Understanding How Covid May Affect Your Clients' Exercise Plan

Mar 11, 2021

By Tim Saye

It's important to know how coronavirus can affect your clients' ability to train after they've recovered from the initial illness and stopped isolation, this allows you to plan appropriate modifications to their exercise program. Here we look at how COVID-19 can effect your clients and explain what that means for their training.

What Does COVID Do To The Body?

Compared with when COVID was first diagnosed over a year ago, our understanding of it has changed considerably. There are now several recognised strains of COVID, but there are some commonalities between the different variants. COVID-19 enters your body the same way any virus would - entering your healthy cells through mucous membranes. The invading virus cells make copies of themselves and duplicate throughout the body. 

The virus's surface is spiked with surface proteins, meaning it can attach to receptors on healthy cells. In particular, the cells in the lungs and the viral proteins can break into the cell through the ACE2 receptors. Once the virus cells are inside, they can hijack the healthy cells and take over, killing the healthy cells.

Although the virus enters the body through the nose, throat, eyes or mouth, it then moves into the respiratory tract. The lower airways have more ACE2 receptors, which is why COVID seems to "sit deeper" on the chest than other viruses or URIs. The presence of the virus cells inside the lungs can inflame the tissue, making it difficult to breathe. Many people that have COVID go on to develop pneumonia - an infection of the alveoli. This part of the lung is responsible for the exchange of oxygen and carbon dioxide in the blood. This is even visible as shadowy patches if doctors perform CT scans of the chest.

Symptoms are usually evident after 2-14 days. If your clients are not in a high-risk category and catch COVID, they're likely to present with a persistent cough and a high temperature. While around 80% of cases are uncomfortable but not critical, for some clients - especially those who have exercise-induced asthma, the experience can be more dangerous. 

If your client has shortness of breath that isn't otherwise explained, this is a critical indicator that COVID symptoms may present. The sign is called dyspnea, and a few days later, acute respiratory distress syndrome (ARDS) may appear. 

Further effects are felt in the nervous system, with severe headaches, muscle and joint pain, a profound sense of tiredness that's likely to affect a client's willingness to train long after the symptoms have disappeared, as well as cognitive impairments, the loss of some senses (including changes to taste) which can have an impact on dietary planning - and can last weeks. In extreme cases, there can even be recorded strokes. 

Although the primary biological system affected by COVID is the cardiovascular system, research published in The Lancet reported several symptoms related to the digestive system, including a lack of appetite, diarrhoea, vomiting and general pain in the abdominal region. 

The Perils Of Long COVID

One of the observations that seem to be emerging from the fitness industry is that pushing through and trying to train too close to having COVID can worsen the symptoms and prolong the effects of long COVID. 

In particular, researchers reported that patients are at risk of heart problems. This is because the stress induced through exercise can worsen the inflammation of the heart tissues, with professional cardiologists recommending that non-professional athletes "take it easy for 6 months".

For personal trainers, this could mean a significant need to adapt a client's training plan. Medical professionals recommend that people who have had COVID stick with lower intensity exercise, like walking or gentle cycling and having regular reviews and even assessments by their cardiologist. 

They might expect to have a reduced capacity for intensity for at least 6 months or even a year. Managing your clients' goals in light of this could be challenging, but as a personal trainer, you are creative and will find a way to support your clients through long COVID.

It seems now more than ever, the focus may need to be on putting positive habits in place, supporting a client's recovery through a balanced and nutritious diet, and focusing their energy and attention on mindset.

Reports from Jasmine Hayer, a 31-year-old coach, yoga instructor and manager at a health club in London, document her on-going battle with long COVID and the impact it's had on her physical and mental health over the last year. 

The symptoms of long COVID are described as "baffling" and include the typical shortness of breath and fatigue and somewhat stranger symptoms such as irregularities in her menstrual cycle, PTSD like symptoms, and even acid reflux!


Patients who have suffered from COVID have experienced a significant physical setback. Even if their initial COVID symptoms were relatively mild, they might experience symptoms that impact their health and fitness over the longer term.

For all COVID patients, their immune systems have worked incredibly hard to battle this virus and restore them to health. For some people, that road to recovery may be longer than for others, and as a personal trainer, your responsibility to your clients will be to support their return to full health. 

You can fulfil that role as part of a suite of health professionals, and the advice you give to your clients will need to be based on guidance provided by the rest of the health care team.

At this point, your creativity and compassion have never been more critical. If you're an online trainer, you can offer your clients far more than exercise. You can support them when they feel isolated and unwell. You can provide them with a community and a sense of belonging.

A personal training community can be one of the most positive and uplifting forces in people's lives. A focus on sound nutritional principles and habits that restore their energy and health and a sense of being part of something are essential elements in feeling well again. 

Next time we'll be looking at how to safeguard ourselves against a client's compromised cardiovascular system and how personal trainers have a vital role to play in supporting their clients as part of a network of health professionals.