LifeBridge Health, a regional health care organization based in Baltimore, MD, has partnered with Under Armour in some mask research and development. Now, as COVID-19 stay-at-home orders ease and athletes of all levels consider returning to their pre-pandemic workouts, it is dealing with questions about how to do so safely.

Dr. Daniel J. Durand, chief innovation officer for LifeBridge, answers some common questions about exercising while wearing a mask to provide clarity amidst confusion and help team dealers guide athletes looking to get back in the game.

‍While social distancing is still the main way to halt the spread of the coronavirus, the alternative has been to wear a face mask in places where social distancing isn’t possible. Should people working out follow the same guidelines?

Dr. Durand: Absolutely. I think of wearing face masks as a team sport, because it requires the participation of each team member to be successful. When everybody wears masks together, it can be quite effective in reducing the spread of COVID-19, which could be especially important in close-contact environments like a gym or when training with a group.
When it comes to physical activity, you breathe more and the more you breathe, the more virus you will project if you have it, so it’s very important for those exercising to wear a mask where social distancing is difficult to maintain.There is more and more science suggesting that the decision to wear masks has had a positive impact on lowering transmission within a community.

Should those exercising wear a mask for both outdoor and indoor workouts?

‍Location aside, proximity to others is the most important factor to consider when deciding whether to wear a mask while working out. When it comes to wearing a mask when exercising indoors and outdoors, there is some gray area. If you’re running outdoors and you know that you aren’t going to get near anyone, it’s probably not necessary to wear a mask. But there are a few other scenarios athletes may find themselves in where it is a different story.
For example, athletes may be together training on a field and need to get close to discuss a play with teammates or their coach. In that case, they may project respiratory droplets when speaking. Or, if you’re running right next to someone else indoors on a treadmill.
Although no one has proven masks can prevent 100 percent of COVID-19 spread in the gym environment, there will be far fewer droplets if athletes have masks on, which should be safer for everyone.

If an athlete is going to be around others while exercising, what is the best kind of face covering to wear?

‍The most important thing to look for in a face covering is proper fit. An effective face mask will keep the nose and mouth covered consistently. If it’s so uncomfortable that you’re constantly adjusting it or wearing it incorrectly, then you might as well not be wearing a mask at all.
In addition to fit, athletes should also consider the mask’s material. If certain masks get wet and touch your lips, particles from outside the mask could wind up seeping through the barrier into your mouth, so it’s best to find a mask made of materials that will wick moisture away from the wearer.

Finally, there should be an element of breathability in an athlete’s face mask, though that means there will be a bit of a trade-off when it comes to protection. Medical-grade face coverings like N95 masks have very strong filters — the 95 means that the filter is powerful enough to catch 95 percent of particles. But because these masks prioritize protection, they are not optimized for activity.

When it comes to masks worn during exercise, this balance is incredibly important, because the individual is not just breathing at a usual rate, but instead they are usually breathing heavily. While you will have to give up some protection to ensure airflow when exercising while wearing a mask, you will still contribute to a safer social environment.

Are there any risks to wearing a mask while exercising?

‍There’s always some risk to exercise, but it is true for most people that its riskier to not exercise at all than to have an active lifestyle. I recommend people make the transition to working out in a mask with an increased level of awareness, especially with to how well they are able to breathe and regulate their body temperature. Covering the nose and mouth will make it more difficult for air and heat to leave the body, so it is paramount that athletes are actively checking in on how they feel and adjusting their workouts accordingly.

How could wearing a mask while exercising affect performance?

‍Though it may take some time to get used to wearing a mask while exercising, it isn’t impossible to adjust. We know from other areas of human excellence that you can adapt to these conditions.

Take surgeons, for example. These people who do amazing things on the millimeter or micrometer level are kind of like professional athletes — they’re one-in-a-million type talents. They do everything, every day with a mask on, not to protect themselves, but to protect the patient. It would be far easier for them to conduct a surgery without a mask on, but they figure out a way to perform at their peak, taking those precautions for the good of others.
There’s nothing stopping the rest of us from doing the same.

This interview has been edited and condensed for clarity and brevity.