The first week 26-year-old Kay had COVID-19, she burned up with a high fever and slept 12 to 14 hours a day. It took her another three weeks before she could climb stairs or walk a few blocks without being out of breath. But as an avid runner, she considered the true test of her recovery to be when she could lace up her running shoes again. And so, eight weeks after her diagnosis, she stretched a bit before dashing out into a beautiful summer day.
She couldn’t make it two blocks before she found herself bent over, gasping for air.
“I pushed through for another 10 minutes and then called it quits. I was so out of breath that walking was a struggle,” she tells me. “My muscles were fine — I didn’t have any cramping or muscle fatigue — but I did have the inhaler my doctor had given me when I was symptomatic, and I had to hit that a few times. When I got home, I sat in a hot shower to ease some of the chest pain.”
Understandably, she’s only been on a few runs since. “I’m trying slower paces, which has helped,” she says. “Right now, I’m working my way up to a 16-minute mile.”
According to John Martinez, a former team physician with USA Triathlon who’s part of his local county’s COVID response team, that’s what Kay should have been doing all along — i.e., eased her way back in. “We’re still trying to figure out the after-effects of COVID-19,” Martinez explains. “With just five months of experience, it’s still not clear the long-term effects of this virus on otherwise healthy people.”
As such, the advice he’s been giving patients eager to get back into shape after having COVID-19 is to first realize it’s going to take a long time, regardless of how bad their symptoms were.
Such was the case for Ryan, a 25-year-old in North Carolina. His fever, body aches, stomach issues, headaches and sore throat were “medium-bad by comparison,” he says, “in part because they only lasted a week.” But once they cleared up, the damage to his lungs became readily apparent. “I couldn’t catch my breath,” he tells me. “Walking down stairs even was difficult; every time I took a breath in, it felt like I was breathing in fire.”
All of which is a big problem with coronavirus patients — even if they have no symptoms, that “doesn’t mean that there were no changes in their lungs or body in general,” explains Dr. Omiete Charles-Davies. “People who didn’t have obvious symptoms can have some form of lung damage without knowing it. The damage may not be obvious when you walk or talk, but it will be when you strain your respiratory system by running or playing intense sports.”
Not to mention, 22 percent of hospitalized COVID-19 patients suffer from cardiac damage, which could lead to severe consequences upon resuming exercise and is why the Journal of American Medical Association recommends they consult a physician before doing anything particularly strenuous.
Again, taking things slow is the name of the game (or run). “You shouldn’t try to run as long or as intense as you normally would after recovering from COVID-19,” Charles-Davies tells me. “As your lungs heal from the damage, your performance will gradually get better with time.”
Martinez goes a step further, and gives his patients strict boundaries for their heart rate. “I have patients start off with easy running efforts, trying to stay in zones 1 or 2 in terms of heart rate for the first four weeks or so,” he says. “Which for some people may mean a brisk walk instead of a run.”
As for Ryan, it was only after a month that he was able to walk without his lungs “feeling like they were singed on the outside and fine on the insides, like a burnt marshmallow.” It obviously didn’t get any better when he tried to run. “Every breath hurt at first,” he says, but he adds, “in a good way, weirdly.”
“My runs started slow,” he continues, “maybe taking 30 minutes to run 1.5 miles because I had to stop and start a lot. After a while, though, the burning sensation went away, and I started feeling like I was back at a baseline of a non-runner, but at least not damaged. It felt good to be alive, and I could actually run far enough to challenge my body.”
Ken, a 47-year-old in Georgia, has been running since he was diagnosed with high blood pressure five years ago. Before the pandemic, he’d gotten down to an 8-minute mile, running 10 miles a week. But then he got coronavirus — bad. “The flu-like symptoms sucked, but it was the eighth day where my arms and legs started tingling and going numb — that was the real problem,” he tells me. “My O2 levels fell to 90, and my sister, who is a nurse, told me to head to the ER if they fell any more.”
Luckily, he managed to keep them up doing breathing exercises, and a few days later, he was feeling much better. So much better, in fact, that he thought he’d try to go for a run. “It took me 27 minutes to run 1.2 miles,” he says. His post-run recovery was even more miserable. “The next few days I started feeling worse — particularly in the evening, I’d feel very dehydrated, even though I was drinking lots of water.”
Ken held off from running for a few more days until he felt good enough to get out there once more, which Martinez says is the best thing he could’ve done. The more you overdo it, the longer you’ll suffer setbacks for, so “listening to your body and being okay with skipping a workout if you’re still tired and fatigued from the last workout is the most important part of getting back to running after having COVID-19.”
Now, Ken is back on the road, and while it’s still slow going — he recently finished a mile in 14 minutes — it’s progress nonetheless. “I was completely overcome with emotion and started bawling like a baby [after the 14-minute mile], because I didn’t have to walk for the entire mile,” he says. “So that’s where I am now.” And in time, he vows, “I’ll be stronger than I was before — that’s my motivation at least.”