Getting back to your exercise routine after having Covid is often difficult and frustrating. But scientists are starting to develop some guidelines.

The best approach, they say, is gentle and gradual—and guided by your doctor. Some people have post-Covid complications that can make exercise higher-risk. And many Covid patients continue to experience symptoms for weeks or even months after their initial diagnosis, making even gentle activity arduous.

“People can feel well and still have a relapse that could be triggered by exertion,” says David Salman, a general practitioner and clinical research fellow in musculoskeletal and sports medicine at Imperial College London. But physical activity is, of course, essential for your overall health, so it’s worthwhile to work on finding the right balance.

Dr. Salman co-authored a paper published in the British Medical Journal in January to help doctors advise patients about resuming physical activity after Covid. It recommends not returning to exercise until you’ve had at least seven days without symptoms and starting with at least two weeks of minimal exertion. “This is not a period of time to be pushing for a personal best,” says Dr. Salman. “You are recovering from an illness that we don’t understand fully.” Take into account your past level of activity: If you were accustomed to walking for exercise, don’t start training for a marathon.

One approach is a four-part phased plan based on a scaled “rate of perceived exertion” or RPE, Dr. Salman says. This is a subjective assessment of how hard someone feels they are working, from a low of 6 (no exertion at all) to a high of 20 (maximum fatigue). Each phase can last at least seven days, and can be adjusted to accommodate different levels of skill. You can stay on a phase for as long as necessary.

This post first appeared on wsj.com

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