Shingles is a painful condition caused by the reactivation of the varicella-zoster virus (VZV), the same virus responsible for chickenpox. After an initial infection, VZV remains dormant in the nervous system for years. Many people wish to maintain their routine, making the question of whether physical activity is appropriate during an outbreak common. Understanding the systemic nature of this viral infection and the risks involved with intense physical exertion is necessary before considering any workout.
Shingles is More Than Just a Rash
Shingles, also known as herpes zoster, is a viral infection involving the nervous system, meaning symptoms extend beyond the localized skin rash. Before the characteristic stripe of blisters appears, many people experience a prodromal phase. This phase is marked by deep, shooting, or burning pain, tingling, or itching along the affected nerve path on one side of the body. This intense nerve pain (neuralgia) results from the virus reactivating and traveling along the nerve fibers.
The body’s response is systemic, often manifesting as flu-like symptoms that indicate a widespread infection. Common symptoms include severe fatigue, headache, and fever. Since the immune system is actively suppressing the reactivated virus, the body’s energy reserves are heavily taxed. This establishes a rationale for prioritizing rest and recovery, even before the rash appears.
Why Intense Exercise is Not Recommended
Strenuous exercise during the acute phase of a shingles outbreak carries several risks, primarily by interfering with the body’s natural healing process. Intense physical activity requires a significant amount of metabolic energy, which would otherwise be directed toward supporting the immune response. Diverting this energy can potentially prolong the recovery time and worsen systemic symptoms like fever and exhaustion.
Physical activity also poses direct risks to the blistering rash, which is highly sensitive and contagious during the weeping phase. Movements involving friction, chafing from clothing, or excessive sweating can irritate the fluid-filled blisters, potentially causing them to rupture or become inflamed. This irritation increases the risk of developing a secondary bacterial infection in the open sores, which complicates healing and increases the likelihood of permanent scarring. Loose-fitting, natural-fiber clothing is recommended to minimize this irritation.
There is a public health consideration regarding the contagiousness of the virus. VZV is spread through direct contact with the fluid from open blisters to someone who has never had chickenpox or has not been vaccinated. Exercising in public spaces like gyms or pools creates environments where blister fluid could easily spread to equipment or surfaces. Avoiding shared public spaces prevents transmission and protects vulnerable individuals until the rash is completely crusted over and no new blisters are forming. Furthermore, intense exercise, particularly movements that stretch or compress the area of the affected nerve, can severely exacerbate the already debilitating nerve pain.
When and How to Safely Resume Workouts
The decision to return to exercise should be based on clear physical benchmarks, not a fixed timeline. The most important sign that activity can be considered is the complete resolution of the rash, meaning all blisters have dried out and fully crusted over. All systemic symptoms, such as fever and debilitating fatigue, must also have completely subsided. While blisters typically dry and scab within 7 to 10 days, the scabs may take several weeks to fully clear.
When restarting physical activity, a gradual and moderate approach is advised, as this is a time for gentle healing. Initial activities should be low-impact and low-intensity, such as light walking, gentle stretching, or movements like Tai Chi. The goal is to maintain movement without placing undue stress on the recovering body or the affected nerve path. Avoiding high-intensity cardiovascular workouts and heavy lifting is prudent until complete recovery is confirmed.
Monitor the body closely for any signs of discomfort or renewed symptoms. If any activity causes an increase in pain, new fatigue, or discomfort in the previously affected area, the exercise should be immediately stopped. Individuals who experience postherpetic neuralgia—persistent nerve pain that can linger after the rash heals—should consult a healthcare provider before resuming rigorous activity. The reintroduction of exercise should be a slow process, prioritizing listening to the body’s signals over returning to previous fitness levels.