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Can (And Should) You Exercise With COVID-19?

Dr. Scott Cheatham 0

COVID-19 has spread worldwide, causing the fifth documented pandemic in history since the 1918 flu pandemic (Liu et al., 2020). The pandemic has had a significant impact on the world, resulting in humans having to isolate themselves to prevent community transmission of the virus. This has changed how individuals exercise during these challenging times.

 

In this blog, we will answer some common queries using the latest research evidence. And if you are interested in exploring this subject even more, see the free NASM course on COVID management!

 

Can you exercise with COVID?


The CDC and healthcare professionals recommend that individuals diagnosed with COVID-19 to refrain from physical activity for the approximate 10-14 day period (CDC, 2021). This is due to the highly contagious nature of the virus and how the virus can affect different individuals. Some individuals may have no symptoms, and some may have severe symptoms.

 

Currently, there is no research on how individuals with COVID-19 will respond to exercise, which has prompted researchers and experts to be cautious and recommend isolation and rest during the approximately two-week period of the COVID-19 virus (CDC, 2021).

Fitness professionals should recommend that their clients rest during the viral period and consult with a qualified medical provider regarding exercise. Best practices (currently) include following COVID-19 guidelines and working with the client’s medical provider to ensure their safety. Due to the many unknowns of COVID-19, a conservative approach is optimal until more information is known about the effects of exercise on this disease.

Does exercise reduce the effects of COVID-19?

 

The short answer is yes! Sedentary individuals may suffer more long-term COVID-19 complications than active individuals. Researchers from the United States recently published a large-scale study of 48,400 adults with COVID-19. The researchers found that inactive individuals (less than 10 min per week of exercise) had a greater risk of hospitalization, admission to the intensive care unit, and death due to COVID-19.

More active individuals (Up to 150+ minutes of exercise per week) had more minor risk factors (Sallis et al., 2021). Researchers from Brazil also found similar positive outcomes among active individuals (150 min a week of moderate-intensity, or 75 min a week of vigorous-intensity physical activity), having a 34.3% reduction in hospitalizations compared to sedentary individuals (de Souza et al., 2021).

 

Should you work out while sick (in general)?

 

Researchers have documented that short-bouts (e.g., up to 45 min) of moderate level exercise may improve immune function and be beneficial for individuals with viral infections (e.g., Influenza)(Simpson et al., 2020). The severity of symptoms and days of illness might be reduced by exercises (Grande et al., 2020). However, the research is promising; however, experts still caution sick individuals not to expose others to the illness (e.g., exercising in the gym) or overtrain themselves through prolonged intense exercise, which may cause immunosuppression (Martin et al., 2009). Regarding COVID-19, no research has examined the immune response of moderate level exercise for infected individuals.

This supports the current CDC guidelines that individuals with COVID-19 should refrain from exercise due to the many unknowns about the disease. Sometimes, rest can be the best medicine! Best practices for fitness professionals include advising clients with infections to refrain from exercise if they are experiencing symptoms such as fever (Dick & Diehl, 2014). Also, clients can consult their medical provider since different viral and bacterial illnesses can have other effects on the body.

 

What are the COVID-19 long-term complications and the risk for Myocarditis among athletes and fitness enthusiasts?

 

The fitness professional should consider that researchers have documented that 80% of individuals hospitalized with COVID-19 experienced at least one lingering symptom six months after recovering (Lopez-Leon et al., 2021). The five most common long-term symptoms include fatigue (58%), headache (44%), attention disorder (e.g., COVID-19 fog) (27%), hair loss (25%), and shortness of breath (24%) (Lopez-Leon et al., 2021). Other common long-term symptoms may include but are not limited to cough, chest pain, intermittent fever, musculoskeletal pain, and heart palpitations (CDC, 2021).

Individuals with long-term complications are often classified as “long haulers” due to lingering issues (Baig, 2020). One emerging complication is heart conditions, including Myocarditis (inflammation of the heart muscle). Researchers have documented that 10-30% of hospitalized individuals with COVID-19 have suffered from some type of heart condition, including Myocarditis (Mitrani et al., 2020). For athletes and fitness enthusiasts, Myocarditis has become a growing concern among experts. Myocarditis is the leading cause of sudden death among competitive athletes (Daniels et al., 2021).

Recent studies have documented an increase in Myocarditis among competitive athletes who had COVID-19 (Martinez et al., 2021). The fitness professional should consider that this condition can also occur in active post-COVID-19 clients who participate in vigorous exercise.

 

Best practices for fitness professionals include having the client working with their healthcare provider and possibly undergo a cardiac return to activity screen before participation in a vigorous exercise program (Starekova et al., 2021). Cardiac screening has proven to be an excellent method of detecting Myocarditis or any other cardiac risk factors for athletes and active individuals returning to exercise after having COVID-19 ((Martinez et al., 2021; McKinney et al., 2020).

 

What are the recommended COVID-19 safety guidelines for client management and general facility hygiene?

 

The fitness industry has experienced sweeping changes since the onset of COVID-19. Different states have allowed fitness facilities to return to partial indoor occupancy along with continued outdoor exercise. All fitness professionals should consider following the latest CDC, state, and local COVID-19 regulations as they apply to their professional practice. Best practices also include following standard person-to-person COVID-19 precautions when training clients (Table #1).

 

These preventive measures should still be considered until updated guidelines are in place that changes such person-to-person interactions. 

 

Recommendations for person-to-person

COVID-19 precautions

  • Wear face coverings
  • Social distancing
  • Virtual symptom check
  • Contactless temperature check

 

During a typical day within any fitness facility, different individuals may touch the same surfaces and equipment, increasing the risk of COVID-19 transmission. Researchers have found that the coronavirus can last for up to 9 days on inanimate surfaces (Wiktorczyk-Kapischke et al., 2021).

 

Exercise equipment surfaces such as but not limited to handles on machines or cardiovascular equipment, touch screens, free weights (e.g., dumbbells, kettlebells, etc.), or machines' weight stack pins can be a potential transmission risk due to repeated contact among individuals. Portable equipment that can be a transmission risk may include but is not limited to physio balls, foam rollers, and latex tubing or bands (CDC, 2021).

 

Read also: How to Clean Your Gym


The CDC and EPA recommend using an approved low-level chemical disinfectant or preferably an intermediate-level disinfectant (Veiga-Malta, 2016). Common intermediate-level disinfectants include 70% isopropyl alcohol, Lysol® brand disinfectant products, and Clorox® brand disinfectant products.

 

Bleach can also be used to clean (e.g., five tablespoons or 1/3 cup bleach to 1 gallon of water) but can be corrosive to some surfaces (Veiga-Malta, 2016). Best practices in client management and facility hygiene will provide the safest environment for all clients.

 

Conclusion

These are common questions that fitness professionals and clients may ask regarding exercise and COVID-19. The fitness professional should make it a point to stay current with CDC and local government COVID-19 guidelines and research on this topic. Ensuring a safe environment and exercise program for both the client and fitness professional should focus on all fitness programming.

Fitness professionals are encouraged to see the new NASM COVID-19 Fitness Management course, which provides more comprehensive coverage of this topic.

The Author

Dr. Scott Cheatham

Dr. Scott Cheatham has a PhD in Physical Therapy and is an Associate Professor in the Division of Kinesiology at California State University Dominguez Hills in Carson, California. He is owner of Sports Medicine Alliance (SMA). He also holds several fitness certifications and is a certified ergonomic specialist. He has also authored 100+ publications on a wide range of subjects including: health, fitness, orthopedics, and sports medicine. Additionally, Dr. Scott Cheatham is a NASM Corrective Exercise Specialist and Performance Enhancement Specialist.