I already have several friends who have complained that getting back into sports after having COVID-19 has been more difficult than usual. A former classmate of mine, who is a serious athlete, was one of the first to be diagnosed with COVID-19 back in March 2020, when a COVID-19 diagnosis was far rarer in our country than the “nihilissimus acutus” that had sent the colonel’s widow to the hospital in Smuul’s play.
When we went on a running trip to Otepää together in early June of last year, it turned out that he hadn’t yet regained his fitness after a few months, and even at a running pace of around 6:00–6:30, which isn’t particularly strenuous for him under normal circumstances, he had to take several walking breaks during the 12-km loop around Lake Pühajärv. I thought to myself at the time that I certainly didn’t want to catch that virus myself. So far, I’ve been lucky and have stayed healthy (knock on wood). By now, I’ve heard quite a bit about how others are recovering and that getting back into training is harder than with other illnesses. The days are finally over when someone in a group of friends could claim that COVID-19 is like a snowman—if you haven’t seen it, then it doesn’t exist.
Has the strength gone?
Let’s set aside for now Estonian weightlifting legend Mart Seim, who may have lost not only Christmas but also an Olympic medal thanks to COVID-19. Ordinary people among us have also lost their strength and fitness. I got the “request” for this story from my niece. After we launched FitQ, she started working out diligently at home using video tutorials. Her physical performance improved rapidly; whereas she had previously scored 240 points on the Estonian Defense Forces’ general physical fitness test, her score jumped to 280 out of a maximum of 300. But suddenly, after recovering from COVID-19, she asked me if she could get back into sports, but she couldn’t find workouts that suited her, since she was even having trouble doing the downward-facing dog pose in yoga.
While recovering from COVID-19, doctors recommend doing breathing exercises as a form of exercise: breathing through pursed lips, blowing soap bubbles, blowing bubbles through a thick straw into a water bottle, or inflating a balloon. Read more detailed advice from family doctors here.
However, these exercises are too simple for someone who already feels healthy and thinks it’s time to return to daily life and their workout routine. So how do you get started, and what should you keep in mind? I asked for advice from people who have had more experience with COVID-19 and/or exercise.
A Doctor’s Perspective
Mari Arak is a doctor who works at Tartu University Hospital and, unfortunately, has had a great deal of contact with COVID-19 patients recently. She is also an athlete herself, playing volleyball for the University of Tartu Bigbank women’s team, and serves as the team doctor for the Estonian women’s national volleyball team. To begin with, she says that while she has seen more patients than she would like, but since she is not following up on their recovery or return to training after they are discharged from the hospital, she is offering her personal opinion rather than any scientific perspective.
Mari Arak: “My main experience has been with adults hospitalized due to COVID-19, the majority of whom are unvaccinated and have required prolonged intensive care, resulting in multiple complications. Recovery for these patients takes several months; for them, walking down the hospital hallway without supplemental oxygen is a major milestone. It’s hard to say how long it will take for them to fully return to their normal daily routines, because we haven’t been monitoring them for that long.
As for athletes, it is now clear that most experience COVID-19 with mild to moderate symptoms. A study conducted among Estonian athletes found that, on average, they are sidelined from training for 2 weeks due to COVID-19. In cases of mild illness, I think that’s sufficient. Of course, you should monitor how you’re feeling. If symptoms persist during training or new symptoms arise, you should definitely see a doctor. Many athletes are used to monitoring their heart rate during workouts—it’s helpful to continue doing so and adjust your training intensity based on your heart rate and how you feel."
A Coach’s Perspective
Renowned coach and athlete Ott Kiivikas cautions, just to be safe, that he is by no means an expert on post-COVID recovery and cannot say when someone can be considered healthy enough to resume training. Drawing on his personal experience as a coach and as someone who has had the illness, he says:
"First of all, it definitely depends on how severe the lung damage a person has sustained is, and there’s no one-size-fits-all standard here. No matter what kind of lung damage you have, you always start with just movement—like walking—because even a small amount of exertion is tiring. I know this from my own experience. As fitness improves, the proportion of aerobic exercise increases right from the start, but this happens week by week. Of course, strength training isn’t prohibited or ruled out, but in that case, the intensity should be at least 50% lower than it was at the start of the training break. You should definitely monitor your heart rate and how you feel; these two factors will help you find the right level of exertion."
More Specific Recommendations for Returning to Training
The topic of returning to training has been widely studied, and for those seeking more specific advice, we’ve found recommendations from around the world that are specifically geared toward competitive athletes, and thus unquestionably for returning to a level of physical exertion significantly greater than average:
| Phase 1 |
| Diagnosis, Illness, and Recovery Duration: At least 10 days from a positive test or the onset of symptoms. A healthcare provider must give permission to return to training. Symptoms must have resolved, with the exception of loss of smell and taste. |
| Phase 2 |
| Light exercise Duration: At least two days Walking, light jogging, stationary bike—no endurance training. < 70% of maximum heart rate. Exercise duration: < 15 minutes. |
| Phase 3 |
| Light to moderate exercise Duration: At least one day Exercise types: running drills, bodyweight resistance exercises, circuit training. <80% of maximum heart rate. Exercise duration: <30 minutes. |
| Phase 4 |
| Moderate training Duration: At least one day More challenging training: sport-specific exercises, running, strength training. <80% of maximum heart rate. Training duration: <45 minutes. |
| Phase 5 |
| Moderate to intense training Duration: At least two days Regular sports activities: non-contact activities, sport-specific exercises, running. <80% of maximum heart rate. Training duration: <60 minutes |
| Phase 6 |
| Continue your regular training Duration: At least one day Before returning to competition-level training, do at least one day of regular training |
| Phase 7 |
| You may resume competition and training without restrictions. |
We’ve heard that some people have a harder time with it, while others get through it more easily. My former colleague Evelin, who had COVID-19 in March 2021 and is a big fan of CrossFit workouts—which, as we know, are exceptionally physically demanding— had a milder case and summed up her COVID-19 experience and return to training as follows: “At first, I might have gotten tired a little faster, but otherwise I was okay and got my strength back quickly.”
Regardless of whether the illness was mild or severe, the Cleveland Clinic’s website recommends that even if you’re athletic and used to intense workouts, and your symptoms are mild or practically nonexistent, that you should still take a 10-day break from training after receiving a diagnosis. The main reason is that the illness is insidious and increases the risk of developing myocarditis.
Recommendations
My niece Diana also found her own solutions for working out; she describes the workout routines she chose as follows: “To start, I did the first half of the Netfit Verve 01 program for breathing exercises. The tai chi and yoga exercises familiar from BodyBalance are also suitable, as are gentle stretches at the end, such as those in Yin yoga. For me, this made life more bearable.”
From the workouts in the FitQ program, we recommend looking for categories such as “body and mind” workouts if you feel you’re ready to exercise. If you’re not quite ready yet but would like to try, start with the meditation and movement categories—and be sure not to push past your comfort zone at the very beginning.
Wishing everyone a good recovery!
Read more:
Family Doctor’s Guide to Recovering from COVID-19
The Cleveland Clinic’s guide to returning to exercise
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