Amid all the rules to stay put during the coronavirus outbreak, there's a consistent companion message: it's important to keep moving. Exercise, outdoors and indoors, helps maintain good physical and mental health during this stressful time.
But for those movers, there are rules too.
Let's start outside, where health experts say the risk of infection is lower than inside.
"That's due to a variety of factors," says Dr. Kevin Winthrop, a professor of Infectious Diseases in Epidemiology and Public Health at Oregon Health & Science University in Portland.
"Usually there's a lot more social distancing outside," Winthrop says. "And environmental factors like wind and UV [radiation, which degrades most viruses] make it less likely you're going to come in contact with viral particles."
Biking, running, power-walking can be done while maintaining at least a 6-foot social distance. Hiking too, although at times that 6 feet can shrink to near nothing on narrow trails.
"I think the risk is extremely low in those situations," Winthrop says. "Of course if someone coughs on you right when you're passing them then there'd be risk. If you find yourself in that position where you have to pass someone on a trail, standing aside and giving as much [room] as possible, not coughing or sneezing while that person's going by, would be greatly appreciated."
When possible, outdoor exercisers should even try to increase the recommended 6 feet of social distancing.
"The mnemonic I like to use is double your distance," says Dr. Ben Levine, a professor of Medicine and Cardiology at the University of Texas Southwestern Medical Center in Dallas. Levine also directs the Institute for Exercise and Environmental Medicine at Texas Health Presbyterian Hospital.
"The greater volume and rate of breathing that occurs during exercise has the risk of spreading droplets farther," Levine says. He doesn't have actual data, but says, "I think it's reasonable [to increase social distancing] based on the known changes in breathing during exercise."
How about a catch?
For many, outdoor exercise isn't much fun without throwing or hitting some sort of ball, with another person waiting to throw or hit it back. Are these simple acts of fitness and companionship still safe?
Yes. With some commonsense guidelines.
Winthrop recently let his young son play catch with a friend who lives across the street.
"The [friend] had been in his house the last two weeks [with] no symptoms," Winthrop says. "I let them throw a baseball but I made them wash their hands before and I made them wash their hands after. I told them not to touch their faces with their hands. And I reinforced the idea that they had to be at least six feet apart, which of course is easy to do when you're playing catch."
For his daughter, who plays high school and club basketball, the rules were similar.
"It's a great time not to play one-on-one," he says, "but to work on your game [by yourself]. You can play horse with one other person or two other people maybe. With the before and after hand-washing and maintaining social distancing."
Winthrop doesn't know of any documented transmission of COVID-19 through a baseball, basketball, football or frisbee, although he says it's theoretically possible.
"I guess you could sanitize your own ball and you can wash your hands before and after using it," he says.
In Texas, Dr. Levine thinks it's "quite reasonable" for two people to have a good catch, [as long as they're] without symptoms, without fever, [they've] been sheltering at home and haven't been exposed to COVID-19 patients.
He advocates using a sterile wipe to clean the ball beforehand. And his pre-clean advice also applies to other ball sports.
"For example I play tennis," Levine says. "[I] played this past weekend with a colleague who feels well and is without fever. I took some sterile wipes and I wiped off the net. I carefully cleaned off the racket. We only used brand new balls. We washed our hands before and after. And we were social distancing at about 72 feet. So I thought that was a pretty safe social distance."
Moving indoors
With gyms closing around the country, many people are discovering, or re-discovering, the joys and challenges, of indoor home exercise.
It's been nearly 70 years since the late fitness guru Jack LaLane took to the relatively new invention of television to lead millions of Americans on a path to physical fitness. Today, video-chatting, Skype, the meeting platform Zoom and countless online fitness classes are giving people around the world many more tools to stay inside and stay fit.
It can be as simple as a yoga mat and a laptop or phone. Or even simpler.
"Two words: jump rope," says Mayo Clinic exercise physiologist Dr. Michael Joyner.
The current situation is more of a challenge for those whose personal fitness is a team effort.
Aaron Orton is a personal trainer who lives and works in Eugene, Ore. The former Marine Corps infantry squad leader has built a bustling business over the past decade.
"Usually I'm packed," says Orton, who's 34. "8 [a.m.] to 8 [p.m.] every day. [But] I'm probably [at] a third, or half [of his client list] right now. I've told those sticking with me [during the outbreak] their patronage will not be forgotten."
Due to social distancing and stay-at-home rules, Orton has made the transition to online training, "seeing there are so many tools for us to use now."
He says his client list has dwindled because of obvious financial reasons. But also because some prefer the one-on-one in-person sessions. And so does Orton.
"When you're in-person with somebody," he says, "you can not just visually demonstrate something, but everything else. The subtle facial expressions, the movement patterns and the feeling [of those patterns], and being able to show people exactly what they need to feel and do. [This] transfers the information a lot more effectively than me saying 'hey, watch this video and this is how you do a movement.'"
Orton's Genuine Fitness in Eugene is about a 4,000-square-foot facility just for personal training, and not a membership gym. It's shut down for the foreseeable future.
"We're given this hand right now, and we've got to play it," Orton says.
Fit or fat
Youth athletic coaches are doing what they can as well.
The Galaxy is a boy's elite travel soccer team in Takoma Park, Md.
Without in-person access to his teenage players, Galaxy head coach Alex Kao sent detailed instructions on what team members are expected to do, absent normal practices.
The instructions include three to four training sessions a week of 75 to 90 minutes. The sessions should include agility/footwork, cardio/fitness and "ball mastering." The team is connecting on Zoom to train together virtually, allowing the coach to have some presence with his players.
And parents are asked to engage as well. It's hoped they provide motivation for the kids if the player's drive starts to flag. Toward that end, coach Kao is counting on parents to do "30 minutes of cardio four times a week."
"If their parents are getting after it," the coach's handout says, "then [the players] should push more."
For those parents who do get after it, it's an added benefit. Under normal circumstances, they'd mostly be dropping off and picking up their aspiring soccer stars. This way, Galaxy team manager Elizabeth Sullivan jokes, parents have a choice. "When this is over, you'll either be fit or fat."
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