Since mid-March, most of the country has been dealing with social distancing rules, stay-at-home orders, business closures, overcrowded hospitals and limited health services.

Consequently, many people are feeling isolated and lonely and may be hurting emotionally and financially. Even as parts of the world are reopening, the fear of coming into close contact with someone who has the virus is causing many to feel anxious.

As we navigate the latter half of 2020, the far-reaching effects and potential traumas associated with COVID-19 are still unfolding. Few people will be unaffected by the pandemic, and mental health experts expect that post-traumatic stress disorder (PTSD), most commonly associated with combat veterans, may become more commonplace. COVID-19 survivors, in particular, are at high risk for developing PTSD (Xiao et al. 2020).

How can you help clients who need to move, be heard and be seen? This article takes a broad look at PTSD, how exercise can help, and what you as a fitness professional can do, all while remaining within scope of practice.

Note: The information provided is for general education purposes only. Do not diagnose or attempt to treat a client who you believe may have PTSD. Always refer the person to a qualified healthcare professional.


PTSD is a mental disorder that can develop after a person is exposed to a traumatic event, such as a natural disaster or serious accident; a terrorist act; war/combat; or violent personal assault, such as rape (APA 2020). Symptoms include disturbing thoughts and feelings, dreams related to the event, mental or physical distress due to trauma-related cues, and an increase in the fight-or-flight response.

While symptoms usually begin within the first 3 months after the event, they may not occur until years later, especially if the event is not acknowledged or processed. Trauma survivors often develop depression, anxiety and mood disorders (APA 2020). Drug and alcohol abuse are also common.
Events that often trigger PTSD:

• wartime trauma
• child abuse
• sexual assault or abuse
• physical violence
• threats with a weapon
• fire
• life-threatening illness
• traumatic injury
• kidnapping
• a traumatic accident (e.g., car/airplane crash)
• a natural disaster
• a terrorist attack
• an abrupt, unexpected event like the pandemic

People who lack a strong support system, endure long-term emotional trauma, or have an alcohol or substance-use problem are especially vulnerable to PTSD.
Symptoms of PTSD:

• chronic anxiety
• difficulty falling or staying asleep
• irritability
• anger and angry outbursts
• panic attacks
• hypervigilance (being constantly on guard for threats)
• excessive startle reflex (a tendency to be easily startled)

Trauma that results in PTSD may occur over a long period of time or as a single event (National Collaborating Centre for Mental Health 2005). Symptoms such as hyperarousal (an abnormal state of heightened anxiety) typically develop as a result of the body’s overreaction to the stress response, which causes biological changes in the brain.

Simply remembering a traumatic event can trigger this effect (Center for Substance Abuse Treatment 2014)—even if the threat is gone, the body responds as if it weren’t.