Returning-to-Sport after Covid-19
Athletes and sport organizations alike face a tremendous challenge when dealing with the Covid-19 virus. The SARS-COV-2 virus is a multi-organ pathogen, which can sometimes leave long-term effects on the lungs, heart, brain, liver and kidneys. The virus creates symptoms similar to the common cold, including but not limited to:
- Fever
- Sore Throat
- Cough
- Tiredness
- GI or stomach upset and diarrhea
- Loss of taste or smell
Individuals may experience different symptoms or effects when they contract the virus. If an athlete contracts Covid-19 they need to be aware of the potential long-term effects and how to safely return to their sport. Sadly, returning from Covid-19 may not be as easy as returning from the common flu. Some studies have shown to treat the return to play procedure for Covid similarly to the return-to-sport concussion protocol.
When an athlete is training for their sport they are pushing themselves to their limits. Covid-19 can make this difficult to return to sport quickly because of the stress it causes on the body. Covid-19 needs to be treated the same as an injury to the muscular system or the brain. There should be a clear plan in place for athletes to return-to-sport after contracting the virus. The theory behind a return-to-sport plan for Covid-19 is that when you contract the virus your lungs and heart can be directly impacted and require a phased return to sport in a similar manner as the brain would be with a concussion. It is imperative that you give your body time to fight the infection from the virus , and not rush to return to sport too quickly. Depending on the severity of the athletes’ symptoms, the return to play timeline may go as follows:
- Be symptom free
- Have a medical assessment completed if required ( see document below from Canadian Academy of Sports Medicine Return to Play guidelines)
(only proceed to next step if medical assessment is clear)
- Demonstrate ability to complete regular activities of daily living
- Return to light activity
- Gradual return to weight lifting or increased physical exercise
- Return to practice
- Return to full activity
Once an athlete has completed their seven-day isolation and is symptom-free, the first step is to get a medical and physical assessment completed, especially if the athlete had significant symptoms. . The following step should be slowly increasing low-intensity exercise for one week before engaging in a more strenuous and/or rigorous type of exercise. Keep in mind the athlete should monitor their fatigue and recovery from exercise as each return to sport seems very individualized with this particular virus. The athlete should follow a gradual step wise increase in intensity level until reaching a normal level to fully return-to-sport. The increase of intensity needs to be slow, consistent, and specific to the athletes’ previous fitness level. To learn more about the return-to-sport procedure for Covid-19 check out these articles:
As previously stated, Covid-19 can potentially damage the lungs and heart, which are the two vital organs to the cardiovascular system. Athletes need to have a strong cardiovascular system to compete at their peak performance level. There are two heart conditions that have been connected with the Covid-19 patients, Myocardial Arrhythmias and Myocarditis. Both of these conditions are rare but significant and athletes returning to play need to be aware of the effects and symptoms of these conditions:
- Fatigue
- General feeling of discomfort, illness, or uneasiness
- Reduced performance
- Muscle soreness or poor recovery from exercise post Covid-19
- Increased resting heart rate
The concern with these symptoms is the ability to misinterpret them. These symptoms are often similar to training-related exhaustion, overtraining, and depression. If you experience these symptoms post Covid-19 you should see a physician to have further assessments done. Myocarditis is one of the leading causes of sport-associated sudden cardiac death in the group of athletes under 35 years of age, here is a link to learn more about these heart conditions in athletes https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7314071/.
There’s more to life than the sports we play, our health needs to be the first priority when returning from this virus or any other serious health issue. To ensure your health and successful return to sport following Covid-19, adjust to signs and symptoms of each instance and have patience. This virus often takes 4-6 weeks to resolve. If you have any concerns about your symptoms as you return to sport see your physician or health professional.