How To Get Back into Shape After Taking Time Off

Dr. Amanda Anderson, PT, DPT, MS -Certified Orthopedic Clinical Specialist

At a glance

How do you return to working out consistently after taking time off from regular physical activity? You will need to progress slowly in order to make sure that you avoid overuse injury. It may also be helpful to modify the type of activity you are doing. For example, instead of running or HIIT training, try lower-impact activities like walking, biking or dancing as you build back up your fitness levels. Expect some soreness for at least two weeks when you first start exercising again. If you have any questions about exercise types or progressions, make sure to contact your healthcare professional about individual recommendations for your particular situation.

Gyms are opening back up, and the weather is getting nicer as spring morphs into summer. In the aftermath of shelter-in-place restrictions, it is very likely that many of us are having trouble getting motivated to head back to the gym. It’s been reopened for a month and you went maybe once about three weeks ago? You have gotten into a work-from-home groove and “working out” just doesn’t seem to fit into the schedule anymore.Maybe your gym did open back up, but you’re not sure if you should risk it since they may not be open.

So how do you return to working out safely after over six or more weeks off? While the answer to this depends on what types of activities you were doing before your time off, the general recommendations for returning to activity are the same.

Is exercise even safe if I haven’t been doing it?

The short answer is yes. Physical activity is safe for almost everyone. It is important to pick activities that are in line with your current fitness level and goals, because some activities do tend to be safer than others.

In general, both inactive people and those who were inactive for over two weeks should “start low and go slow.” Start with lower intensity activities and gradually increase time and intensity of these activities. The good news is most people will not be injured as long as they are following the recommended guidelines for progression of exercise. Studies show that only one injury occurs for every 1,000 hours of walking and less than four injuries occur for every 1,000 hours of running.

People with chronic health issues may want to consult a health care provider about types of exercise and the appropriate amount for them (1).

What types of exercise are safest?

If you are just returning to activity after a prolonged shelter-in-place order, start by choosing a moderate-intensity, low-impact activity. These would include activities like:

• Walking
• Gardening
• Bicycling
• Dancing
• Swimming
• Golfing

More intense activities, like sports that involve collision or contact, like football, hockey, and soccer, have a higher risk of musculoskeletal injury as well as concussion.

Doing many types of activities also tends to reduce overuse injury risk. Instead of just focusing on walking as your type of exercise, try to incorporate some yoga or strength training on days that you don’t walk for some variety in your routine(1).

What causes injuries after a break from exercising?

The problem most exercisers are going to have with returning to activity is immediately trying to return to their previous level of activity immediately. Keep in mind:

• You will not be able to jump right back in where you left off.
• During your time off, especially if you were not exercising and/or doing the activities you were doing prior to quarantine, you will have lost some level of fitness.
• For example, if you were running six miles every other day prior to the shelter-in-place, trying to run six miles after not doing it for six weeks will increase your risk for injury.

Research suggests that musculoskeletal injury risk is correlated to the gap between a person’s usual activity level and new activity level. This gap is called “overload.” During quarantine, your level of overload likely significantly decreased. Unfortunately, now that means instead of running six miles at a faster pace, you may need to do just two miles at a much slower pace. The body needs time to adapt to the increase in overload in order to reduce injury risk(1).

How do I increase my physical activity levels safely?

No matter if you’re just starting out (or starting over), or if you’re an elite athlete returning from some time off, all physical activity needs to increase gradually over time.

General guidelines for progressing physical activity are as follows(1):

1. Start with low-to-moderate intensity activity. Avoid more vigorous activities, like shoveling or running, when you are starting out.
2. Make sure you are only making one variable at a time harder. For example, start by increasing the duration of the session (minutes exercising) and then increase the number of days per week (frequency of exercise). Then, once your body has adjusted, try increasing the intensity of the activity you’re doing. Do not exercise for longer and increase the intensity of the workout you’re doing on the same day!
3. As a general rule, do not increase your walking or running percentage by more than 10 percent each week. See an example of areturn-to-running progression from the University of Delaware. This can also be modified to be a walking progression if you substitute the “walk” for “slow walk” and “jog” for “fast walk”(2).
4. Older adults may require more time to adapt to overload than younger adults, but this does not mean they do not need to progress.
5. Slower rates of increase over longer periods of time will reduce injury risk, especially if you are overweight or obese.

Will I be really sore when I start to exercise again?

The short answer is yes. Delayed-onset muscle soreness (DOMS) is inevitable when you start to exercise again. Appropriately managing the amount you progress each week will help with the amount of soreness you get, but you should definitely expect some soreness for at least two weeks of consistent exercise.

The “peak” level of soreness will usually be delayed about a day, so you’re actually more sore the second day after a workout instead of just the day afterward. This is normal. The purpose of progressive exercise is to reduce feeling like you may have torn something, but in all likelihood, you’re experiencing DOMS. If you are this sore though, it is likely you progressed yourself too fast and may need to take a rest day or two before starting again at a slower pace(3).

Is there anything I can do to reduce DOMS?

We’re not sure. DOMS is so much more complicated than originally thought. It does seem to be an inevitable part of anything outside of your “normal activity” level. DOMS seems to be made worse by:

• Eccentric (or elongation) contractions
• Genetics
• Other physical factors, like if you’re dehydrated.
• There is even some research that shows that being worried about being sore will tend to increase your DOMS(3).

So what is DOMS exactly? Think of the muscle burn that you get during your exercise -- delayed-onset muscle soreness seems to be a continuation of that feeling. It is not direct microtrauma to your muscles and it’s not inflammation, even though it may feel like it. It seems to be a combination of neurological, immune, metabolic, and physical stressors that come together to create a big jumble of soreness after you use your body in a way you aren’t used to(3).

There is some promising research that curcumin, a compound derived from turmeric, may be helpful in reducing soreness associated with DOMS.Physician’s Choice Joint Support Formula andPhysician’s Choice Turmeric Curcumin may both be helpful in reducing pain related to delayed-onset muscle soreness. There is also some research suggesting that the use of caffeine and bed-sourced mineral water may be other ways to reduce muscle soreness, but more studies are needed to confirm this(4).

There is absolutely no research to suggest that massage, specific-stretching or warm-ups, compression garments, icing, ultrasound or Epsom salts are helpful in reducing the effects of DOM(3).

So what happens if I played a sport pre-quarantine? How do I get back into it?

Getting back into high-intensity sports is very doable after a break, but will require more preparation and time. Obviously thereturn to sport timeline will depend on the sport, but ultimately, you will still need to have baseline endurance, strength, power, speed, and agility, depending on the sport.

So what is the first step?

In general, you need to at least start with a running progression in order to appropriately increase physical activity while minimizing the effects of DOMS. It would not be a good idea to immediately just return to your sport of choice without giving your body a chance to adapt to exercise again.

How will I know if I’m ready to progress?

The length of time of this “readiness” period depends on your level of fitness prior to quarantine. If you were in a soccer league practicing once a week and having a game twice every week, then your progression to return to activity will be much shorter than someone who hasn’t played soccer for five years.

Is there a good return to sport progression I can follow?

For people who are looking to return to high-intensity sports that include a lot of cutting, pivoting and unpredictability, like soccer, basketball and football, it may be helpful to start an ACL injury prevention program. While most of the research on ACL injuries suggests that female soccer players are most at risk, applying the basic principles of thePrevent Injury and Enhance Performance (PEP) Program, can be beneficial for everyone attempting to return to a higher-level activity.

The PEP program is a 20-minute routine designed to take the place of a typical “warm-up.” It uses education, stretching, strengthening, plyometrics and soccer agility drills. Based on the study results, there was an 88 percent reduction in ACL injuries in the first year. While this would technically only be applicable to females who play soccer, the program’s focus on single leg, hip and core control make it a valuable program that isn’t too time-consuming especially if you’re planning on warming up anyways(5).



I’m having trouble getting motivated to exercise...what can I do?

1. Remember it is normal to fall off the bandwagon. The stressors during shelter-in-place may have been too much for you to mentally and/or physically sustain an exercise program -- and that’s okay! You will get back to it.
2. Take your time. It isn’t a race to see how fast you can get back to where you left off. It takes 6 to 8 weeks to build a habit and also 6 to 8 weeks to get back into an exercise routine. That can’t be a coincidence.
3. Find an activity that you enjoy. If you hate going to the gym, please don’t get a gym membership! Moderate intensity activity may mean that your daily exercise twice a week is walking outside to hang the laundry outside. Your exercise plan needs to fit your lifestyle and if your lifestyle is still going to be at home for the unforeseeable future, you need to make it work for you.
4. Make reasonable, measurable, and specific goals. “Getting stronger” is not a good goal because how will you know when you’ve attained this goal? Being able to lift 50 pounds with both hands so you can carry your oldest child out to the car from the house is something that you will know when you’ve met.
5. Make a schedule and stick to it. This does not mean you need to have the same schedule every week. Perhaps you start with a schedule that includes only one “workout” day with the rest of the week focused on getting jobs done around the house. You’ll still be moving and depending on what your goals are, this may be plenty! Sometimes scheduling a class in advance at the gym or on an app is motivating; you’ll go so you can avoid the late cancel fee! Also making plans to meet your friends at the gym may make you less likely to skip out since someone else is holding you accountable.
6. Don’t skip sleep. In order to most efficiently recover from bouts of exercise, you need adequate rest. The good news is usually a consistent exercise routine helps you sleep better and helps you get up feeling more rested.
7. Take rest days if you need them! Your body will let you know when it’s had enough. Yes, you’re going to get sore when you first start out. Yes, you’re going to be tired. But if you had a stressful day at work or a terrible day at home with the kids and you feel like you can’t even lift a pot, much less a dumbbell, don’t go to the gym! Take the dog for a walk or do a little yoga on the patio. Sticking to a routine won’t happen if you’re constantly stressed out of your mind.

In summary

No matter what your situation has been like during quarantine, just remember that some activity is better than no activity. Taking the garbage can out to the curb and doing yard work may be your “workout” for the day, and that’s okay! As you figure out a new routine, you will become more comfortable with exercise and your workouts will go from ‘optional’ to ‘necessary.’

Make sure you are taking it slow as you ease back into it. Don’t assume you will be able to pick up right where you left off. You may need to initially modify the types of exercise you were doing or maybe break up your exercise into spurts throughout the day as you get back into it. Expect some soreness initially and don’t be afraid of it! It means your muscles are adapting and changing to be able to handle higher-level activities again. As always, if you have any questions about progressions, make sure to contact your healthcare professional for suggestions specific to your particular situation.