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Covid-19 Primary Care Resources

Returning back to physical activity and sports training post Covid

A summary of guidance for GPs and patients

This information is sourced from the Faculty of Sports and Exercise Medicinethe BMJ and Your Covid Recovery:

Guidance for GPs:

The following patient groups need examination +/- investigations in primary care:

  • People who have had severe Covid-19
  • Patients with ongoing symptoms (respiratory, GI, rheumatological or psychological)
  • Patients with a history suggestive of cardiac involvement (chest pain/palpitations, severe breathlessness or syncope)

This is to determine whether they can returning to physical activity or should be referred to a long Covid rehabilitation service.

People with a history suggestive of cardiac involvement should be considered for cardiology review. They may have had viral myocarditis which requires three to six months of exercise restriction.

Guidance for patients:

  • Only return to exercise (or any strenuous physical activity) after at least seven days free of symptoms
  • Begin with at least two weeks of minimal exertion
  • Then increase levels of exertion each week, and aim to gradually return to your baseline level of exercise over five weeks (but drop back a level if you are finding it difficult at any stage)
  • Use daily self monitoring to track progress, including when to seek further help

Additional guidance for athletes:

  • Athletes who have more complicated infections or a requirement for secondary care support will need to have a medical assessment before returning to exercise
  • Athletes should wait until they have had a minimum of 10 days rest from sport AND have been symptom free for seven days before resuming any exercise other than walking or activities of daily living
  • The Faculty of Sports and Exercise Medicine have produced a progressive exercise programme called the Graduated return to play protocol (GRTP)
  • Before considering a GRTP, the athlete must be able to complete all activities of daily living without excessive fatigue and/or breathlessness and walk a minimum of 500m on the flat without getting breathless
  • Seven days is the minimum time to progress, especially in sports of an aerobic nature
  • All treatments should have stopped that may mask symptoms, eg, paracetamol
  • Exercise and progression should cease if concerns are raised


Published: 08/01/2021

Published: 24/07/2020