PEOPLE with Covid or long Covid may make their condition worse by returning to exercise too quickly. Different research has shown that exercising to the point of breathlessness can slow down your recovery.

A new study of 500 long Covid patients by a leading British university found that 75 percent of sufferers reported how the physical activity made their symptoms worse. One co-author of the study, Doctor Manaj Sivan, a medical professor at The University of Leeds, concluded that long Covid has an unusual relationship with exercise compared to other conditions.

For many chronic diseases, such as heart disease, asthma, diabetes, and more, exercise can help. In asthma, exercise can limit the number of asthma attacks.

But in Covid, physical activity can risk bringing on excessive breathlessness and even further complications.

Although the current understanding of the disease is limited, the British Medical Journal (BMJ) explained that the first risk is the potential for cardiac injury, including viral myocarditis.

Myocarditis refers to inflammation of the heart caused by Covid. Exercising even more with this condition can lead to severe complications, including death.

The BMJ’s advice after a Covid infection is to “only return to exercise after at least seven days free of symptoms, and begin with at least two weeks of minimal exertion". However, the advice for long Covid is slightly less clear cut.

Based on the results of the Leeds study, Sivan said: “There needs to be careful planning and a structured tailor-made program to become active again.”

Since the start of Covid, scientists have learned more and more about the virus’ effect on the body, and why it causes symptoms like fatigue.

One recent study published in the American Journal of Respiratory and Critical Care Medicine found that the energy-producing structures – the mitochondria – in the body did not function properly in long Covid.

In the study, the researchers monitored long Covid patients as they exercised intensely on a bike.

The patients wore a special mask, and electrodes to monitor their breathing and heart function. Some even worse an arterial line to track oxygen in the blood.

The mitochondria problems were found in the muscle tissue of the participants but researchers also believe that these issues are likely to be the cause of lung and neurological symptoms too.

Some researchers have likened the damage over-exercising does to the body to the effect of chronic fatigue syndrome.

People with chronic fatigue syndrome decrease their physical and mental capacity over time, sometimes even permanently if they increase the amount of exercise they do.

The problems with exercise intolerance don’t only occur in people with severe Covid patients.

Even those who had a “mild” version of the disease can experience these issues, according to a study in the journal Chest.

How to safely reintroduce exercise after long Covid
The World Health Organisation has published a self-management booklet on long Covid. It offers tips about how to return to physical exercise safely.

They recommend returning to exercise in five phases, staying at each phase for as little as a week before moving to the next.

The phases of returning back to exercise:

Preparation for return to exercise - gentle walking, balance exercises, controlled breathing
Low-intensity activity - walking, light household/gardening tasks
Moderate intensity activity - brisk walking, going up and down stairs, jogging
Moderate-intensity exercise with coordination and functional skills - running, cycling, swimming, dance classes
Return to your baseline exercises - regular exercise

However, the leaflet warns that if you experience any “red flag” symptoms such as chest pain or dizziness, you should stop immediately and not restart your exercise programme until you have been seen by a health care professional.

“No exercise should be painful. If you experience pain, chest pain, or feel faint or dizzy during exercise, you should stop immediately and not restart your exercise programme until you have been seen by a health care professional. “

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