Returning to Exercise: The Do’s and Don’ts After Illness or Inactivity

For many (or even most) of us, the last few years have been challenging and disruptive for our normal exercise routines. Whether it was due to: (1) recovering from a novel respiratory illness affecting your cardiorespiratory fitness coupled with possible fears or worries around being active again, (2) persistent fatigue or weakness from prior illness or injury, (3) a change in your exercise routine or sports and feeling like you haven’t fully been able to get back on track, or (4) your office commute and lunchtime walks have disappeared now that you work from home. Or maybe you are new to exercise and have been hearing about the benefits of exercise for physical and mental health, on podcasts, in the news, or from your neighbour down the street, but don’t know where or how to start.

The good news is you’re not alone and exercise is for everyone. The other good news is there is no bad news when it comes to exercise; a little is good, a lot is better. Let’s look at the benefits of exercise, the common challenges people face, and solutions to help get you back on track with your activity and exercise goals.

Disclaimer: These recommendations do not replace medical consultation.

A thorough medical history and assessment, including risk factors associated with cardiovascular exercise, is required. When indicated, medical evaluation may be required prior to starting or progressing an exercise program.

What are the Benefits?

In many ways, exercise does it all. The benefits for physical, mental and emotional wellbeing are many. A stronger heart, endorphins to improve mood and a high performing brain are a few of the things your efforts will be rewarded with.
Consistent exercise results in feeling stronger, less fatigued, less headaches, better sleep, and improved mental health.
Exercise is also a key component of brain health. Cardiovascular exercise (where the heart rate is elevated), results in more blood flow to the brain which helps maintain and improve cognitive function (meaning better focus, better concentration, better decision making).
Illness and injuries, such as concussions or Covid 19/ Long Covid, often have fatigue, brain fog and exertion intolerance as primary features. Research strongly supports cardiovascular exercise as a safe and effective way to improve and overcome these bothersome and often debilitating symptoms.

How do I approach exercise?

The long-term goal: The Canadian Physical Activity Guidelines encourages 150 minutes (or 2.5 hours) of moderate to vigorous intensity exercise a week for adults to achieve mental and physical health benefits, which breaks down to 30 minutes of exercise 5 days/ week. Moderate intensity is approximately 60-80% of your maximum heart rate and can also be thought of as 4-7/10 in RPE, or rate of perceived exertion. This means you can use how hard exercise feels to you as a guide.
With Post Concussion or Post Covid/ Long Covid, these recommendations will differ as they include other considerations, including your current symptoms and medical status, and often use specific (and personalized) heart rate targets to guide and progress appropriate exercise levels. (Note: Your work to recovery ratio is often the key to minimize unwanted fatigue).
If you are frustrated with symptoms as you are getting back into exercise and feel like you are guessing at the right approach, our team can help.

Common Challenges + Solutions

After illness or periods of inactivity, many individuals attempt to start back at where they left off and become discouraged when they are unable to do what they could before. It is important to know that they body undergoes changes when your activity level decreases, called deconditioning, which results in decreased strength and cardiovascular fitness (aka you’ll get tired in 10 minutes vs 20 minutes at a lower exercise intensity and feel tired for longer after). Deconditioning starts in as little as 2-3 weeks. So meet your body where it is at and start slow with gradual progressions which promote the right balance between reintegrating exercise and allowing the time for sufficient rest and recovery between training sessions.
Walking is a good place to start for many. Your physiotherapist or medical professional can help you identify specific exercise targets considering your current and past exercise tolerance, medical factors, and your exercise goals. We will teach you what is normal and abnormal with exercise to help reduce any fears associated with activity.
If you aren’t sure where to start, pick a type of movement or activity you enjoy. Enjoyment is a big factor in getting the most out of exercise and helping you build consistency in your routine.
A heart rate monitor can also be a helpful tool to guide your exercise progressions and track your return to fitness. Use that smart watch on your wrist to your advantage!

Exercise and Neuroscience

If your activity level has decreased, you may have noticed that your ability to manage stress has decreased, as well.
In addition to the above benefits, exercise helps train the nervous system. It helps to create a better balance between sympathetic nervous system activity (think fight or flight) and parasympathetic activity (think rest and calm). A balance between the two is needed for optimal response to stress and optimal body/ brain performance.
If you feel you are struggling with stress and fatigue, exercise may be a missing piece to help you get back on track.

Our physiotherapists at ALPHA are here to help you understand how to approach exercise and support you to reach your goals. Whether you are wanting to get back on track after illness, get started, or want to get past the Winter slump… let’s gear up for Spring, build a routine, and keep moving!

– Hilary Johannson, Registered Physiotherapist