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Safe Return to Physical Activity Following Covid Infection

We have seen COVID cases rise in the Hawkes Bay over the past week, with almost 6,000 active cases reported yesterday. While, in large part due to vaccination and boosters, the majority of persons infected will have a mild illness, there will be some requiring hospital level of care, with 18 inpatients currently. We wish those people a speedy recovery.


Looking beyond the current infection wave, we expect many members of our local community will be keen to return to sport and physical activity following COVID infection. We have the benefit of overseas experience in this regard, with our colleagues developing and implementing return to physical activity protocols. We can therefore use these to safely manage your return to activity with knowledge and best practice.


We recommend medical evaluation prior to return to physical activity for those who:

  • Required hospitalisation

  • Had significant symptoms but did not require hospital admission, eg: chest pain/tightness, shortness of breath at rest or with mild activity, persisting fatigue

  • Have pre-existing asthma/heart conditions/other concerns

These people may need further investigations and advice before safely returning to physical activity.



The majority of the population is likely to experience mild symptoms lasting about 7 days. COVID can affect many different organ systems, and all will need to recover from the illness. A step-wise approach to physical activity is recommended, rather than getting straight back in to your previous levels. Making sure you give your body the ability to recovery well between sessions is just as important as the physical activity itself. When returning to exercise, you should be mindful of symptoms which require prompt medical attention (see list below). Here are a few pointers to help your progression:

  • While unwell/in early days of recovery, gentle walking and usual household activities should be fine to continue unless you feel unusually breathless/fatigued during or after the activity

  • As a general rule, you should wait until you are symptom free for at least 7 days before beginning exercise. Symptoms should not be masked by Paracetamol or Ibuprofen

  • Start with low level activity (eg: walking/light jogging) for a short duration (eg: less than 15 minutes)

  • Gently progress your duration of the same activity before increasing the intensity

  • Gradually increase the intensity (eg: walk with short periods of jogging, then increase the time jogging in subsequent sessions)

  • Ensure you recover well between sessions (ie: no fatigue/unwell symptom)

  • Listen to your mind and body to make sensible decisions on whether to stick with the same level of activity or progress to the next level

  • Make sure you are doing everything else well: nutrition, sleep, mindfulness and laughter are just as important as physical activity for overall well-being


Please see your Doctor if you develop or are worried about the following symptoms:

  • Breathlessness disproportionate to effort

  • Sharp chest, abdomen or leg pain

  • Dull central chest pain, radiating to arms/neck

  • Limb swelling

  • Light-headedness/fainting with exercise

  • Excessive fatigue

  • Unusually high or slow heart rate during exercise or recovery

  • Feeling like you’re working too hard for the actual activity (ie: feeling like you’ve run/are running a marathon when out for a simple walk)


‍We are available and happy to offer appointments to assess your readiness to return to physical activity, and can help arrange further investigations and referrals as appropriate. We can also offer guidance to safe return to your sport or physical activity. There are a number of protocols to follow, a good example is this one published by the British Journal of Sports Medicine:



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