How athletes with long COVID adapt their exercise routine

The central theses

  • Exercise can worsen symptoms such as fatigue and drowsiness in long-term COVID patients.
  • A recent study found that long-term COVID patients carry a SARS-CoV-2 S1 protein in cells that are mobilized through exercise, leading the body to believe that it has been exercising more than usual.
  • Former athletes with long-term COVID are learning to slow down and move themselves to deal with their condition.

Jess Scolieri, 37, reinvents herself in the fight against COVID.

As a former weightlifter, boxer, CrossFit enthusiast, and world traveler, Scolieri’s athletic prowess plummeted after contracting COVID-19 in March 2020.

“My old mentality of lifting a heavy weight and simply pushing through the pain no longer applies,” says Scolieri. “You have to assess yourself. Because if you try to assert yourself, you really end up going backwards. ”

Scolieri is one of many longstanding COVID patients who experience an increase in symptoms after exercising. Some researchers have found a link between exercise intolerance and a specific SARS-CoV-2 S1 protein in long-term COVID patients, while others have found that exercise can reduce long-term COVID fatigue.

Right now, some athletes with long-term COVID are slowly working to get back on their feet while watching their energy levels at the same time.

Scolieri caught the virus while working as a podiatrist in the UK and flew to Darwin, Australia a few months later when her symptoms did not go away.

“I was at a point in May where I had had enough,” says Scolieri. “I lived there alone and decided to come home because I thought I couldn’t make it.”

In the months that followed, she developed worsening symptoms – most of which were neurological while others involved her heart. Back in Australia, Scolieri continued to monitor her diet and exercise to avoid relapses. Your flare-up symptoms are similar to those associated with Postural Orthostatic Tachycardia Syndrome (POTS), such as drowsiness and palpitations.

She now incorporates small amounts of exercise, like 10 minutes of stationary cycling or rowing, into her routines. These exercises are easier on her spine than walking or running, she says.

To avoid the effects, she only exercises three days before resting for two days, even if she feels fresh.

“[It] is really frustrating because I just want to go and do things, ”she says.

A recent study showed that exercise intolerance is common in long-term COVID patients. It is largely a consequence of the SARS-CoV-2 S1 protein found in endothelial cells that are mobilized through exercise.

Bruce Patterson, MD, a pathologist and virologist who led the study, tells Verywell that when these cells are mobilized, they can infiltrate a person’s blood-brain barrier and cause vascular inflammation in the brain.

Patterson does not recommend exercising early in a patient’s recovery. Some clinics are promoting exercise therapy for long-term COVID patients that “couldn’t be worse for these people,” he adds.

“Patients should return to exercise, but only when they are ready, after treatment and tests to show that their cytokine levels have returned to normal,” says Patterson. “Otherwise movement is likely [to] more harm than good. ”

There are currently no active cases of COVID-19 in Scolieri’s hometown. This is a blessing as it has a lower risk of reinfection, but it also means that there are limited options for long-term COVID treatment. With no clinic nearby, Scolieri relies on trial-and-error methods to protect her health.

“It’s like plugging your finger into an electrical outlet,” she says. “If you stick your finger in too often, you start learning.”

Cesar Velasco, who has also been dealing with long-term COVID since last March, has started adding low-intensity workouts to his weekly routines.

Before the pandemic, Velasco practiced martial arts and fighting. Now he’s trying to do a few minutes of physical exercise, like pushups (he can now do eight), hitting, and kicking every few days. This steals a lot of his energy and usually gets him to bed for a few days, he says, but the effects are well worth doing what he loves.

“At least I could do something again to help my mind remember that I did it before, and I don’t want to stop,” Velasco tells Verywell. “It is also part of my confidence building. In a way, I still know that there is hope to get better. ”

Peter Staats, MD, Survivor Corps medical advisor and president of the World Institute of Pain, says the messages around exercise and long-term COVID are mixed. He recommends that people who experience extreme fatigue speak to their doctor about their symptoms first to better understand why they feel this way and how exercise affects their recovery.

Overall, Staats says the available data does not suggest that physical activity will significantly worsen long-term long-term risk of COVID. People who want to exercise should start slowly, taking breaks to reevaluate their recovery, and if one method doesn’t work, try another, he says.

“If you did an hour of exercise before COVID, do 10 minutes and then work your way up to 15 minutes the next day and slowly regain your strength,” Staats told Verywell. “That’s the best I can tell people at this point.”

For people like Scolieri, regaining strength doesn’t mean reaching pre-COVID fitness levels. It means leaning against and adapting to your new self. She takes things one day at a time.

“I am really resilient as an individual,” says Scolieri. “I really had to say, ‘Well, you know what, this is old Jess’ and now I have to reinvent this new one and learn again.”

What that means for you

If you are an athlete who has struggled with COVID for a long time, speak to your doctor about how exercise could affect your recovery. Chances are you’ll need to start slowly, take breaks, and set different fitness goals than you did before you became ill.

The information in this article is current as of the date indicated, which means more recent information may be available by the time you read this. For the latest updates on COVID-19, visit our Coronavirus news page.