Sports & COVID-19: Clearance needed to exercise after an infection

This page has been updated on 9/23/22 to reflect the most current AAP recommendations.

This month the American Academy of Pediatrics (AAP) updated its guidance for young athletes who have a COVID-19 infection. We continue to learn more about COVID-19 and its effects on multiple organ systems, and the changes in the guidelines reflect this new information:

• We know that children, adolescents, and adults can develop post-COVID-19 conditions after infection, including cardiac issues. 
• There is a risk of myocarditis (inflammation of the heart muscle) from even a mild or asymptomatic COVID-19 infection. 
• This risk appears to be lower than what was thought earlier on in the pandemic, 1-3 young people out of 100 develop this complication While that is not a large number, exercising with this condition can make things much worse.

While most children and teens who have had COVID-19 will be fine, screening to identify those with any heart issues is important. That is why we will follow the American Academy of Pediatric’s (AAP) recommendations for sports clearance after COVID-19 infection.

If your COVID infection is mild or you had no symptoms, these are the recommendations:

• You should not exercise during the 5-day isolation period.
• After the 5-day isolation period, you should be fever free and have a minimum of 1 day prior to beginning a return to physical activity progression. You must still wear a mask around others until day 10, even when exercising.

If during your COVID infection you had a fever for 4 days or longer, or had a week or more of muscle aches, chills, or lethargy:

• You should not exercise until you have been cleared by a doctor.
• You should make an appointment to be seen once your isolation and symptoms are both over. You will need an exam and an EKG.

If everything is normal and it has been 10 days from the positive test or start of symptoms, you may resume physical activity if you can accomplish these activities without symptoms:

• 1-day symptom free (excluding loss of taste/smell), and tolerating activities of daily living
• one light practice or 30 minutes minimum of cardiovascular exercise
• full practice
• may return to games

If at any time you have these symptoms, you should STOP EXERCISE and call us:

• * chest pain
• * shortness of breath out of proportion for upper respiratory tract infection
• * new-onset heart palpitations

What if you’ve already had sports clearance done? If your child has had a diagnosis of COVID-19 since then, it does mean another appointment and further screening. Call our office if you have any questions about these recommendations. Together, we can work towards a healthy future!