Spending time in hospital or being ill at home with COVID-19 can cause your muscles to become weaker. Exercise is important for regaining your muscle strength and endurance. BUT this needs to be safely managed alongside your other COVID-19 symptoms. This applies to children as well as adults.
On this page, you can find the following information:
- What happens when I exercise after I have been unwell?
- How do I get back to exercise?
- What sort of strengthening exercises could I do?
- What about children/teens who have had COVID?
When you have been unwell with COVID-19 and have not been exercising, or even moving around much, your muscles can get weak. When you start exercising again your symptoms can get worse, or you can get very tired even after a small amount of activity. This is known as post-exertional malaise, or PEM, and it is an important part of recovery after COVID-19.
- PEM can happen hours or days after physical or mental exertion.
- Recovery times can vary and can take between 5-20 days where symptoms can become worse over a number of days.
- If you experience PEM, you need to avoid exercise and activities that cause fatigue or symptoms and conserve your energy – see managing fatigue.
- If you don’t experience PEM, you can gradually increase your level of activity or exercise.
Your return to exercise should take place gradually in 5 phases. The following sections describe these phases and give suggestions for activities at each phase.
It is important that you:
- stay at each phase for a minimum of 7 days before progressing to the next
- drop back a phase if you find it difficult, or if you experience setbacks in your symptoms
- stop immediately if you have any chest pain or dizziness, and don't restart your exercise programme until you have talked to a healthcare professional.
Preparation for return to exercise: These activities should feel easy, and should not make you feel short of breath.
Examples: Controlled breathing exercises, gentle walking, stretching and balance exercises. Stretching your muscles can be done sitting or standing. Each stretch should be performed gently, and you should hold each one for 15–20 seconds.
Low-intensity activity: These are the kind of things you feel like you could keep doing for hours. You should be able to breathe easily and have a conversation while doing them.
Examples: Walking, light household/garden tasks. If you can cope with these activities and continue to talk to someone, you can gradually increase the time you spend exercising by 10–15 minutes per day. You’ll need to spend at least 7 days in this phase without getting post-exertional malaise before you move on to the next phase.
Moderate-intensity activity: When you do these activities they make you breathe heavily, but you could keep talking.
Examples: Brisk walking, going up and down stairs, jogging, introducing slopes, resistance exercises. If you can’t talk while doing an activity, then you are not ready for this phase. You could start the arm and leg strengthening exercises described below.
Moderate-intensity exercises with coordination and functioning skills: These activities make you feel short of breath, and you can only speak about one sentence at a time.
Examples: Running, cycling, swimming and dance classes.
Return to your baseline exercises: You’re now able to do the types of exercise/sports/activities you could do before you got COVID-19.
|Things to look out for when exercising|
|No exercise should be painful.
If you feel any of the following symptoms, do not exercise (or stop exercising if you have already started), and contact your healthcare provider:
Strengthening exercises will help improve muscles that have become weaker as a result of your illness.
Examples of strengthening exercises for your arms and legs
Wall push off
Arm raises to the side
Sit to stand
Image credit: WHO
If your tamariki have had COVID they need to be careful about returning to their normal physical activities as well. KidsHealth provides advice on how they can safely get back to activities and sport depending on how ill they were with COVID-19.
Back to activity & sport after COVID-19 KidsHealth, NZ
COVID recovery resources Moving Medicine, UK
Workbook for an active recovery from COVID illness Moving Medicine, UK