*Note, this blog will be periodically updated as new evidence emerges*
I hope this catches you on the upside of the corona-coaster ride we all seem to be on.
In case it’s not familiar term to you, that’s what accurately describes where I’m at during this pandemic: alternating between highs (“I’m adapting well, really proud of how I’m re-framing these challenges into positives”) and lows (“this really sucks, I’m so sick of this whole thing”).
Perhaps giving you some solid information and perspective today on staying healthy can steer the ride to a more positive path, or even better help keep you there.
So here’s what I’ve got for you today.
- What is the known risk of getting COVID by going to the gym?
- What are the benefits and risks of wearing a mask while you work out?
- Is Spectrum anything like a gym?
- Is now really the time to get healthy and fit?
Honestly, I’ve debated whether to write on these topics at all. There seems to so much anxiety and harsh judgement of differing opinions surrounding these topics. But my mission is to share the best available facts about health and fitness and help you apply them to your situation. And more often than not, the awareness of such facts is one small way to reduce uncertainty to help make optimal decisions for your unique circumstance.
What is the known risk of getting COVID by going to the gym?
Two very recent studies were released showing the risk of contracting COVID-19 from going to a gym was surprisingly low.
A researcher at the University of Oslo conducted a randomized control trial of early 4000 residents of Oslo in late May 2020 around when gyms were re-opened. Half of the subjects worked out at 1 of 5 gyms throughout the city, and the other half served as the control group. All participants were tested for COVID before the study, and again 3 weeks later. No participants from either group tested positive.
It should be noted that this study does not provide definitive proof that there is zero risk of anyone getting COVID-19 by going to a gym. Far more robust studies would be needed to have that level of certainty. It does show, however, in this population, the risk of becoming infected by COVID-19 was not increased by going to a gym where enhanced cleaning protocols and social distancing policies are instituted.
It should also be noted that there were no methods to determine the degree by which the individual participants (gym goers and gym operators) actually followed these policies. It’s also interesting that the participants in the study were not required to wear a mask.
It’s important to realize that results from one region does not exactly correlate with what would happen in another region. Population size, density, infection rates, etc are factors to consider when making a comparison.
Interestingly the size of Oslo, Norway where the study was performed is similar to Essex County Massachusetts (where Spectrum and OP offices are located). Oslo is only about 100K people smaller. Also, both regions are experiencing a significant decline in infection rates. However, at the time of the study, Oslo was averaging only about 43 new cases a day (late May to Early June), or about .06% of the population, while Essex county is experiencing about 200 new cases a day, or .25% of the population.
In short, this is very encouraging data, and likely the best available to show that the risk in a declined infection rate environment is low. (Bretthauer, M MedRxiv 6.24.20)
A better study to help determine the risk of going to gyms, however, would involve data from contact tracing from regions of the country experiencing a surge in cases that were not on lock down. This way we could determine where people were being infected and have evidence to consider the relative risks of various activities (Gyms, churches, restaurants, etc).
That is exactly what happened in Arkansas in June 2020.
After experiencing 678 new cases on a single day towards the end of June, Arkansas performed contact tracing on the infected individuals for the prior 14 days. They found that less than .3% of those infected had been to a gym during that time. To see how this stacks up to other activities: 2% had been to a church, 2% had been to a restaurant, 2% had been to a doctor’s office, .6% to a Barber, .4% to a hotel, and .3% daycare. This is very helpful information in that it tells us the risk of going to the gym related to other activities, and that the absolute risk is low. Go here for the report.
Also, according to data from a fitness industry consultant Blair McHaney of MXM/Medallia survey, the incidence of positive cases reported from 135 gyms and 3,443,123 check ins is .004% as of June 30th. This data, however, can not be verified as reflecting a true incidence because check-ins do not equal the number of people (each person may attend multiple times) and there is no standard or obligation established for gyms or individuals to report positive cases.
The same group teamed up with the International Health, Racquet, & Sportclub Association to perform a similar study involving 2873 gyms across the US from May 1- Aug 6 2020. After 49.9 million check-ins, only .0023% tested positive.
The evidence we have thus far shows that it is not likely to contract COVID-19 if you are going to a gym that follows enhanced hygiene and social distancing practices. Also, in places where there are surges, gyms are relatively less risky than other activities, like dining out, going to churches, and going to the barber.
No studies were performed in smaller facilities where more enhanced protocols were followed, such as a strict restriction on the number of people allowed per square footage, and higher ratio of employee to clientele dedicated to enhanced cleaning, a screening process upon entry, and enforcing a mask wearing policy. These are customary practices in smaller fitness studios. This would likely drive down the risks even farther. More on that later.
In summary, there is limited direct and indirect evidence to establish the safety of going to a gym in regards to your risk of getting COVID. The studies that we do have show the absolute and relative risks are very low and should be taken into consideration with individual factors and the benefits with the activity.
What are the benefits of wearing a mask while you work out?
So if you are going to work out around other people, you’re likely considering wearing a mask while doing so. But is wearing a mask even effective? Does wearing a mask while you exercise pose any risks or problems independent of the Corona virus?
There are good concerns to address, because we don’t want to incidentally harm our health while trying to do something to protect our health (reduce infection risk, improve health and fitness).
Let’s first briefly address why wearing a mask is effective, then we will address the risks of exercising with a mask on.
Wearing masks, of various forms, has been shown to decrease the risk of spreading viruses based on 88 studies. The PhD reviewers of this data at examine.com have done an amazing job of objectively reporting and summarizing the finding related to what masks do, and don’t do, to effect the transmissions of viruses, including COVID 19. It is the most thorough compilation of such data and is frequently updated, so I strongly urge you to peruse it. In short, they determine that masks will significantly reduce your chances of spreading and contracting COVID-19 compared to not wearing a mask. They also go into the relative effectiveness of different types of masks as well. Go here to check it out. Finally, I break down an excellent study from Duke on the effectiveness of 14 commonly used masks, as well as rank the masks with pictures here.
Since the benefits are well hashed out in the above referenced article, let’s address the risks. This is something that is equally important. If the risks of wearing a mask are well known, it is easier to weigh those against the benefits of wearing a mask to determine action.
What Are The Dangers Of Exercising With A Mask?
The most common claim regarding the risks of exercising with a mask is that exercising with a mask will impair your oxygenation levels, similar to being at high altitude. Others have claimed it will produce other symptoms, like lightheartedness, which are symptoms of a lack of oxygen.
Fortunately, we have some good evidence that can help us see if these claims are true. Some of this comes from indirect evidence and personal experience, others come from direct evidence.
Interestingly, most of the evidence exploring the dangers of exercising with a mask are performed with the intent to investigate the benefits of exercising with a mask! Altitude training masks were popularized several years ago and promoted as a means of enhancing performance through simulating altitude deprivation.
These altitude training masks are likely to be more restrictive than the cloth masks or surgical masks that most would be exercising with. Plus, studies looking at altitude training masks are having subjects exercise intensely. This means that if masks were to pose a problem, since they are more restrictive and subjects are working harder, these studies would certainly find these dangers if they did exist.
So let’s see what they found.
Several studies failed to show that they actually improved aerobic performance compared to exercising without a mask. One study found wearing masks did actually improve the performances of respiratory muscles, but it did not directly result in improved aerobic performance. None of these studies showed a decrease in aerobic performance from mask training. (Warren, B, et. al. Int J Exerc Sci 2017. Sperlich, B, et. al., Military Medicine, 2009. Maher, M, Master’s Thesis) New Jersey. William, Paterson University, 2016. Biggs, NC, et. al., Int J Exerc Sci, 2017. Porcari, JP, et. al. E J Sports Sci Med, 2016. Sellers, et al. JSCR 2016. Bellovary, BN. et al Journal of Human Sport and Exercise. 2019).
3 Studies measured whether altitude masks reduced oxygenation levels. Two showed no change (Bellovary, BN. et al Journal of Human Sport and Exercise. 2019. Jagim, AR. JSCR 2018) and one showed oxygen saturation levels briefly dropped to 90% when the mask was adjusted to it’s most restrictive setting, which is still above the 88% level at which supplemental oxygen would be needed and symptoms experienced if sustained (Granados, Jorge et al. JSCR 2016).
The evidence convincingly shows that altitude masks do not significantly reduce oxygen saturation. Given that altitude mask are likely more restrictive and subjects were exercising at very high intensities, it is very likely that recreational exercise with a less restrictive mask will not cause oxygen saturation compromise. When we address investigations using surgical masks below, we’ll have an even stronger case to refute this assumed danger of wearing an exercise with a mask.
What About Other Risks Of Exercising With A Mask?
Going back to studies on exercising with altitude mask we can find some insights about other side effects of exercising with a mask.
One study reported that perceived effort and anxiety did increase in those wearing masks, but to a small and not statistically significant amount. (Granados, Jorge et al. JSCR 2016). Studies on weightlifters wearing masks found that perceived effort was higher, bar speed was slower, and there was inconsistent findings on whether the total amount of work done was effected. (Jagim AR, JSCR 2018. Motoyama, Y.L., et al. Sports 2016, Andre, TL.JSCR 2018).
Another perceived risk is that masks do make breathing more challenging. But this isn’t necessarily bad. For many of those who have breathing problems, that is precisely the aim of respiratory therapy. Cardiopulmonary Physical therapists and Respiratory Therapists use devices for patients designed to temporarily make breathing harder with the goal of strengthening their inspiratory muscles! This is similar to what we do for people with weak muscles. We have them do strengthening exercises to make them stronger.
So the notion that we should avoid mask because of the fear that masks make exercise harder is not based on sound reasoning. It’s like saying we should take off our clothes when we run because clothes make us heavier. A more reasonable approach is to appreciate that respiration will be impaired and your workout may feel more difficult, so alter your workout dosage by resting longer or reducing the intensity (at least initially).
It is important to reiterate two issues regarding all of the above studies discussed when interpreting risks of wearing a mask:
- These studies were mostly done on people working out at extremely high levels.
- The altitude masks are not the same as cloth and surgical masks that folks may be exercising with. Altitude masks are likely more restrictive than cloth and surgical masks, however no studies that I am aware of have compared them both. Thus the risks inferred from these studies are indirect evidence.
Few studies exist regarding the risks associated with surgical and cloth masks. While there is some evidence to suggest decreased oxygenation, skin breakdown, and headaches with prolonged use of N-95 masks, no one is exercising at a gym with one of those, and if they are, it is for a relatively short duration. A few studies on healthcare workers do report increase sensations of being hotter than normal (Marabito, M. et al Sci Total Environ. 2020) , and increased heart rate by workers who use surgical masks (Li, Y. et al. Int Arch Occup Environ Health. 2005). However, there is little data to prove that wearing masks have any negative side effects with exercise. Regardless, the above potential side effects can be easily managed by exercising in temperature controlled environments and modifying activity (more frequent rests, monitoring heart rate).
For some direct anecdotal experience, I have performed a few sessions of intense exercise while wearing a mask. I documented what that experience was like here in a quick video. While I did not notice any performance changes, I did get hotter quicker and needed to take quick mask free breathers outside.
A Cardiopulmonary Specialist and PhD researcher gives a detailed account of restricted breathing implements used with respiratory compromised patients, and tracks his respiratory metrics real time here. If you want to skip the video, the O2 saturation does not significantly change.
While these anecdotes and demonstrations can’t serve as evidence that there are absolutely no risks, this adds to a strong trend that exercising with masks are safe. Just be sure to account for feeling warmer and breathing harder than you would otherwise.
We should also look to comparisons to familiar examples of people being active with similarly masked scenarios. It really should not be of much of a surprise that masks cause little complication with exercise, especially when you consider that skiers and motor cyclists wear masks and face coverings for prolonged periods while expending energy without issue.
Some experts do consistently recommend that surgical masks get thrown away as soon as they become moist and they also recommend that cloth masks get cleaned frequently. This makes sense as moisture makes the masks less effective, and wearing masks may increase the frequency of touching them with your hands.
*Fortunately, a recent study in Canada did investigate the effects of wearing a surgical or cloth mask compared with wearing no mask in healthy individuals exercising vigorously. The results showed no difference between mask wears and non-mask wears in performance, arterial oxygen saturation, tissue oxygenation index, rating of perceived exertion, or heart rate at any time during the exercise tests. (Shaw, K et al. Int. J. Environ. Res. Public Health. Nov 2020)
In summary, the physiologic rationale and research is strong to support the idea that wearing a mask while exercising near others confers a benefit while posing little, if any, risk.
Is Spectrum Similar to a gym?
No. Philosophically and structurally, Spectrum is very different from a gym.
This is a vital distinction to make.
Many people need help to get healthy and fit. Getting this help can be the difference between being unhealthy vs taking actions towards feeling great, performing well mentally and physically, and lowering your chance of acquiring one of 34 different diseases or conditions, including improving COVID-19 survival.
Many people make the mistake in assuming that this help and support is tied to going to a gym. And if people believe going to a gym is too risky, they will get stuck in a frustrating holding pattern at best, and spiraling down towards decreased health, fitness, and morbidity at worst. COVID-19 will then lay claim to another casualty: an infectious disease now becomes a contributor to non-infectious disease.
But it doesn’t need to be that way.
Because when fitness studios like Spectrum get lumped into the same category as gyms, this perpetuates the notion that people are without safer solutions to help guide them to their essential health and fitness goals.
The difference between a gym and Spectrum is best appreciated by comparing a library to a school.
Let’s first consider the structural differences, as this is important to the risk of contracting COVID-19.
Public libraries and private school libraries are similar in that they both have books and are places to learn. Similarly, gyms and the Spectrum Fitness studio both have weights and exercise equipment, and are a place to exercise. But the structural differences are important. Public libraries have large amounts of the general public in the region coming and going, perhaps hundreds of people a day. Small private libraries have a smaller number of known members, so you can regulate who will be there. The ratio of staff to patrons is very low, where as there are more staff to patrons in smaller libraries.
This allows you to better service the facilities and make sure everyone is following the rules. The same can be said for gyms vs Spectrum. At gyms, it is very difficult to regulate who is coming and going in a gym, how many people there are, make sure they are following the procedures, and clean the facilities to the same extent as you are able to in a smaller, appointment only, well controlled environment like the Spectrum studio. You can see what Spectrum is doing to keep our studios safe during the pandemic here.
Most important is our ratio of employees to clients, max allowable people per square feet, and masks protocol that makes a clear distinction between how we are following these protocols vs other environments.
But the philosophical differences between gyms and Spectrum are even more important.
If you want your kid to learn, you don’t just drop them off at a library and tell them to go get smart. They would be overwhelmed and lost. Maybe they would just go find the magazines or computers and hang out there because that’s where they feel comfortable, and that’s where most people are going. But they won’t likely learn much, and if they do, it will take them quite a while.
Rather, you enroll them in a school with a curriculum designed for their abilities, guided by a teacher. It just makes sense.
Going to a gym is like going to a library. At a gym you get most of the tools you need and space to use them. But you are mostly on your own without any strategies. And based on the data, you won’t go very much or use it regularly, if at all.
Going to Spectrum is like going to school instead of a library. At Spectrum, you get assessed, have a plan tailored to you and modified as you progress. It’s guided by an expert assigned to you, progress is constantly monitored, and there’s feedback tailored to empower you, just like a private tutor in an elite school system does for their students. Instruction is individualized or in small groups, just like one to one attention and low student to teacher ratios so strongly coveted in high performing schools. Multiple subjects are addressed, and if you need special assistance, it is available for you onsite.
Let’s say your child needs a reading specialist. You would not want to pull them out of school, take them across town to see the specialist, and bring them back to school every day. It would be best if the specialist was in house, or even better if their teacher was also a reading specialist. That’s what happens at Spectrum. If you have an ache, pain, or injury, you have access to physical therapists onsite to help manage that issue right away, delivering far more effective and convenient treatment.
You don’t drop your kids off at a library and expect them to be educated. Yet, we are using this same mentality with our health and gyms.
Now, more than ever, we need to re-evaluate what works to get healthy and fit. Doing so will positively affect every aspect of our health, including our immune systems and our sanity, which are directly under assault during this pandemic.
If we are going to purse exercise, we want to make sure it’s effective and safe. While gyms are an option, they are not the most safe and most effective option.
Rather, fitness studios like Spectrum are more effective and safe. Some may say it is not an option for many, much like individualized instruction by specialized teachers or tutors is not an option for many students. But that’s not entirely true. Good teachers provide resources for independent learning and empower students to utilize these resources beyond the presence of the teacher or the school. For example, a good teacher will provide assignments that take advantage of all the resources uniquely available to the student. They give them assignments to complete at the library, or in their home, depending on their circumstances.
Similarly, Spectrum coaches can show you how to make the best of your gym if you are ready to go back, or make the best use of your home if that is where you can exercise. While doing this long term isn’t sustainable for everyone, the short term investment pays off long term dividends. In fact, many who work with Spectrum are able to avoid gyms completely while achieving amazing results, as we have taught them how to replicate highly effective routines in their homes.
Like a great school with amazing teachers which is so universally valued in education, Spectrum strives to provide the same value to health. We all know that a beautiful library is nice, but it is the schools and the teachers that make the big difference.
In the same vain, I’m all for a well-stocked gym, but private instruction with expert trainers, physical therapists, and nutritionists is what gets results and provides true value.
Is now really the best time to get healthy and fit? Shouldn’t we wait until this whole thing blows over?
This pandemic has caused us to fear for our health, and rightfully so. While not as urgent or imminent as a highly contagious and infectious virus like COVID-19, we must remember that non-communicable diseases also are very important, and account for 71% of the causes of death worldwide each year. These are the diseases like heart disease/stroke, diabetes, cancer, mental illness, and respiratory diseases. These diseases also cause millions of premature deaths and a large percentage are preventable. Debilitating musculoskeletal conditions like arthritis and chronic pain are a forgotten, but immensely important related conditions.
Proper exercise and nutrition are critical means of preventing those non-communicable diseases and conditions from causing premature death. In fact, inactivity itself is responsible for approximately 1.6 million deaths a year. Such non-communicable diseases are thought of as ‘far away in the distance’ issues. You don’t catch a heart attack by hanging out too closely with friends. But COVID-19 is a ‘right here and now’ problem that has spread rapidly. While non-communicable diseases don’t seem as urgent as COVID-19, they are equally, if not more so, important.
Prior to the pandemic, the ways to prevent non-communicable disease was hampered partly by misinformation and partly by how to do it. As if these challenges were not enough, now with this pandemic the focus on these diseases is diminished.
This is a huge mistake.
It’s important to realize that we can’t treat communicable diseases like COVID -19, the flu, pneumonia, etc. by ignoring non-communicable diseases.
Fortunately, we can take similar actions to address both. Some of the ways we can address one problem simultaneously helps us fight the other.
For example, exercising has shown to help reduce the risk of premature death and rates of cancer by 29% and 34% respectively. Regular exercise has also proven to improve immunity, acutely and chronically, and lessen the time to recover from illness. Read more about this in our previous blog here. Furthermore, obesity is a huge predictor of severe illness in those who contract COVID-19. Go here for the extensive research on this association. Reducing excess body fat will not only reduce the risks of many non-communicable diseases, including some cancers and arthritis, it will also increase the chances of surviving a COVID-19 infection.
Improving health and fitness can be difficult under ideal conditions. With the added challenges of a pandemic, it can seem even more so. But it’s not really the case.
Many are needlessly complicating the process by equating getting fit with going to a gym. And since going to a gym may be out of the question for some, their plans to get healthy seem to be as well.
The truth is that there has never been a better time to get healthier. Using the pandemic as an reason to hold off on improving your health isn’t valid. Here’s why.
- Expert coaches, not gyms, are the key to getting help and support for your fitness journey. Much research has proven the power of coaching. And coaching is far more readily available now than ever. Spectrum offers comprehensive and unique coaching, including fitness, rehab, and nutrition in one service. It’s offered in our studio and modified to the best practices of the COVID-19 pandemic. It’s offered online virtually as well so you can get coaching and instruction at home, even if you lack a lot of equipment. I’ve written a book on that.
2. Time is the biggest constraint to getting healthy and fit for most. And many people have more time available now, with less commuting, traveling, and socializing.
3. Scientists are re-emphasizing the importance of getting healthy. Now more than ever, people are routinely hearing the message that exercising and losing weight is vital to stay healthy during a pandemic and reduce the severity of illness should you have COVID-19. Not believing that you need to make changes is a major obstacle for people to get motivated to exercise, lose weight, revamp their routine, fix their knee, get stronger, have better mental health, etc. The science is getting harder to ignore
4. Adaptability is making a comeback. Most can thrive under ideal circumstances. Fewer know how to adapt to changes and thrive. This ability is a skill that can be learned, but is rarely taught in large group classes, and never learned by mindlessly following old routines. Our clients are taught to think like an elite quarterback; Go into the game with a plan, go into each play with a clear strategy, but be able to adapt at the line of scrimmage and change the play on the fly. That’s how you move forward in a changing world. The world throws a lot of challenges at us: sickness, work, kid struggles, social responsibilities, and even pandemics. Perfect plans for perfect situations fail miserably. Ideal plans for real life allow for adaptability. If you can learn how to adapt better health habits now, you can do it anytime. And that is exactly what we have seen from our clients over the last few months. The majority of our clients have lost weight, gained muscle, and improved health markers- in the midst of a pandemic! Equally admirable, many have held on to their progress, rather than regress in the face of a challenge.
To wrap up, gyms may be a safe place to go based on the limited evidence we have, masks are a good idea to keep you safe and will not harm you if you exercise with one on, Spectrum is completely different from a gym, and now really is the best time to get started on getting fit.
Take action by scheduling a free consult here.
Ask me your fitness questions and get them answered live here
And get a free home exercise program here.
We’re always here to help you get healthy and fit, pandemic or not!