The four stages of exercise to help get your fitness back after Covid

One of my sons has had a nasty bout of Covid and recovery is slow. He’s eager, however, to get some exercise even if it’s only taking the dog for a short walk.

Even that exhausts him and I imagine there are many people ­recovering from the virus who are in the same boat. So how should they and my son go about getting back to their pre-Covid fitness level?

Well, David Salman and colleagues from Imperial College London, Hull-York Medical School and the Army Medical Service provide useful steers in the BMJ with a safe four-phase return.

We now know that about one in five people recovering from Covid remain unwell for six weeks or more and they can find trying to return to exercise an uphill struggle.

The priority is to start exercising safely – and may mean going more slowly than you’d like, not pushing yourself to achieve old goals and ­stopping if tiredness overwhelms you.

Only think about resuming exercise after at least seven days without ­symptoms, and the first two weeks should be very gentle indeed.

The English and Scottish Institutes of Sport advise not to take up sports before daily tasks are easily achieved and you can walk 500m on the flat without getting tired or breathless. People who have had severe illnesses are prone to heart damage so should have a cardiac check-up before starting to exercise.

Begin gently with household and light garden tasks, gentle walking, and balance or yoga exercises. Add in breathing, stretching, and light strengthening activities. David Salman and colleagues recommend seven days (phase one) of very light activity, including flexibility and breathing exercises.

For the next seven (phase two) ­incorporate light activity like walking and light yoga, with graduated increases of 10-15 minutes per day.

For phase three, try intervals of two five-minute blocks of activity such as brisk walking, going up and down stairs, jogging, swimming, or cycling separated by a block of recovery. Avoid getting out of breath and make sure you are able to hold a ­conversation. Try adding an interval each day.

Phase four exercises promote ­coordination, strength and balance, such as running with changes in ­direction, side-steps, shuffles, and circuits of body weight exercises. Once phase four is over, try normal exercise.

The researchers propose a minimum of seven days for each phase However, people should stay at the phase they feel comfortable with for as long as they want. Keep a diary so you can see your progress.

By Dr Mirriam Stoppard