Interruptions in sport mode are often due to not very positive circumstances. In the last year, the coronavirus has been added to these. Physical activity strengthens the immune system, but any load can become serious stress and lead to complications for an organism weakened by disease.
We are figuring out how to safely return to running after suffering COVID-19 and not aggravate its consequences.
What happens to the body after an illness
Symptoms, the severity of the disease, and the duration of recovery are so individual that it is impossible to fit all the nuances into a single framework. For the same reason, the consequences of COVID-19 have not yet been fully understood.
The fact that COVID-19 can make itself felt for a long time after recovery is a fact. This phenomenon is called “Postcoid syndrome”… It is very unpredictable. It can last for weeks and does not allow you to quickly return to the usual rhythm of life, even though the worst, it would seem, is over.
Lung dysfunction. Due to pneumonia and the accompanying high temperature, the amount of oxygen entering the blood and muscles decreases. After acute severe respiratory syndrome and mechanical ventilation (ALV), patients experience impaired lung function and decreased exercise tolerance. Hence – shortness of breath and a feeling of shortness of breath.
Complications in the heart. The most common are arrhythmias and myocarditis. Symptoms: fatigue, chest pain, heart palpitations. Moderate cardio loads positively affect a healthy person, but after suffering COVID-19, a heart examination (exercise ECG and echocardiogram) is necessary.
Other complications. During illness, physical activity naturally decreases sharply. This leads to the risk of blood clots and exacerbation of chronic diseases, reduces metabolism and insulin sensitivity. It also slows down and complicates the subsequent recovery process.
Psychological complications are also possible, including anxiety and depression.
Abrupt and untimely resumption of sports can delay the healing process and cause long-term complications, including “subacute,” that is, protracted COVID-19.
But there is good news as well. According to statistics, people who regularly play sports most often carry the infection in a milder form. Consequently – and recovery is faster.
How long should the break be
The German Journal of Sports Medicine and JAMA Cardiology has categorized three categories according to the severity of symptoms and made recommendations for each type.
Mild or asymptomatic disease
Even in this case, you should stop playing sports for 10-14 days when you get a positive test result. After two weeks, you can resume activity on your own, starting with half an hour of walking and breathing exercises. Rest every other day is a must to understand how well the body copes not only during stress but also after it.
You can use a pulse oximeter to monitor your heart rate and blood oxygen levels (saturation). If there is no shortness of breath and the pulse and oxygen saturation are normal, try alternating walking with jogging and gradually move on to light jogging.
If the disease has clearly made itself felt, but there was no hospitalization, you need to allocate an additional two weeks of rest after recovery. Before resuming physical activity, it is recommended that you consult a doctor and have your heart examined.
Any physical exercise is indeed contraindicated in the presence of symptoms, but this does not imply complete inaction. It is important to maintain a minimum of mobility. You can set aside 20 minutes a day to work out the feet, for example. There are no contraindications to this kind of exercise.
A severe form, hospitalization
For people who have survived hospitalization and mechanical ventilation, the return to sports should be as careful as possible and only under the supervision of a doctor. Examination of the heart, lungs, and blood tests is required. Recovery after mechanical ventilation is sometimes delayed for months. Even after a year in some patients, the oxygen level in the blood does not return to normal values (in a healthy person – 96–99%).
Three main principles of recovery
The British Medical Journal highlights the following key points:
- Exercises can be resumed at least (!) After seven days of complete absence of symptoms. Start with the smallest exercise: yoga, slow walking, breathing exercises.
- It is important to monitor your condition on a daily basis and, if necessary, immediately pause your workouts and seek medical help.
- All risks need to be assessed before returning to physical activity after COVID-19. Patients with persistent symptoms, cardiac and pulmonary involvement require serious clinical evaluation before starting exercise.
Is there a single formula for recovery?
Research is still ongoing, but now the universal system is considered “50/30/20/10”, recommended by the NSCA and CSCCa (National Strength and Conditioning Association and Collegiate Strength and Conditioning Coaches Association).
In the first week of resuming sport mode, start at 50% of your baseline workout volume. It is quite expected that the usual loads will be given many times more difficult after illness and inactivity. A 20-minute workout should be sufficient. And don’t forget to warm up, cool down, and rest every other day. Many runners report a drop in pace, but at this stage, it doesn’t matter at all. Start by running so slowly that your heart rate remains calm.
Second week. If you feel good, you can slightly increase the load level: so that it is reduced by 30% from the baseline. It’s too early to resort to intensive training – try to keep your heart rate in the second heart rate zone (60–70% of your maximum heart rate). The time of the jogging itself should not be delayed for more than 30-40 minutes.
In the third week, provided that the body has time to adapt to stress, you can already reduce the volume by 20% of the original but still adhere to the second heart rate zone.
So gradually, by the fourth week, you will already be doing 90% of your usual training base, and in a month, you will actually return to the loads that were before the illness.
Important: division into weeks is conditional. It is recommended to proceed to the next stage only if the body has adapted to the current load and does not feel excessive stress. If necessary, you should stay in the comfort phase for as long as necessary. Recovery can take up to several months, and that’s fine too. One of the protocols for returning to loads. Infographics from here.
How to know that you are not ready for the load yet
If the body has not yet had time to recover, the signals will be more than obvious:
- excessive shortness of breath
- chest discomfort
- feeling short of breath
- difficulty with coordination
The main thing is not to ignore them, but to stop exercising and, if necessary, seek medical help.
When you resume physical activity, try a simple test: walk around the room for five minutes and monitor the readings on a pulse oximeter. If the pulse quickens, the oxygen level drops by more than 10%, and shortness of breath appears, which means you are already demanding more from yourself than your body is ready to give. This means that you need to rest for at least another day, repeat the test the next day, and not include anything more extreme than short walks in your routine.
Abrupt resumption of activity. The usual training plan will have to be temporarily delayed. The first weeks will be spent exclusively on adapting to the usual rhythm of life and restoring physical form. This process must be gradual. It makes sense to start with hiking or Nordic walking. Slowly build up the number of steps, gradually bringing it up to your usual daily rate of 10 thousand.
Training to the limit. Fatigue is one of the most frequent consequences of the postponed coronavirus. Please do not confuse it with bouts of laziness and force yourself to perform unbearable loads for now. The postcoid state is not a time to focus on speed and endurance.
Focus on a comfortable pace and length of your run, and allow yourself to rest.
Excessive requirements for yourself. Do not despair that shortness of breath appears already on the second kilometer, and it seems that even pedestrians are moving faster than you. This is natural against the backdrop of a long break and a serious illness. Do not try to squeeze dock-like indicators out of yourself immediately. You’re already well on your way to recovery, and that’s great! Now the main thing is patience.
Here is what Evgeny Suborov, Ph.D., anesthesiologist-resuscitator and marathon runner, says:
“It is important to remember that the disappearance of the consequences of COVID-19 is a matter of time, and this situation cannot be forced. Therefore, returning to sports after an illness is a long and tedious process, consisting of neat and very slow steps, light activity. In no case should you try to ‘catch up’ the lost form, it is fraught with consequences for health, which has not yet fully recovered from COVID-19. “
Runners share how they survived COVID-19 and got back to running:
“I returned from a half marathon in Kiev in November, went for a run, and after 8 km, I felt a complete breakdown. In the frost, I somehow reached one and a half kilometers to the house. The next morning the temperature is 37.4. The next day – already 38.9. On the third day, the temperature subsided, but the sense of smell disappeared, and severe weakness appeared. I barely made it to the hospital, passed the COVID-19 test – the result is positive. On the fourth day, it seemed to have become easier, but there was wheezing in the lungs and a desire to cough up. I drank many fluids, cough syrups, ate a lot of bananas, persimmons, citrus fruits, consumed vitamins C, D, and zinc. In ten days, the wheezing disappeared.
The return to activity began with walking. Based on my own feelings, I gradually increased the distance and speed. When I overcame the top ten on foot, I returned to light running: one kilometer, two, three … After three months of constant training, I reached a “working pace.” Four more later – improved the dock-like results. The main thing is not to rush to recover. “
“The temperature suddenly rose to 37.5. The weakness was such that it was difficult to walk even ten meters. It’s easy to understand that you have COVID-19: this has never happened to you before. On the second day, the temperature was already 39.9. I drank paracetamol, vitamins A, E, C, echinacea tincture. On the fourth day, the sense of smell and taste disappeared, but the general condition improved, it became easier. There was no cough. I drank a lot of water, ate fruits and vegetables.
It wasn’t easy to return to training. Muscle weakness persisted for almost a month. I started by jogging 2 km, just as best I could, at a languid pace. Then 4 km, a little later – 6 km. After a month and a half, I already felt the same as before the illness. “
“I have been running from time to time since I was 11, but more seriously and regularly – since January 2019. The virus was most likely caught during the Staleviy Gart ultra-run in August 2020. After that, I really wanted to run a half in my native Khust, I began to prepare and reduce the volumes, but the coronavirus was positive. The disease was easy. Of the symptoms, only two things were remembered: for several days, the dullness in the head, and for three nights, “twisted” the joints. It is not known about the smells because I do not smell them anyway.
During the illness, he did not stop training, but he significantly reduced the running loads for one week. Somewhere twice during the whole time, I measured the temperature – everything was normal. But according to the data in Strava, it is very noticeable how the average pace dropped during training. Because of the illness, I got minor complications in my heart, but I already have a peculiar relationship with him.
Nevertheless, I think that it is more correct to pause for a while, but again – all this is very individual and depends on health. At the beginning of October, I ran Kyiv Last One Standing-2020, and from January, I started to increase the weekly volume as planned. Overall, it’s lucky that everything went so easily. “
Over time, most athletes manage to return to their previous figures and improve them. The main thing is not to rush, listen to the body and allow it to recover completely. The desire to get to the start as soon as possible is quite natural, but it definitely should not be stronger than common sense.
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