Exercise After Covid with Iyad Salloum

Mark: Hi, it's Mark from Remarkable Speaking. I'm here with Iyad Salloum of Insync Physio in North Burnaby. We're gonna talk about a really relevant, timely thing, exercise after COVID. How you doing Iyad? 

Iyad: Good Mark. How are you today? 

Mark: I'm good. So my wife had COVID when she should go back to exercising.

Iyad: That's a great question. It's something that we kind of we’re learning on the go because of how new this disease is. And, you know, we thought we could maybe extrapolate from previous diseases like that. We used to do, for example, like with the flu and with the common cold and other respiratory viruses.

But one of the things that's really interesting is, it seems that we can probably start exercise soon, within a few days after the majority of the major symptoms settled down. But the exercise parameters are not well understood. Like, so for example, we can't just say, oh, you're day five here, go do this thing. Pass a handout to the general population, because everybody seems to be very different. 

So the way we are kind of doing this now, we're realizing at first was when we tell people to push into symptoms and push into their exertion, is that they actually would have contrasting reactions. So some people would actually get a bit worse and some people responded well.

So general idea now is you should kind of do a little sub-threshold exercise in the early days. So don't go into those symptoms where your heart rate's racing, or you're hitting that shortness of breath in the first few days. And that's kind of something that we're starting to see more and more of in the clinic. And the interesting part is I haven't seen two people that present it the same way.

Mark: So it's very individual. I guess it depends on a myriad of factors depending on, you know, what your original fitness level was or who knows, I mean, it hits everyone. Even really well trained athletes sometimes get pretty severe symptoms. 

Iyad: Yeah. And that's really significant actually to note. Everybody's symptoms have been so different. So you have people who say, oh, I had a lot of headaches and kind of fogginess and maybe some kind of nausea with different movements. Some people have developed heart related symptoms. So like a popular example is Alfonso Davies, a soccer player had inflammation of the heart muscle tissue, which again, it happened. It's not luckily as common as we hear about it, which is good. So that's a cardiac symptom. And then you have the common one, which is the shortness of breath where people feel like they just can't inhale and exhale properly. 

So depending on what presents to us, we basically would do an assessment of just very basic things. Like, you know, some breathing assessments. We do an exercise tolerance test where we monitor the heart rate, we would monitor a few things. And then depending on the impairment, for example, if you have some respiratory kind of issues, we would start everybody almost on a breathing program.

And it sounds kind of funny. You almost have to relearn how to breathe again. And that's something that we've seen work really well for a lot of people. And it's not too different from other respiratory conditions where we find breathing exercises to be very helpful. And then some people will need a prescribed walking program where they stay within a certain heart rate or a certain exertion level.

And that's something that we would determine just from the, you know, we get you to do this kind of think of like a exercise test. And then we kind of adjust the parameters according to that. And then sometimes, you know, in cases where there's something a little more severe, we would want some medical intervention there.

We had one person in the clinic where we needed to work closely with the cardiologist office to make sure that they're safe to just move and walk and get their heart rate up a bit. So, and again, it's so different person to person and that's kind of what makes it, I'm sure hard for a lot of people to self-manage and you know, like even us healthcare professionals, we're trying to kind of learn about this thing every day and just trying to do the best. But yeah, that's why we can't just make these concrete statements say everybody should be doing X, Y, or Z, because it seems to vary a lot between the people.

Mark: So you mentioned something earlier as well. When we were talking prior to recording where you had COVID and in your recovery process, it was a little bit problematic for you. What was that like? 

Iyad: Yeah. So for example I had no symptoms at rest, but one of the things that we noticed is with a bit of activity, I would get different responses. So it'd be like a bit of you know, shortness of breath sometimes, or sometimes you'd feel like a little dazed, but generally that seems to have improved pretty well with just a gradual program. But that's the piece where it's so different again. So I've had lots of people who just their primary symptom is just respiratory.

And that's basically the only thing they have. Is they just have shortness of breath and then it takes them a while to kind of settle that kind of sensation that they're gasping for air afterwards. So really, really depends. And one of the things we obviously want to make sure when we are getting people to exercise, is they're staying safe, for example. Like we monitor things like blood oxygen level. 

And this is something you could just do with a pulse oximeter from the pharmacy where you just kind of see, are you actually losing oxygenation in your blood, because then it's a different story. And obviously the exercise guidelines would change significantly and we'd want to work pretty closely with our medical colleagues for some of those cases.

But, yeah it's just so different person to person. And this is, again, I want to stress that it's not the same when we're talking about with cases of long COVID, which tend to be a little different and we could probably do two hours on that thing, because it's not the same. Long COVID is we're learning more and more about it, but it's not the same as recovering from an acute infection.

Mark: Thanks Iyad. So if you are looking for some great support in recovering from your COVID experience and it's still happening folks. I was out yesterday, I was the only one wearing a mask in all the stores I went into. And there's another wave happening. I mean, we can be tired. The COVID ain't tired. It keeps doing stuff. It's still there. If you need help with your recovery, with getting back into exercise, with doing it smart and safe and in a way that increases your abilities and brings them back, the guys to see are Insync Physio. Insyncphysio.com is the place to book or you can call them at (604) 566-9716 in Vancouver. Or in North Burnaby (604) 298-4878. Again thanks Iyad. 

Iyad: Thank you.