Exercise after COVID-19, under the guidance of a physical therapist, can help combat the fatigue and weakness that can linger for months after recovery.

Published: January 17, 2022 | Updated: November 18, 2022

Exercise after COVID-19, under the guidance of a physical therapist, can help combat the fatigue and weakness that can linger for months after recovery.

KORT physical therapy’s Recovery and Reconditioning Program, R2 for short, aims to improve strength, mobility and endurance so people can return to their prior level of functioning, according to Corey Malone, DPT, clinical director of KORT – Six Mile.

For some, being sick with COVID-19 has meant a long period of inactivity. This deconditioning can lead to loss of muscle mass, reduced flexibility, joint stiffness, balance issues and other concerns.

“Deconditioning can happen to anyone for a number of reasons. It can impact your overall function, safety and quality of life. Reconditioning is possible, so you are not doomed if you’re deconditioned,”  Corey said during a recent Norton Infectious Diseases Institute presentation, “COVID Comeback: Recovery, Exercise and Reconditioning.”

With exercise and strength training, people can start feeling stronger and having more energy after only two weeks. It takes six to eight weeks of exercise after COVID-19 to see physical changes in the muscles, according to Corey.

In the R2 Program, licensed physical and occupational therapists tailor a plan to address each individual’s needs and goals so they can resume pre-COVID-19 activities. The program typically takes 15 visits over two months.

People with Medicare or Medicaid need to see their primary doctor first to get a referral for physical therapy. In Kentucky, people with private insurance can call a physical therapy clinic directly and make an appointment. Patients generally get an appointment within 24 to 48 hours.

Exercise after COVID-19 can reverse the toll of weeks of inactivity

Inactivity can cause big changes in the body quickly, according to Corey. Bedridden patients can lose up to 12% of muscle a week. That means in three to five weeks, someone can lose almost half their normal strength.

“It does not take that long to get weak,” Corey said.

Inactivity also results in muscles getting shorter, resulting in less flexibility. This process, called muscle contracture, can develop in as little as four days.

“It can take months or years to reverse that, so it’s pretty significant,” Corey said. “If you’re not able to move your body the way that it’s supposed to move, you can start to develop other issues walking or getting in and out of bed or a car.”

It can start to lead to pain and balance issues, according to Corey. In addition, inactivity can lead to changes in joint and bone structure, meaning you can develop osteoporosis and arthritis by not moving your joints.

“When you become deconditioned, you become weak and you become stiff. That can really make simple movements labored and painful,” Corey said. “When it takes more effort to move your body, it can drain you of your energy levels.

“This can become, you can imagine, a vicious cycle where you lose motivation to move because it hurts and it’s difficult, and then you start to suffer from more muscle atrophy or muscle loss and joint stiffness.”

Exercise after COVID-19 can help maintain overall mobility, halting a decline that can lead to needing a walker or cane.

Therapists screen patients just starting out in the R2 Program for fall risks. Patients  receive information on a safe home environment. For example, making sure there are no rugs around the house that could pose a tripping hazard. The R2 program also offers education on what are safe vital signs during exercise.