If you’ve been diagnosed with coronavirus, use caution and listen to your body when you begin to exercise.
Severity of illness from the coronavirus varies widely, from those suffering mild cold-like symptoms, to those with devastating long-haul symptoms that restrict any level of activity.
Because the medical world is still figuring out the disease, runners and gym aficionados who experience Covid are generally left with more questions than answers when it comes to returning to the sports they love.
Jordan Metzel, M.D., a New York-based sports medicine specialist well known as “The Athlete’s Doctor,” points out that, even though we’ve been living with Covid almost a year now, the guidance surrounding it is ever evolving.
“This is a new disease, and we see short-term and long-term ramifications every week,” he says. “The more we learn, the better our advice becomes, but that’s continually changing.”
“If you break an ankle, we can predictably give you a timetable for when and how to return to activity,” Metzel explains. “With Covid, we don’t have that database yet. It seems to be a different disease for everyone who gets it.”
What is known is that in some cases, heart and lung damage are a result of the infection, making a hasty return to exercise risky. According to an article in the British Journal of Sports Medicine, a meta-analysis of six studies with over 1,500 patients found that 8 percent suffered acute cardiac injury, for instance.
“The issue of myocarditis looms large,” confirms Matthew Sedgley, an orthopedic specialist in Maryland. “Some studies early on raised the possibility of it being very common. Newer data may not confirm that, however.”
The old rules of return to play don’t apply to Covid. “One thing we’re starting to advise is that those who exhibit symptoms need to be more careful than those who had a positive test but were asymptomatic,” says Metzel.
Even within the symptomatic patients, there’s a wide range of severity. How much implication this has on the recovering body remains a question mark. However, the more severe the symptoms, the more cautious the return should be. “If you’ve had Covid, we want to see a slow return,” says Sedgley, “I recommend 10 days symptom free before beginning a cautious progression.”
Caveats to this, says Sedgley, include anyone who was sick enough to be hospitalized. “Then a larger work up is in order,” he says, “with an ECG, ECHO and labs.”
When it comes to the respiratory component of the disease, Metzel advises that those with severe respiratory symptoms should be followed by a specialist, who can recommend exercise guidelines as time goes on.
One thing everyone can agree on is that, as you return to strenuous exercise, like running, be prepared for a few steps back if you’re experiencing heavy fatigue. “If you had Covid and feel lousy after exercise, back off,” says Metzel. “This is not a time to run through.”
Metzel emphasizes the importance of listening to your body. “For example, many runners see a race on the calendar and want to push to get in the training,” he says. “Runners are used to enduring and dealing with pain, but this isn’t the time for that.”
Ignoring this advice can lead to what Metzel calls a “chutes and ladder” effect: “You are headed up the ladder but then push too hard and go down the chute back to where you began,” he says.
Source: The Half-Marathoner e-newsletter
