How To Safely Get Back In The Game

Unfortunately, despite the increasing availability of the vaccine, many people are still getting the coronavirus (COVID-19). While running and being fit can potentially help prevent complications and respiratory symptoms severe enough to land you in the hospital, running isn’t in and of itself a guaranteed shield from getting COVID-19.

Even if you take good care of yourself, run regularly, eat well, have been fully vaccinated, and are in relatively good health, you still might get COVID-19 and find yourself quarantining, recuperating, and then trying to navigate how to return to running after COVID.

If you have been affected by Covid, we are here to help you navigate your return to running after COVID. We spoke to two physicians about how to safely do so.

In this guide, we will cover:

  • When Can I Start Running After COVID?
  • Do I Need to See a Doctor Before Returning to Running After COVID?
  • How Do Runners Know When It’s Ok to Resume Running After COVID?
  • What Should Runners Expect When Running After COVID?
  • Can Runners Cause Any Damage If They Return to Running After COVID Too Soon?
  • Takeaway Advice for Runners With COVID

Let’s get started!

According to the World Health Institute (WHO) Coronavirus (COVID-19) Dashboard, as of April 8, 2022there have been nearly 495 million confirmed cases of COVID-19 worldwide, including well over 6 million deaths reported to WHO. Europe alone has suffered nearly 207 million confirmed cases and the Americas aren’t far behind with roughly 151 million.

Running After COVID

Like any illness, running after covid is typically not as smooth as we’d like it to be. Getting back to running after COVID-19, especially in terms of returning to previous training levels, can take some time.

Moreover, there are no hard-and-fast rules or answers as to how long it will take to feel back to normal with your running after Covid.

This is primarily because recovery is highly individualized and dependent on numerous factors, such as how long you were sick, the specific symptoms you experienced, the severity of your symptoms, your fitness level before you got COVID, and your overall health status.

Because COVID tends to cause at least some degree of respiratory symptoms, such as coughing, congestion, and shortness of breath, returning to running after COVID can be even more difficult than running after some other illnesses.

Even medical experts and exercise physiologists are still learning the effects of COVID on runners and athletes and are working on guidelines for returning to exercise after COVID.

A woman leaning up against a wall coughing.

For example, the American College of Cardiology’s Sports and Exercise Cardiology Section created a consensus document with return-to-play recommendations, which was updated in October 2020.

Therefore, it’s important to bear in mind that recommendations for runners may change.

When Can I Start Running After COVID?

One of the primary questions runners with COVID have is, “When can I start running after COVID?”

Dr. Michele C. Reed, DO, FAAFP, CPT, the Owner and Medical Director of MS Family Medicine Health Care, stresses how Resuming running after COVID-19 is highly individualized.

“Some runners can resume exercise after a week or so after they were first diagnosed with COVID-19, and others, it will take weeks to months,” says Dr. Reed.

“It is key to remember that COVID-19 can affect every organ system and this is a time to really think about your body and how you are feeling. If there is any level of discomfort, please follow up with your physician,” she adds.

A person walking on a fall day.

Dr. Richard H. Smith MD, FACC, a clinical cardiologist at Mount Sinai Doctors/Long Island Heart Associates, says The longer and sicker you’ve been, the more gradually you should begin to resume exercise.

“It is best to hold off until all symptoms have resolved, and this will take five to ten days for most individuals, depending on the severity of the illness,” he advises. An exception is loss of smell or taste. If this is your only symptom, it is reasonable to resume exercise again after about five to ten days.”

He says that for runners who were truly asymptomatic with COVID, taking three days off of running is a good rule of thumb to ensure that symptoms do not develop over this time period.

Do I Need to See a Doctor Before Returning to Running After COVID?

Dr. Smith says this is highly dependent on the symptoms you had, the severity of those symptoms, and your overall health status.

A woman holding her chest, coughing.

“The main concern is in patients who have cardiopulmonary symptoms during COVID: defined as symptoms associated with shortness of breath at rest or on exertion, chest pain or chest tightness, palpitations and dizziness, lightheadedness or fainting,” he explains.

“These individuals are at highest risk for an infection or inflammation of the heart muscle known as myocarditis, or they could have other forms of heart disease, such as vascular involvement aggravated by the recent COVID infection.”

Dr. Smith says that runners with these types of symptoms should have a cardiac evaluation including an ECG, echocardiogram, and blood test for cardiac damage (cardiac troponin assay) before returning to running or other workouts.

Any abnormalities from these studies may suggest the need for additional testing such as a cardiac MRI, which is important to ensure there is no serious damage that may get exacerbated by exertion from running.

On the other hand, Dr. Smith says not every runner will need to see their physician before returning to running.

A doctor checks a patient's heart for effects from Covid.

According to Dr. Smith, “Individuals who have had COVID and no symptoms or non-cardiopulmonary symptoms such as fever, chills, muscle aches, fatigue, upper respiratory symptoms, GI symptoms such as changes in bowel movements, loss of smell or taste, or headache, do not require cardiac testing before returning to running.”

How Do Runners Know When It’s Ok to Resume Running After COVID?

According to Dr. Reed, “It is ok to start back running if you no longer have any severe fatigue, shortness of breath, increased heart rate, or palpitations. It is recommended that you start slowly and start with a walking routine before full-on running.”

What Should Runners Expect When Running After COVID?

As with returning from any illness or injury, the key to returning to running after COVID is to take things slow and listen to your body. Your fitness might also be well below what you’d expect, even if you didn’t take that many days off.

In other words, The dip in performance may be disproportionate relative to the duration of your illness.

A person experiencing chest pain from covid, a sign that running after covid will need to be done gradually.

“Runners should listen to their bodies, especially if during COVID-19, they had any chest pain, palpitations, shortness of breath, or dizziness,” advises Dr. Reed. “Depending on the severity of their symptoms, they may have become deconditioned or out of shape.”

“Runners can expect slight to major symptoms of fatigue or change in their endurance as resting heart rates may be higher post-COVID-19,” cautions Dr. Reed, who recommends a gradual return to running.

Dr. Smith says that palpitations, shortness of breath with exertion, and an increase in resting heart rate are common after returning to running after COVID.

Dr. Reed says walking is often a good place to start. “Ten to fifteen minutes of walking might be all you can do initially and that is fine and it is important to gradually pace yourself. If at any point you have difficulty breathing or [have] wheezing or chest discomfort, please stop exercising,” she advises.

A person sitting on a couch checking his temperature and sneezing.

Can Runners Cause Any Damage If They Return to Running After COVID Too Soon?

Runners who have had cardiopulmonary symptoms with COVID should not exercise while they have any symptoms because there is an increased risk of cardiac events, including dangerous heart rhythms, vascular complications, and heart damage.

“Individuals who return to running after COVID should do so responsibly,” cautions Dr. Smith. “This means having concern for others if running in a group or a race.”

“First, wait until symptoms have completely resolved. Participate only in socially distanced outdoor training until [you have a] negative COVID test or ten days have passed since the initial infection,” asserts Dr. Smith. “This is true for vaccinated or unvaccinated individuals.”

A person walking on the beach.

Takeaway Advice for Runners With COVID

Both Dr. Read and Dr. Smith are runners, and both have had COVID. As such, they speak from experience.

“As runners, we are used to pushing ourselves but post COVID-19, it is imperative to listen to your body and respect it,” says Dr. Reed. “Just as the body needs recovery and rest, it is important not to do more than the body can tolerate.”

In other words, be patient. Listen to your body, readjust your goals, and seek medical care if anything seems off when you try to start running.

If you need to take a gradual step back into running, you can take a look at our article on Jeff Galloway’s walk/run method here, or a plan to walk a marathon here.

We also have some low impact cardio workouts that you can adjust to your needs if you are not quite ready to get back to pounding the pavement just yet:

Low-Impact Cardio Workouts

A close-up of a person tying their shoe.

Amber Sayer

Amber Sayer is a Fitness, Nutrition, and Wellness Writer and Editor, and contributes to several fitness, health, and running websites and publications. She holds two Masters Degrees—one in Exercise Science and one in Prosthetics and Orthotics. As a Certified Personal Trainer and running coach for 12 years, Amber enjoys staying active and helping others do so as well. In her free time, she likes running, cycling, cooking, and tackling any type of puzzle.

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