While we’re still learning so much about both short and long-term effects of having covid-19, one of the most commonly known symptoms and lasting effects of covid-19 is fatigue. This is partly attributed to the impact that this virus has on our bodies, and partly due to strong medications depending on what medical treatment regimen one is subscribed. For those impacted by this fatigue, finding motivation to exercise might seem next to impossible.
However, we do know that exercise plays a large role in covid-19 recovery. Moreover, what patients who have suffered the virus have noticed is that after spending several days confined to small spaces or a bed, their bodies are inclined to move. When your body tells you it’s ready to move, it’s critical to start improving your circulation and getting oxygen to your cells that were previously deprived due to the sedentary state in which the virus puts us. However, the key is to start slow (and get permission from your physician). The current rule of thumb is to wait a minimum of 6 weeks before beginning even moderate intensity exercise, and at least spend another 2 weeks with activity no more rigorous than a short stroll. Because there are a number of patients who experience severe symptoms including cardiac arrest several weeks even after minor symptoms subside, the medical community recommends being much more conservative after covid-19, than one might expect with other cold-like viruses.
The first few exercises to try are those that simply improve breathing and mobility. Leaning into classic yoga poses like prone stretching and Pranayama help with controlling breath and relaxing the body. One can also regulate breathing by inhaling through the nose and exhaling through the mouth as one should during exercise. Only once you’re comfortable with breath control and feeling less breathless, can you proceed with mobility and stretching.
Before getting started with resistance training, one should slowly begin with functional activities like walking and stretching, even for short intervals lasting 15 minutes. The importance of lower body movement is to increase venous blood return to the heart, to re-oxygenate and circulate newly oxygenated blood through the body more frequently. This improved circulation helps cells and organs feel less tired, by providing them with energy when coupled with improved nutrition.
The next steps after breathing and light functional exercises could include the following exercises gradually and over time. It is possible that not all of these can happen in a single session, but one must slowly bring themselves up to at least doing all of the following together (which should take approximately 30-40 minutes) before resuming a full workout.
All exercises below are body weight exercises with minimal or no equipment:
1. Hip flexions (use a chair for support)
2. Knee extensions (use a chair for support)
3. Body weight squats (sit on the edge of your chair and stand up therefore mimicking a squat)
4. Light weight shoulder presses (use water bottles/ tinned beans cans. If the weight is difficult, do the movement without weights)
5. Push-ups against a wall (can progress to a chair and then the floor if you’re finding it too easy)
6. Glute Bridges
7. Hip Abductions (We call this a ‘hair pin’ position. Lay on a mat).
8. Ab curls (Lay on a mat).
Do 6-12 repetitions of each exercise across 3 sets. Breathing through the movement (inhaling through the nose and exhaling through the mouth) is most important while doing all of the above.
As a rule of thumb, once you’re able to do these exercises in a single session and you’re not left feeling excessively breathless, or experiencing any nausea, dizziness, tightness in the chest or increased pain, you could be ready to progress to a more sustained low-impact exercise routine with moderate intensity. Ideally, you should do so with a buddy or a trainer who can help support, monitor and guide you through movement in case you have any difficulties.
Getting into a more sustained exercise routine which incorporates light weight training (no more than 1-2 kilos to start) with more frequency helps build muscle tone over time, which aids in building overall strength post recovery. Depending on how long one has been bed-ridden or immobile, building muscle tone is not so much about aesthetics in this case as it is about functional movement (balance and stability) and increasing your metabolic rate to expedite bodily functions along with recovery. The more muscle you have, the better your circulation and resting metabolic rate. But remember to keep your initial post-covid-19 workouts low-impact since high-impact exercises can result in increased body pain and fatigue, along with posing a risk of injury if you haven’t focused on balance and stability exercises first.
In barre workouts, a post-covid patient after the recommended grace period mentioned above can begin with ‘Stretch and Recovery’ classes, which assist in getting the body acclimated to movement and help to re-introduce flexibility. Another key characteristic to these classes is precisely choreographed movement set to music, which introduces an element of fun. Heart-pumping beats and physical movement lead to a release of endorphins, which compete for your pain receptors and help diminish physical pain perception as well as elevate mood.
While mood may not have been an incentive to exercise pre-pandemic, it has certainly become a focal point in the fitness universe in the post-pandemic era. Finding an exercise routine which is low-impact with varying intensity, that focuses on light cardio, strength training and stretching along with being fun and empowering is the best fitness prescription for a recovered covid-19 patient.
Mallika Parekh, M.S., M.P.H., is a health & wellness expert, and the owner of Physique 57 India, a barre-based workout that originated in New York and launched in Mumbai in 2018.