Miami-Dade County

A Local Healthcare Expert Shares Tips on Exercising While Wearing a Mask

Dr. Stewart says that wearing a mask while doing strenuous workouts is worth it if it means gyms can stay open; while there are some short-term risks, the practice also carries long-term benefits

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Public health guidelines have been back-and-forth in Miami-Dade County, where the mayor reversed his decision on gym shutdowns. Now, gyms and fitness centers are allowed to stay open, but everyone indoors is required to wear a mask, even when you're working out.

NBC 6's Roxanne Vargas sat down with Dr. Allan Stewart, Chief of Cardiac Surgery at HCA East Florida, about what the risks and benefits are of working out with a mask, and what we should watch out for when doing it.

Roxy: Dr. Stewart, how much more should we expect our heart rates to go up when working out with a mask?

Dr. Stewart: There’s so much controversy over reopening gyms with masks because it does impose a bit of a risk. It’s critically important, now that we’re wearing a mask, to have a heart rate monitor. Because what we’re used to, at least those who exercise a lot, is maintaining a certain pace when we use a treadmill, elliptical, etc.

That’s not going to be your case with a mask. Any mask that does its job creates a degree of restriction of your breathing, and that restriction along with higher heart rates translate into low oxygen. That’s going to have an impact on your heart rate and on your endurance.

So, it’s important when wearing a mask to lower that expectation a bit, and build back up. If you’re running an 8 minute mile, start off on a 10 minute mile, but pay attention to your heart rate. Remember it’s your zone of exercise that’s important; wearing a mask will make you reach zone four, 80-90% of your maximum heart rate, quicker because you're restricting the flow of oxygen.

Roxy: Let’s talk about that the flow of oxygen, our breathing. We’re exhaling more carbon dioxide during our workout, into our mask, so what’s the effect of that?  

Dr. Stewart: In the long-term training that many endurance athletes do to prepare for triathlons or marathons, they'll often go to Colorado and train in high altitudes in the mountains. That's essentially what we're doing when we wear a mask. We're restricting our breathing, and therefore restricting the amount of oxygen that comes in. In the short-term, that puts your heart under stress, and it does increase your risk of having a heart attack, passing out, or getting dizzy.

You don't have the same degree of oxygen flow in your body, so it's important to pay attention to pay attention to pay attention to that, and lower your expectations prior to training at maximum. Your high-intensity and interval training classes like CrossFit, like 54D, that really require maximum exertion, you really need to bring down your standards a little bit to avoid any increased risk to your life.

Roxy: There's a lot of technology that people use nowadays to keep track of their heart rates during a workout. Is there a number we should look out for, that would indicate we need to tone it down?

Dr. Stewart: It's a very simple formula: 220 minus your age in years. That's your maximum heart rate. I'm 50 years old, so my maximum heart rate is 170. Ideally, for cardiac conditioning, you want to be between 80-90% of your maximum heart rate, so take your maximum heart rate (220 - your age) and multiply it by .8 or .9. That is the zone you want to stay in.

When you start exceeding your maximum heart rate, you're not giving yourself any benefit fitness-wise, but you are starting to risk having too high a heart rate. You're not adequately getting blood flow through your body.

Roxy: Is there a positive here, other than protecting ourselves from COVID-19? Could we see a higher calorie burn?

Dr. Stewart: Absolutely. Again, you're putting yourself under more stress by training with a mask. What you don't want to do here is check a box and wear a mask that has no restriction at all, because you're not helping yourself or others The reason we wear masks is to prevent a spread of disease. It's important to wear one that has some degree of restriction.

Any degree of restriction of breathing will increase your cardiac restriction over the course of time; it's a short-term risk but carries long-term benefits. So yes, training with a mask does not have benefits over time, and it will increase your endurance.

These masks are going to be with us for a while, and we're going to be wearing them at the gym for a long period of time. The consequences of not wearing masks and having to close gyms again, I think outweigh keeping them open, because as a heart surgeon, the people I've seen that have been in quarantine for so long are smoking more, drinking more, eating poorer qualities of food. They're not exercising and gaining weight. So I think getting to the gym and wearing a mask will give people the opportunity to hit 'reset' on those 12 or 14 weeks that we have spent in quarantine, and start prioritizing our health, our cardiovascular fitness.

Roxy: This is a question from one of our viewers, Jose Suarez. Are there specialty masks for this, or do regular masks that we're wearing all the time work the same when we use them at the gym?

Dr. Stewart: The important thing to note is that when we exercise, we're essentially panting. That's going to accomplish two things: we're getting rid of carbon dioxide, and we're trying to bring our temperature down. It's much like when we see a dog with its tongue out when it's hot and trying to get rid of moisture and heat. Disposable masks, the ones I wear in surgery, are useless once they're wet, so those aren't advisable to work out in.

Wear a fabric mask, one that you can easily take off, rather than a tie-on that may create more anxiety. You also want something that dries quickly, something comfortable that you can take on and off, not something that will be attached to your face.

Roxy: My mask was drenched in sweat this morning during my workout at the gym, and certainly afterwords. Does that minimize the mask's protection?

Dr. Stewart: Absolutely. Remember that a mask is a filter, and that filter has little pores in it. If they get clogged with droplets of sweat, then they won't be able to do their job anymore. You want something that's not stuck to your skin, so that you won't wet the mask when you sweat.

Roxy: What about changing your mask during a workout?

Dr. Stewart: I think that's a great idea. The only downside is (you have to be careful about when you take the mask off.) If it's in the middle of an intense workout where people are breathing at 40 or 50 breaths a minute, having all of them take off their masks to swap for a new one during a water break in a closed space would kind of defeat the purpose of having a mask in the first place.You'd need to be cognizant, and time who changes their mask when.

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