Seljelid J, Persson HC, et al. Physical activity, acute severity and long-term consequences of COVID-19: an 18-month follow-up survey based on a Swedish national cohort. BMJ Open 2024;14:e079927. doi:10.1136/bmjopen-2023-079927
2. Elliott N, Martin R, Heron N, Elliott J, Grimstead D, Biswas A. Infographic. Graduated return to play guidance following COVID-19 infection. BJSM. 2020 Jun 22.
3. Hughes DC, Orchard JW, Partridge EM, La Gerche A, Broderick C. Return to exercise post-COVID-19 infection: A pragmatic approach in mid-2022. JSAMS. 2022 Jul 1;25(7):544-7.