Mononucleosis (mono) is a viral infection, often caused by the Epstein-Barr virus (EBV), though other viruses can also be responsible. Symptoms include extreme fatigue, sore throat, and fever. Many active individuals with mono wonder about the safety of strenuous physical activities like weightlifting during recovery. This article addresses considerations and precautions for exercise during and after a mono infection.
Why Lifting is Risky
One of the primary concerns with mononucleosis, especially regarding strenuous activities like weightlifting, is the potential for an enlarged spleen, known as splenomegaly. The spleen, located in the upper left abdomen, filters blood and helps fight infection. During mono, it can swell, becoming softer and more fragile. Up to half of individuals with mono can develop splenomegaly.
An enlarged spleen is vulnerable to rupture, a serious and potentially life-threatening complication. While splenic rupture is rare (less than 0.5% of cases), it is the leading cause of death associated with the infection. The risk of rupture is heightened by increased intra-abdominal pressure or direct impact to the abdomen. Activities like heavy lifting, which increase abdominal pressure, or contact sports, can lead to this severe injury. Most splenic ruptures occur within the first month of symptoms.
Safe Activities During Recovery
During the acute phase of mononucleosis, prioritizing rest is paramount for recovery. Intense physical activity can prolong symptoms or increase complications. Even if fatigue is not severe, the body is under considerable stress.
Light, non-strenuous activities are permissible if an individual feels up to it and has no fever or dizziness. Examples include gentle walking, light stretching, or mild household chores. Listen to the body’s signals and avoid any activity causing fatigue or discomfort. High-impact sports, heavy lifting, and any activity risking a fall or abdominal trauma should be avoided due to splenic injury risk.
Resuming Exercise Safely
Returning to strenuous exercise, including weightlifting, after mononucleosis requires a cautious and gradual approach. Obtaining medical clearance from a healthcare provider is the most important step before resuming intense physical activity. A doctor will assess recovery and evaluate spleen size. Physical examination alone may not reliably detect splenomegaly, so imaging like ultrasound may be used to confirm the spleen has returned to normal size.
Avoid contact sports and heavy lifting for at least one month, often longer, after symptoms appear, potentially up to 8 weeks or until splenomegaly resolves. Once cleared, a gradual return to exercise is advisable. Begin with light activities and slowly increase intensity, duration, and resistance. This phased approach allows safe reconditioning and helps prevent setbacks.
Warning Signs to Watch For
While uncommon, splenic rupture is a serious medical emergency. Individuals recovering from mononucleosis should be aware of the warning signs. The most prominent symptom is sudden, severe pain in the upper left abdomen, which may radiate to the left shoulder (Kehr’s sign).
Other symptoms indicating internal bleeding or shock include dizziness, lightheadedness, confusion, and a rapid heart rate. The abdomen may also feel tender or swollen. If any of these symptoms occur, especially after physical exertion or minor impact, seek immediate medical attention. Prompt medical intervention is necessary to manage internal bleeding and repair the spleen.