A mild bout of COVID-19 can have a big impact on physical fitness. I found my rhythm again.

image of african-american woman kneeling on yoga mat
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January is a month when many people cut back on sugar and alcohol after the holidays and try to get in shape for the new year.

I was excited to reignite my motivational fire this year, but it happened when I got the positive COVID-19 test results for myself and my family.

Everyone was protected and only mild symptoms occurred during our isolation.

It was frustrating that I was not able to exercise because of my COVID-19 diagnosis, as I have been unable to do so for the last 2 years due to the Pandemic.

The virus has had a noticeable impact on my ability to exert myself, since I returned to a regular exercise regimen. I can feel my cardiovascular system has been affected even when I am not awake.

I gained a deeper understanding of how the SARS-CoV-2 virus affects multiple systems of the body, the implications this has for exercise capacity, and the therapeutic benefit gentle exercise can provide during recovery by diving into the post-COVID-19 exercise research.

I began to reexamine my priorities after having those insights.

My goal was not to push toward new levels of power and strength. I worked to establish a new baseline with patience and compassion and ease my way back into exercise, being aware of my post-COVID-19 limitations.

I think it is important to give context and perspective to my experience as it relates to everyone else who has been given this diagnosis within the last 2 years.

I am fortunate to have had a few minor symptoms, compared to millions of people who have lost their lives or are still suffering from the health crisis.

My initial COVID-19 symptoms were a deep and unrelenting headache and a raspiness in my throat.

I had a lot of trouble staying asleep at night and often lay in bed listening to the rhythmic pulse of my blood through my veins. During the day I felt weak and shaky and was troubled by the rapid speed of my heart.

I had a constant feeling of being in a hurry in my chest, which was accompanied by anxiety and a bit of depression.

I was looking for information on how the SARS-CoV-2 virus affected the systems that were most important to the adaptation of exercise.

The immune system

Some of the initial symptoms a person will experience when they develop COVID-19, as well as those involved in long COVID, are the result of the immune system’s inflammatory response to the pathogen rather than the pathogen itself (1, 2).

When the immune system feels like it’s being invaded, there is an initial release of inflammatory cytokines, which are immune cells that affect other cells of the body. This is a productive and important reaction when the body is mounting a defensive response to a virus (1, 3).

However, this inflammatory response brings with it several symptoms — headaches, muscle and joint pain, and brain fog, to name a few. Long COVID is thought to be a perpetuation of the inflammation of the immune system and other areas of the body to a chronic degree (4).

The cardiovascular system

The cardiovascular system, unsurprisingly, takes quite a hit from COVID-19, in both symptomatic and asymptomatic individuals (2).

This presents as a reduction in the body’s ability to efficiently take in oxygen, transport oxygen to tissues and muscles, and effectively use oxygen as an immediate source of energy (5).

Because COVID-19 makes it harder for the body to absorb oxygen efficiently, the brain signals the lungs to take in more oxygen, leading to an increase in the number of breaths taken in a minute and a feeling of breathlessness — especially with exertion (2).

The compromised cardiovascular system decreases the body’s ability to immediately generate energy for activities like aerobic exercise.

The nervous system

Because COVID-19 can create inefficiencies in oxygenating the body, the central nervous system — the brain, spinal cord, and all tissues that comprise them — may be negatively impacted (6).

When the brain doesn’t receive enough oxygen, there is a trickle-down effect on other organs that it directs. Symptoms can include body temperature changes, altered cardiac function and rhythm, blood pressure abnormalities, and changes to gastrointestinal functioning (7).

The inflammatory response to COVID-19 can cause an interruption in signaling between brain cells and lead to brain cell death (6).

Research on COVID-19 has concluded not only that symptoms are related to a decrease in oxygen to the brain but also that regions of the brain itself can contract the SARS-CoV-2 virus as a result of the virus’s affinity for attacking nerve tissue (8).

This would explain symptoms such as anxiety, depression, short- and long-term memory loss, difficulty with thinking, and sleep disturbances (9).

The research on long COVID was alarm to me.

How had we lived through 2 years of hiding, masking, hand washing, and vaccinations only to find ourselves not just sick but also with a chance of being changed, inflammation, and compromised forever?

The exerciselogist in me wondered how exercise could help. I have always believed that exercise is medicine.

I shifted my view on my physical condition. I looked at all I had to gain instead of focusing on what I had lost.

To begin again is to recognize that regular exercise enhances immune function; decreases inflammation; and improves blood flow to the heart, the lungs, and the rest of the tissues of the body, thereby enhancing brain function (10).

I began exercising again after the acute infection had passed, but some of my symptoms lingered after the infection had passed. I focused on what I did and here is how I did it.

My first piece of advice for anyone beginning to exercise again after having COVID-19 is to assess and monitor your current baseline.

You will have a starting point to grow from if you use tools and techniques to monitor your resting and working heart rate and to tune in to your level of effort.

You can measure your heart rate and effort level with two different methods.

Monitor your heart rate

It’s important to first identify your resting heart rate. This might have changed since your COVID-19 diagnosis, and it’s important to know where you’re starting from.

There are a number of ways to measure your heart rate by checking your pulse. Or, if you’re like me and would rather have a device giving you feedback, a heart rate monitor is a wonderful tool for regular exercise.

Monitor your rate of perceived exertion

Rate of perceived exertion is a numbered scale that helps the exerciser subjectively determine how hard they are working.

This is a way of knowing how much you are working out. It is a great way of understanding your physical determination and strengthens your mind-body connection.

When it comes to exercise, start with walking. Given what we know about the benefits of walking, it’s a simple way to gently oxygenate your body and gain some energy and aerobic conditioning.

Low intensity walking will stimulate dilation of the capillaries — the smallest blood vessels of the cardiovascular system — enhancing oxygen transfer between blood and tissues and throughout the muscles and various organs of the body (11).

Moderate your pace to your liking. Try to not be driven by the need to make up for lost workouts. 30 minutes of walking a day for 3–5 days a week.

Don’t overexert yourself, because your body is still enduring some amount of inflammation. Your immune system could become overtaxed by too much intensity right away (12).

After a couple of weeks of walking, you can begin to exercise at an aerobic heart rate. Be sure to warm up at an easy level for 3–5 minutes, and then increase your intensity so your heart rate is at the lower end of the aerobic level for your age range.

Core exercises, yoga, and Pilates are all great options for waking up your stabilizing muscles, regaining your range of motion, and getting your body moving again.

If you have lost some endurance in your core muscles because of a decrease in activity, you should breathe through your reps and use all your mental energy to make your movement strong, stable, and intentional.

You can spend 20–30 minutes moving — being mindful of staying at a very doable level of work — and then cool down at an easy intensity for a few minutes. Try this 3–5 days a week, and make sure you’re not experiencing any symptoms of overtraining.

You should start to see a change after a month of monitoring your heart rate.

Your resting and working heart rates should go down with the same level of work you are doing. The rate of perceived exertion should decrease as a result.

These are some of the signs that your body is adapting to cardiovascular training. Rest and recovery are very important components of your exercise progress.

Even after you recover from COVID-19, you may experience symptoms of deficiency.

The use of tools and techniques to determine your baseline is essential to your recovery and to your return to exercise.

If you want to start your exercise journey on the right foot, you need to be aware of your current baselines and start with simple aerobic workouts that scale up in intensity over time.

“A personal trainer and a professional dancer, Rose began her career in New York. After receiving a master’s in exercise physiology from Columbia University,Alexandra worked in clinical exercise settings, commercial gyms, and with pre-professional dancers. A certified personal trainer and a Fascial stretch therapist, she works with clients of all athletic endeavors to help restore healthy movement patterns, improve strength and performance, and prevent overuse injuries.”