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