Megan Johnson McCullough, Author at MedFitNetwork

Fit PACE: Substance Abuse & Exercise

Megan Johnson McCullough/1 February 2023/ All MFN blog/

Research has shown the positive influence of exercise on alcohol use disorder (AUD) recovery as well as other drug-related substances. However, qualitative research has been missing regarding the influence of exercise on substance abuse disorders. In 2021, I performed a qualitative study involving interview and exercise journal data, which further validated the benefits of exercise during addiction recovery (specifically AUD). Most importantly, the results of the study showed how exercise can persuade the decisional balance a person has when working through the process of recovery. The benefits of exercise (pros) are better than the benefits of drinking (which are now cons). Another important theme participants expressed was that exercise does help recovery, but it should be a tool, not a replacement to other forms of treatment. Therefore, exercise shouldn’t replace strategies such as group meetings (e.g., AA or NA), cognitive behavioral therapy, or medications. Rather, exercise can compliment a comprehensive treatment program as a tool to maintain abstinence from alcohol and other substances, with the ultimate goal of avoiding relapse and reaching termination of the addiction. The intention of my study was to help medical and fitness professions better understand how persons connect exercise performance to their recovery process. This information also leads to better strategic planning programs for recovery, including exercise.

As a result of my research, I have developed the PACE Method to assist persons in recovery who are using exercise as a tool in order to combat not only relapse but also the threat of replacing one addictive behavior with another. One might replace exercise with the aforementioned forms of treatment, and in doing so, replace the psychology/physiology of their addictive habits with exercise performance. Even if exercise is considered “healthy”, in excess, there are consequences to the body. Currently the DSM-5 (Diagnostic and Statistical Manuel of Mental Disorders from the American Psychological Association) does not have diagnosis for exercise addiction. What is considered the appropriate/recommended, “normal” amount of exercise? Leaving that up to be self-determined, particularly to persons in recovery who are at risk for addictive forming thoughts and behaviors, can be problematic. Just like any program planning, a medical and/or fitness professional may refer/recommend, there needs to be an appropriate guide to properly integrating exercise into recovery without reaching excess.

PACE stands for Proactive Awareness Controlling Excess. Fit PACE is a guideline/tool to incorporate exercise into recovery safely by being proactive and ahead of excessiveness, being aware of your own addictive behaviors, controlling thoughts/actions, and deterring/avoiding reaching exercise in excess. I have just released the Fit PACE mobile app which details a program for persons in substance abuse recovery to follow for exercise performance. Users not only log days performing exercise for accountability (and to avoid excess), but they also log number of days sober. Graphical images display progress and track this information. Users can connect to other persons on the app, which emulates the group meeting, community support aspect recovery. Users can select their exercise goal and tailor workouts to their level of fitness. It is my hope that both fitness and medical professionals can refer/recommend the Fit PACE app to download and use as a tool during substance abuse recovery. This is in alignment ACSM’s Exercise is Medicine philosophies.

To download the Fit PACE app, look in the applicable store for your cellular device:

Online Course: Fit PACE – Alcohol, Addiction and Exercise

Want to learn more? Sign up for Dr. McCullough’s short online from MedFit Classroom, Fit PACE – Alcohol, Addiction and Exercise

Dr. 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 a Ph.D in Health and Human Performance. She is a professional natural bodybuilder, fitness model, and published author.

Hashimoto’s Disease: When the immune system turns against you

Megan Johnson McCullough/21 January 2023/ All MFN blog/

Hashimoto’s Disease, also called Hashimoto’s Thyroiditis, occurs when the immune system turns against the body’s own tissues. The immune system directly attacks the thyroid. This then leads to hypothyroidism, which is when the thyroid isn’t making the necessary hormones for proper body functioning. The thyroid plays a leading role in our body, as it is the controller of our metabolism. Without the right hormones, how quickly our body uses calories from what we eat, can be greatly impacted. It is the most common thyroid disorder, affecting 14 million people in the United States.

Symptoms of Hashimoto’s include having an enlarged thyroid. The front of the neck (where the thyroid is located) looks swollen. Symptoms associated with an underactive thyroid, due to the lack of hormone production, include fatigue, weight gain, cold body temperature, hair thinning and loss, depression, irregular menstrual cycles for women, and joint and muscle pain.

The exact cause is not known. There is a strong genetic component. Hormones play a major role, especially since Hashimoto’s is seven times more common in woman than men. Its primary target is middle-aged women. Many women experience thyroid problems after childbirth and about 20% of these women develop Hashimoto’s later on. Certain medications with high levels of iodine can cause this problem. Radiation exposure also can lead to thyroid troubles. In fact, the atomic bombs of Japan lead to this disease in many people. Then, this can be passed on genetically.

Unfortunately, there is no cure for Hashimoto’s. The medical community is not sure what causes autoimmune disorders. Getting medical help is important in order to prevent the progression of the disease. If left untreated women can experience problems with fertility and the risk of high cholesterol increases.

There are some self-care, natural approaches to try to improve or prevent this condition, including your diet. Making sure your diet consists of enough selenium, zinc, vitamin D and iron. Foods to include would be red meat, poultry, beans and dark vegetables. If you do not eat meat, do understand that plant sources are not as absorbable, but taking vitamin C can help with this. Foods you should minimize and eliminate include those that cause inflammation. These include gluten, sugar, artificial sweeteners, soy and dairy. Gut health is critical so making digestion as clean and easy as possible is important. Avoiding toxins can help too, such as plastics, beauty products, air fresheners or candles. Keep your air clean.

Exercise can also be beneficial for Hashimoto’s because it helps lower inflammation and stabilizes the functioning of the immune system. This is because exercise stimulates regulatory T cells which are big inflammation fighters. Also in the process, exercise can balance the pro-inflammatory Th1 system and the anti-inflammatory Th2 system to be less inflammatory. Exercise also helps to release immune cells called IL-6, which lessen inflammation. Just going for walks is a great start but depending on how the person feels, even high-intensity-interval-training (HIIT) can boost workouts and help manage Hashimoto’s. Exercise tolerance is a case-by-case situation and overdoing exercise will only worsen inflammation.

For those I have trained with this condition, we sometimes have to do a trial-and-error approach to ensure the person is doing what their body permits without causing a flare up. It has been my job to scale back intense workouts but still give the client the encouragement and motivation that inspires them to keep exercise as a lifestyle change to support living with Hashimoto’s as best as possible. Many times clients avoid movement thinking their condition prevents them for doing certain types of exercise so why try at all. Movement is medicine so if it’s just walking, it is doing the body good versus being sedentary and lethargic.

Thyroid disease is becoming a major problem. Nearly 20 million Americans have some form of the disease. Diagnosis isn’t always clear at first, but we know when we don’t feel right. Don’t give the thyroid any more power than it already has. Hormones might be tyrant rulers, but we can control our actions and attitude towards feeling our best. Autoimmune diseases are unpredictable. The thyroid greatly influences our metabolism, so our weight is readily affected by its functioning. Although our genetic makeup can leave us powerless, we do have the ability to control our response, adherence to medical help and ability to keep a positive outlook despite medical situations.

References

Aging and Exercise

Megan Johnson McCullough/12 August 2022/ All MFN blog/

Time dictates so many aspects of our lives. When beginning this article, I thought to myself how much time controls my day from the seconds, minutes, and hours. And of course in relation to this piece of writing, it is the measure of our age. The aging process is unique to each of us. But ultimately, it does impact our life decisions, and that includes our exercise choices. So let’s take a look at the relationship between aging and exercise.

Naturally, activity level changes when we get older. As one of my long time clients put it, “Man, I don’t just roll out of bed anymore ready to go”. This isn’t to say that one is less motivated, rather, the energy expenditure levels are different. This is mainly due to the fact that, “A major fraction of total daily energy arises from resting metabolism, and it is thus important to note that resting metabolism decreases with aging, by about 10% from early adulthood to the age of retirement, and a further 10% subsequently.” (1) Adding to this, “One reason is the loss metabolically active muscle mass and parallel increase in metabolically inert depot fat. In later old age, there may also be some overall reduction in cellular metabolism.” (1) When muscle mass decreases, this can cause body fat to increase. Keeping the excess pounds off can get harder. As such, “Your body fat can increase by up to 30 percent, which leads to a loss of lean muscle tissue and can affect your sense of balance. This can make it difficult for you to perform exercise activities you once enjoyed.” (2)

We need to continue a strength training program in order to not let our bodies replace muscle with fat at the rate it would like to. Not to use a scare tactic but here you go: “Strength peaks around 25 year of age, plateaus through 35 or 40 years of age, and then shows an accelerating decline, with 25% loss of peak force by age of 65 years.” (1)

Exercise becomes so extremely important as we grow older. We tell ourselves that we used to be able to eat whatever we wanted and still look fabulous, but now the odds aren’t necessarily the same anymore. We have to take care of our bodies, and we can help prevent certain diseases with exercise. For example, “Your bone mass begins to decline once you enter your thirties, putting you at risk for conditions such as osteoporosis. If you are concerned about developing this condition, perform more weight-bearing exercises, such as running and tennis. Regular cardio activity will also help you control high blood pressure and high cholesterol, as well as ward off type 2 diabetes and some kinds of cancer.” (2)

As I always say, there is no can’t. That word is not allowed in my studio. There are modifications for so many exercises, and I will be by your side as we run, walk, or crawl to get it done. If we don’t use it, we lose is, right? Not every day is a peak performance day, but we do we can. As long as we are active, we are being productive to our bodies. Running a marathon might not be in the future, but what about making to your training session twice a week and keeping that commitment to your body? Goals should be realistic. Remember the glory days fondly, but know that you are keeping your mind and body in better condition and sticking around longer for your family and friends by maintaining an exercise program. Fitness is a way of life and the destination involves progress not perfection so just keep going one rep a time, one day at a time, and with every age of your life.

Originally printed on the Every BODY’s Fit Blog. Reprinted with permission.

References

Autism Spectrum Disorder – Where Fitness Professionals Land on the Spectrum

Megan Johnson McCullough/1 July 2022/ All MFN blog/

According to the CDC (2022), about 1 in 44 children has been identified with autism spectrum disorder (ASD). Autism Spectrum Disorder (ASD) is a neurological disorder marked by deficits in social communication as well as repetitive behaviors and restricted interests (Hodges et al., 2020. This information tells us, that it is likely in the near future or even now as a fitness professional, we may experience having a client with ASD. Being a neurological disorder, there can be faulty lines between mind and body communication that influence body movements and mechanics. Therefore, as a fitness professional, working with an ASD client would require individualized programming tailored to specific needs, but there are common sensory and motor skill deficiencies we as fitness professionals can certainly assist with.

The Diagnostic and Statistical Manuel of Mental Health Disorders (DSM-5) has now coined the term “spectrum” to include both lower and higher functioning forms of autism.

The ”spectrum” consists of the following:

autistic disorder
Asperger’s disorder
childhood disintegrative disorder
pervasive developmental disorder not otherwise specified (PDD-NOS)

Furthermore, the DSM-5 requires the following for diagnosis:

Individuals must meet all the social communication/interaction criteria:

problems reciprocating social or emotional interaction
severe problems maintaining relationships
nonverbal communication problems

Must also meet 2 of the 4 restricted and repetitive behaviors criteria that do cause functional impairment:

stereotyped or repetitive speech
motor movements or use of objects
excessive adherence to routines
ritualized behavior, or excessive resistance to change
highly restricted interests, abnormal in intensity or focus
hyper or hypo reactivity to sensory input or unusual interest in sensory aspects of environment

There are a number of risk factors for ASD including sex because ASD is 4 times more common in boys than girls. Other risk factors include family history, age of parents when born, and being born early (CDC, 2022). The fitness professional will of course meet the ASD after diagnosis but being aware of certain behaviors and traits is an important component to help better understand and relate to the client’s needs and abilities. The fitness professional can become part of the ASD client’s comprehensive treatment program. There is a need for our help, especially since obesity rates are higher among persons with ASD. Although some of this can be related to diet, lack of physical activity is a key contributor to this phenomenon. We know that P.E. at school alone is not enough time spent moving, and because persons with ASD might need special sensory and motor accommodations, this can be a deterrent for participation. Without the advocacy of parents, activity may not be prioritized.

Common among persons with ASD, there exist vestibular, proprioception, interoception, low muscle tone, postural instability, and compromised endurance and balance deficiencies (Autism Speaks, 2022). Adding to these, persons with ASD have been found to have differences compared to those without ASD with gait (stride width, velocity, and stride length) (Autism Speaks, 2022). As fitness professionals, we have the knowledge and experience to program design for these fitness and skill related components, so having a specialization to reach this population makes us both more credible and more marketable. Special populations need special people like us to add exercise as medicine and improve quality of life, despite the challenges, stereotypes, and stigmatisms that exist when it comes to persons on the “spectrum”.

Join Megan for her webinar on this topic, Working With Special Populations: Autism Spectrum Disorder (ASD) Fitness Integration

References

Autism Speaks (2022). Autism diagnosis criteria: DSM-5.

Autism Diagnosis Criteria: DSM-5 | Autism Speaks

Centers for Disease Control and Prevention (2022). Data and Statistics on Autism Spectrum Disorder. Data & Statistics on Autism Spectrum Disorder | CDC

Hodges, H., Fealko, C., & Soares, N. (2020). Autism spectrum disorder: definition, epidemiology, causes, and clinical evaluation. Translational Pediatrics, 9(Suppl 1), S55– S65. https://doi.org/10.21037/tp.2019.09.09

Tattoos & Heat Loss During Exercise

Megan Johnson McCullough/11 April 2022/ All MFN blog/

Tattoos are personal permanent images on our body that carry meaning and commemoration. At least 14% of U.S. adults have at least one tattoo and the popularity of getting inked is on the rise. Nearly 36% of millennials have a tattoo and it seems to be a reoccurring trend. The athletic community also has a high incidence of players with tattoos.

As much color as these skin decorations bring to the body, they may actually affect cause thermoregulatory problems. This is particularly true for people with sleeves, because the arms have a lot of sweat glands. Compared to a person with no tattoos, skin with ink on it sweats about 50% less. The type of sweat released on a tattooed area contains more concentrated amounts of sodium. Dyed skin changes the saltiness of our sweat. When the dye is injected into the skin, its home is same layer where our sweat glands live. Sweat glands excrete liquid onto the surface of the skin, but before it dries or we whip it away, our skin usually reabsorbs quite a bit of the lost sodium and electrolytes. Tattoos block this reabsorption. The age of tattoo does not influence this sweat alteration. New or old, about 50% of sweat is being produced. It is possible that the sweat glands after being inflamed from the 3,000 or more needles puncturing the skin, are now physiologically different.

This is not a serious condition to sweat about. The body is still able to cool itself down despite tattoos covering perspiration avenues. A person who is covered in tattoos, exercising or working in high heat, or are sensitive to heat, might be at risk. When we exercise we do want to be able to cool down to keep our stamina and performance up. Research has not been adequately performed to determine if the areas of the skin lacking tattoos make up for the sweat not readily perspired by the covered tattoo areas. Don’t worry that if you sweat less you will lose less weight. We all perspire different amounts and quantity of sweat does not equate to quantity of weight loss. As soon as the body become rehydrated, that water loss is replenished. Excessive sweating for weight loss with saunas or body wraps are popular methods among wrestlers and boxers. Maybe they should skip out on marking their bodies.

Sweat is the body’s air conditioning system. Tattoos might alter the desired temperature. 50% of NBA players have multiple tattoos and there hasn’t been a report yet of tattoo related injuries. Your skin will still get shiny with perspiration, but maybe not the same amount or with added salt. Be sure to hydrate, be sure to exercise, and be sure to get a tattoo you want to keep.

References

Genetics & Weight Problems: The Role of Genetics for that Number on the Scale

Megan Johnson McCullough/21 January 2022/ All MFN blog/

There are a number of factors that influence obesity. These include behavioral choices, environmental circumstances, and genetics. Genes don’t always predict someone’s weight future, but science has shown that genetics play a role in obesity. Genes increase a person’s susceptibility to become overweight, but this is not an isolated causality due to behavior and environment.

Take for instance the number of people living in a certain environment with all the same living conditions. How is it so that in an environment that promotes inactivity and high calorie foods that not all of these people become obese? Not all these people will have the same resulting health problems or body fat distribution. Even people in the same family, of the same race, and of the same ethnicity, will not all become obese given this environment. The diversity in body types leads one to believe that genetics do play a role in weight.

Genes are what instruct the body. They map out how the body will respond to a given environment. Genes dictate behaviors including a person’s choice to be sedentary, to overeat, and their metabolic functions. Genes tell the body how to store fat and how to use food for fuel as energy. Both hunger and food intake are associated with genes. For example, take two siblings or twins raised in very similar environments — they still may not have the same body weight distribution.

For now, science does not have genetic testing which would determine one’s weight future. There is no science that shows a personal diet plan or exercise regimen will result in exact body types. Bardet-Biedl syndrome (BBS) and Prader-Willi syndrome are the only two directly related obesity causing genetic factors. BBS is associated with increased body fat in the abdominal area, poor functioning kidneys, eyes, and genitalia, as well as intellectual impairment. Prader-Willi syndrome is associated with a constant desire to eat. This causes dangerous weight gain, stunted growth, and poor health. Research is still being performed on genetic response to weight gain. Knowing one’s family history won’t change the path to obesity, but lifestyle behavior and environment can be adjusted as a proactive and preventable method. For example, children of obese parents are more likely to become obese themselves due to their lifestyle and environment. Marketing has also become a strong influence for eating patterns.

The finger can’t be pointed at genetics alone for weight problems. However, we do know that even under exact circumstances, two bodies can react entirely different. The research is not entirely there YET, but hopefully in the near future we can have helpful answers to help fight the obesity epidemic.

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.

References

https://www.cdc.gov/healthyweight/calories/other_factors.html
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2636925/
https://www.ncbi.nlm.nih.gov/pubmed/12127777

Branched Chain Amino Acids: Protein’s Helper

Megan Johnson McCullough/8 September 2021/ All MFN blog/

Branched chain amino acids (BCAAs) are an essential nutrient in our body that consists of the chain of chemicals obtained from protein. We have 20 different amino acids in our body, 8 of which are considered essential, and 3 are the branch chain aminos that BCAAs are composed of. This chemical chain includes leucine, isoleucine, and valine. We get this protein source from our food, particularly meat, dairy, and legumes. They stimulate protein’s role of building muscle. They also help prevent muscle breakdown.

BCAA’s are a popular fitness supplement. For athletes or even the common gym-goer, these chemicals can improve performance by preventing fatigue, improving concentration, and reducing muscle breakdown. They have been shown to improve muscle soreness post-exercise. They can help reduce DOMS (delayed onset muscle soreness) which typically occurs within the initial 24 to 72 hours post-workout. Leucine aids in the muscle-making process. BCAAs have been shown to increase protein synthesis by up to 22%. Many protein powders contain branched chain amino acids, but they can also be found as a supplement all their own. Most protein powders have about 5 grams of BCAAs per 25 grams of protein.

They are also used medicinally. They are given to people with liver disease. They help the brain translate messages and impede upon faulty signaling related to liver disease, anorexia, mania, and tardive dyskinesia (involuntary repetitive body movements). When cirrhosis occurs in the liver, the brain does not signal correctly to help remove waste products and toxins from the blood. BCAA’s improve appetite to help people with these diseases to have better nutrition.

Bodybuilders like to take BCAAs as a result of the dieting process leading up to a competition. Dieting is part of stage preparation to look your best, but in this process, the body is at a caloric deficit to get the lean, cut look. However, the competitor doesn’t want to lose muscle mass. BCAAs work their magic with protein synthesis trying to build new muscle while fighting the deficit and then work to decrease breakdown.

The best food sources that contain BCAAs are meat and dairy:

Beef: 100 grams = 6.8 grams BCAAs
Chicken: 100 grams = 5.8 grams BCAAs
Whey protein powder: 1 scoop = 5.5 grams BCAAs
Soy protein powder: 1 scoop = 5.5 grams BCAAs
Canned tuna: 100 grams = 5.2 grams BCAAs
Salmon: 100 grams = 4.9 grams BCAAs
Turkey: 100 grams = 4.6 grams BCAAs
Eggs: 2 = 3.28 grams BCAAs
1% milk: 1 cup = 2.2 grams BCAAs
Greek yogurt: ½ cup = 2 grams

Food is always the best source of nutrition. Add supplementation when your body needs extra support. BCAAs are essential in our body. Anything essential needs to be had, so make sure you get the right amount of amino acids to help meet your body’s needs.

Join Megan for her webinar on this topic, Supplements: The Physiology Behind Trying to “Out Supplement” Nutrition

References

Fibromyalgia: Symptoms and Treatments

Megan Johnson McCullough/6 July 2021/ All MFN blog/

Chronic pain, tender to the touch on the body, fatigue, and sleep problems, are all symptoms of fibromyalgia. This syndrome affects the muscles and soft tissue of the body. The trouble with this condition is that there is no lab test for diagnosis, rather, the culmination of symptoms leads to the fibromyalgia diagnosis for sufferers. This condition is frequently undetected and misdiagnosed for this reason. However, for people living in pain, they want a solution to their problem. Other symptoms include headaches, depression, anxiety, memory loss called “fibro fog”, numbness and tingling in the extremities, irritable bowel syndrome, and feeling body aches all over. This is no way to live. The difference between fibromyalgia and other conditions such as tendonitis, bursitis, and arthritis, is that the pain is not located in one area… it is chronic and all over the body. A lot of this pain can even be at the surface of the skin, simply triggered by touch.

Persons with fibro just feel exhausted all the time. Even with quality sleep, the body is still tired. This is disruptive to one’s lifestyle and includes lack of energy to work, exercise, and or even just going to the grocery store. These activities take large amounts of energy. Imagine being too tired to even fold laundry. This is frustrating and mentally exhausting as a person is expected to participate in daily life, but physically too tired to do so. Waking up in the morning is when the body just feels stiff. What sleep a person with fibro does get is easily disrupted. Brain activity continues as if the person were awake. This, in turn, affects one’s mood. A person becomes worried they won’t be able to keep up with daily activities, and this reality leads to depression and anxiety. Relationships can become affected. Short-term memory also starts to suffer. Paresthesia (tingling and numbing feeling in the hands and feet) can stop a person in their tracks. All of these factors seem like walls in the way of being able to accomplish regular daily tasks.

A doctor can prescribe medication to help with the pain and the key is remembering to consistently take these medications . There are also alternative methods such as acupuncture, massage, and physical therapy. Exercise, especially walking, can help increase blood flow and decrease pain, along with balance and resistance training exercises. Keeping the mind active is also important. A person with fibro should pace themselves as they learn to adapt to their energy demands. Trying not to become overwhelmed or easily discouraged is important. Making sure to eat a nutrient-filled diet is critical, and especially including vitamin D. Caffeine should be avoided because the sleep cycle of a person with fibro is easily disturbed. Although caffeine might feel like an energy booster, drinking caffeine has been associated with increased fibro pain.

Communication is important with relationships and with employers. The lack of energy can be perceived as a lack of effort, but when a person with fibro expresses their medical concerns with others, one can aim to find a balance to life’s demands.

Fibromyalgia needs more medical research to help sufferers and alleviate their pain. Living a life with the physical struggles associated with fibromyalgia is no way to live but there is hope with the right pain management treatments.

References

Safely Returning to Exercise Post-COVID-19 Illness

Megan Johnson McCullough/28 April 2021/ All MFN blog/

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.

References

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/