Back from Covid – AW

What to do if you contract the coronavirus? We ask the experts for the latest advice on returning to training

Since the start of the Covid-19 pandemic in early 2020, many people have now caught the virus. Some have had it recently after being vaccinated too. But how do you deal with that if you’re trying to train for track and field?

How long are you likely to have the symptoms?

Each athlete has different experiences but, for a study in the British Journal of Sports Medicine this year, Dr Craig Ranson, director of athlete health at the English Institute of Sport, and Dr James Hull, sports pulmonologist at Royal Brompton Hospital in London, looked at the duration of symptoms and the loss of time in a cohort of elite British athletes, many of whom were training for the Tokyo Olympics at the time.

By interviewing a total of 147 athletes between February 24, 2020 and January 18, 2021, all of whom had been diagnosed with Covid-19 or had symptoms, they found that fatigue was the most common symptom (57%), followed by dry cough (50%) and headache (46%).

Most athletes reported symptoms persisting for 6 to 17 days, although about 14% of symptoms lasted 28 days and an additional 27% were unable to resume full training a month or more after the initial date of. the infection.

Encouragingly, for most athletes this is a “mild, self-limiting illness”, although for some it can be a “prolonged recovery period”.

How quickly can you resume training?

There is no one rule for everyone. Some athletes recover quickly despite severe symptoms, while others describe difficulty re-establishing their training routines, with muscle weakness and persistent breathing difficulties.

In its advice for athletes and performance coaches, the English Institute of Sport says that a “graduated return to play” (GRTP), or training and competition, is essential.

“In the case of Covid-19, it appears that a process that is too fast or too intense can significantly slow recovery,” reads advice developed by leading sports doctors in the UK.

In practice, even athletes with mild symptoms should take their time to resume training and should wait at least 10 days since the onset of symptoms and be asymptomatic for seven days before resuming any type of exercise. Or, as the EIS says, “the first training that can resume is 17 days after the initial onset of symptoms.”

“Published data tends to suggest that after symptoms appear early, there is improvement and then further deterioration after days seven to ten, so it’s important not to come back too quickly,” Hull says.

The loss of taste or smell can persist well beyond 10 days in some cases, but these symptoms are considered less important when making decisions about returning to training.

What should you watch out for when you start exercising again?

Along with the general population, recovering athletes are susceptible to a number of complications related to Covid-19, including cognitive dysfunction and coagulopathy (deep vein thrombosis, pulmonary embolism).

Be aware that shortness of breath and fatigue can persist for several weeks and should be monitored closely. If symptoms worsen, it is advisable to stop training immediately and consult a healthcare practitioner.

Photo: Mark Shearman

When can you regain strength and conditioning?

Guidelines published by the US National Strength and Conditioning Association and the US Collegiate Strength and Conditioning Coaches Association (CSCCa) suggest training adjustment of 50/30/20/10 percent – using totals performed before Covid-19 disease as a baseline.

You adjust the total workload of sets, reps, and weights by at least 50 percent in the first week back, 30 percent in the second week, and so on. A lower percentage of the maximum of one rep is also recommended initially and the percentage gradually increases over the following weeks.

How can coaches monitor a safe return?

The period of inactivity before an athlete can resume training will cause some de-training and increase the risk of potential injury, especially if the athlete bounces too quickly. It is essential to keep an eye on the rate of perceived exertion, heart rate, fatigue and breathing problems as they return.

If an athlete is struggling with any of these issues, reduce the training load until it subsides. Additionally, stay mindful of their mental health – there will inevitably be troubling bouts of anxiety over whether athletes are able to match their pre-virus physical peaks.

A study on the impact of coronavirus disease on elite and semi-elite South African athletes reported that 79% had trouble sleeping and 52% reported feeling depressed during and after symptoms.

Are there long term risks to the heart?

The effects of Covid-19 on the heart are cause for concern, although the long-term consequences for anyone – athletes included – are not yet fully understood. In a small but concerning study of U.S. college athletes who had recovered from Covid-19, researchers reported in JAMA Cardiology it was found that 15 percent had signs of heart inflammation.

For the trial, cardiologists at Ohio State University performed scans on the hearts of 26 male and female athletes who had tested positive for Covid-19 but were mostly asymptomatic.

Analyzes revealed that even after several weeks of isolation, four male athletes showed signs of myocarditis, an inflammation of the heart muscle that can be triggered by viral infections.

Eight other athletes showed signs of scarring or other heart abnormalities. Since myocarditis is one of the leading causes of sudden cardiac death in athletes, the authors suggested that cardiac MRI might offer a useful post-infection tool to identify high-risk athletes among those. who can safely resume training and competition.

However, other researchers warned that this was a small study and did not prove that the virus caused heart damage. They also point out that the hearts of competitive athletes will look and function differently from an ordinary person, so the irregularities might not have been directly associated with the virus.

The results of a later, larger study published more recently (January 2021) looked at 145 competitive athletes, all of whom had tested positive for Covid-19. Using cardiac MRI, EEG and serum markers of cardiac pathology 15 days after their positive test result, these researchers found that only two athletes had MRI results consistent with myocarditis, suggesting an association with Covid-19 which was much less prevalent than previously thought.

“The good news from our studies is that myocarditis may not be as prevalent as you think and the small area of ​​scarring seen may be from athletic reshaping, not the virus,” instructor Daniel Clark said. Cardiovascular Medicine Clinic at Vanderbilt University and lead author on the studies.

“The disturbing news is that some athletes who develop Covid-19-induced myocarditis appear to have sequelae of arrhythmia (irregular heartbeat) and systolic dysfunction.”

A statement from the American College of Sports Medicine suggests that if you notice symptoms of heart damage, including chest pain or shortness of breath, before or after a positive test, you should see a doctor.

How does it affect the lungs?

In research by Ranson and Hull, lower breathing problems including dyspnea (shortness of breath), chest pain and cough were found to be present in 18% of athletes and these athletes had a longer delay before returning to sport. . For some, persistent and residual symptoms, especially a cough and difficulty breathing, may persist for weeks or even months after infection with the virus, so it is important to monitor them carefully.

“Coaches and athletes also need to make sure that existing breathing problems, such as asthma, are well managed throughout the process, and any worsening shortness of breath needs to be addressed immediately,” Hull says.

Tom Bosworth (Mark Shearman)

What about the Long Covid?

Even with the more cautious return to training and competition, not everyone has an easy post-Covid race, and athletes are certainly not immune from the lingering symptoms and lingering fatigue of the ” Long Covid “.

Tom Bosworth, the multiple walk world record holder who finished 25th in the 20km walk at the Tokyo Olympics, said AW how he contracted the virus in March 2020 just weeks after setting UK records of 5,000m and 10,000m but, after resuming light training in May this year, he reportedly discovered the virus was having a ‘strange effect On his body and said he didn’t feel “back to normal” until early August.

“We lost the whole month of June,” he said. “I didn’t do any training in June, then just light training in July, which made my way home easier. At this point, mentally, I was exhausted – of being sick, then resuming training, then moving on and then resuming training. The race seemed very, very far to me.

“You have your symptoms, which is a pretty short stage, and then you have a period of time where your body recovers and that’s the key. I didn’t leave it long enough. When you feel good, you need to leave it for another two weeks. Allow your body to get used to feeling good again.

Former world record holder in the women’s 5,000m, Zola Budd Pieterse, now 54, also shared her experiences with the virus on social media.

“It has now been four weeks since our positive test and three weeks since I first experienced symptoms,” Budd wrote. “I decided to start training again and I have the following symptoms: high heart rate. My heart rate, even doing easy runs of no more than 30 minutes, is about 20 beats per minute faster than normal.

In other words, all athletes should listen to their bodies, be extremely careful, and take longer than they think to come back. It will pay off in the long run.

This article first appeared in the October issue of AW magazine, which you can buy here

Comments are closed.