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Safely Returning to Exercise Post-COVID-19 Illness

The world of exercise and fitness was struck hard by the COVID-19 pandemic, taking access to gyms and fitness centers away for a period of time. With these facilities returning to their open availability, many individuals who personally experienced having COVID-19 have been posed with the question of when is it safe and okay for them to return to exercising again. Factors to consider include, of course, not wanting to spread the virus. But from a medical perspective, when is the body ready to safely return to exercising?

Internally, the immune system has just been through warfare depending on the strain and severity of the contracted virus, so the first consideration is feeling confident that symptoms have been eradicated during normal daily living activities, before venturing on to performing more strenuous or even mild/moderate forms of physical activity. COVID-19 affects the lungs (respiratory system), causing severe inflammation. Normal functioning of taking in oxygen and releasing carbon dioxide becomes impaired when the virus impedes by increasing fluid in the lungs and inflammation. Therefore, breathing becomes the common exercise inhibitor when first getting back into movement patterns. In fact, the CDC estimates that 3-17% of COVID-19 patients develop a complication known as Acute Respiratory Distress Syndrome (ARDS). A simple test for readiness is trying to walk quickly for 500 meters without feeling breathless or fatigue. From this self-assessment, endurance and intensity can progressively improve.

Returning to strength training can be challenging when considering cardiac output and fatigue depending upon resistance training goals and modalities. Therefore, it is best to work in the endurance phase for 2-4 weeks prior to strength or power training. This will help prepare the body for more intense training as well as let the body adjust to feelings of fatigue and breathlessness that might occur. A negative COVID test does not equate to the body returning to its normal workload capacity right away. Patience is key and although this can be a frustrating feat for athletes and avid gym-goers alike — movement is medicine but overtraining in sub-optimal conditions only prolongs the perceived setback.

There is no exact timeline upon returning to exercise post-COVID, but one way fitness professionals and individuals can gradually and safely do so is to utilize the “Rate of Perceived Exertion” to modify and accommodate for any potential risks. An example of this is the Borg Rating of Perceived Exertion (RPE), using a scale of 6-20 with 6 being no exertion and 20 being maximal exertion. Realistically working between 6 and 11 to start and pacing oneself to 12-15 and above is a good road map. Wearing a heart rate monitor can also be helpful with the understanding that if you are working at a higher level than what your lungs currently want to or can even do, taking resting breaks before returning the exercise is recommended. Exercising over time will help repair the body’s systems to again function as efficiently as before.

Megan Johnson McCullough is the owner of Every BODY’s Fit in Oceanside CA. She is a NASM Master trainer, holds an MA in Physical Education & Health Science, and is a current candidate for her Doctorate in Health and Human Performance. Megan also holds specializations in Corrective Exercise, Senior Fitness, Fitness Nutrition, Drug and Alcohol Recovery, and is an AFAA Group Exercise Instructor. She’s also a fitness model, professional natural bodybuilder, and published author.



  • Salman, D., Vishnubala, D., Le Feuvre, P., Beaney, T., Korgaonkar, J., Majeed. A. et al. (2021). Returning to physical activity after covid-19. BMJ, 372:m4721. doi:10.1136/bmj.m4721
  • Yale School of Medicine (2021). Challenge 5: How does covid-19 affect the respiratory system? https://medicine.yale.edu/coved/modules/virus/respiratory/


Knee joint anatomy, 3D model

Musculoskeletal System & Healthy Functioning: Parts that Make Up the Whole

Orthopedics 101: What makes up our musculoskeletal system? In order for our body to move, the joints, ligaments, and tendons must work together. If a person has a disease, injury, or condition, affecting any one of these parts, nerve signals are interrupted and movement is hindered.

When you think of joints, think of two parts of the skeleton being fit together. The bones are connected by joints. Joints are also called articulations. Here’s the lineup….

  1. Bones are lined with cartilage so they don’t grind against each other; it is the covering at the end of the bone.
  2. Bones are joined to bones by ligaments, so where two bones meet that is a joint; ligaments are important for stability.
  3. Muscles are connected to bones by tendons.

Technically, muscles are not part of the joint, but stronger muscles help protect the joints.

You know that cracking sound we sometimes hear with movement?? When you flex or contract a muscle which takes place at the joint, the ligament stretches with that joint. When you straighten out that joint, the ligament helps to pull the joint back to its normal starting position. This means that ligaments are a major part of movement, but over time, they start to lose their elasticity. This loss of stretch makes the joint make that cracking noise from bone on bone.

Tendons are important for our range of motion with movement. They’re found in smaller joints like fingers and wrists. We use tendons a lot, especially at the wrist. A tendon’s job is to make sure you can bend your wrist, but not too far.

After years of constant use, our joints can develop arthritis. This occurs especially in the knee, hip, and shoulder areas. The knee joint has three parts, the hip has two, and the shoulder has the one that seems to be commonly injured.

Tendons and ligaments do wear out. They do not grow or repair themselves. A baseball pitcher who has repetitively used their arm and shoulder to throw the ball as hard as they can over and over again will, after a number of years, most likely experience damage to the rotator cuff. Then it’s surgery.

Long story short, our body sure does do a lot for us to produce movement. As I type and while you read, movement is occurring even in the eyes. We have to appreciate what we have and if we don’t use it, we lose it before that expiration date comes our way.

Your fitness journey is a lifelong commitment to your health, so exercise wisely, fuel your body right, and MOVE!!!!

Megan Johnson McCullough, owner of Every BODY’s Fit in Oceanside CA, is a NASM Master Trainer, AFAA group exercise instructor, and specializes in Fitness Nutrition, Weight Management, Senior Fitness, Corrective Exercise, and Drug and Alcohol Recovery. She’s also a Wellness Coach, holds an M.A. Physical Education & Health, and is a current doctoral candidate in Health and Human Performance. She is a professional natural bodybuilder, fitness model, and published author.