Return to sport after a Covid-19 infection

26th Apr, 2021

After being swamped with news regarding Covid-19 for the past 2 years, it is known that the symptoms of Covid-19 infection include shortness of breath, dry cough, fever, etc. However, you may not be aware that even after recovering from a Covid-19 infection, you are at risk of:

  1. Cardiological, pulmonary and haematological complications due to the infection
  2. Orthopaedic injuries due to prolonged rest and a sudden increase in loads when attempting to return to sport

Hence, caution is recommended when resuming physical activity after a Covid-19 infection.

To begin, you should meet the following criteria before proceeding with a graduated return to play plan:

  • 10 days of rest and 7 days symptom-free
  • No longer under treatment/medication
  • Able to complete activities of daily living and walk 500m on flat ground without excessive fatigue or breathlessness

Thereafter, you may consider using this graduated return to play protocol (GRTP).

Gradually increasing the level of physical exertion during the first few days are crucial to ensure that your body has fully restored its ability to cope with high cardiopulmonary demands. During this period, it is recommended that you monitor the following:

  • Resting heart rate
  • Rate of perceived exertion
  • Sleep, stress, fatigue and muscle soreness
  • Psychological Readiness to Return to Sport (PRRS)

Should there be a significant increase in any of the above 4 measures, you should return to the previous stage and progress again after 24 hours of rest without any of these symptoms.

On the other hand, the progressive increases in load and intensity are critical in preventing musculoskeletal injuries. A period of rest allows for detraining. This means that your muscles and tendons may have reduced their load capacity, depending on the duration of your recovery. Since orthopaedic injuries are often caused by loading these structures beyond their load capacity, re-starting training with a reduced load and working your way up is the safest way to return to your pre-infection performance.

DISCLAIMER: The advice given in this article applies to people who have suffered from mild to moderate Covid-19 symptoms. If you have suffered from severe or prolonged Covid-19 symptoms, or have other comorbidities (e.g. diabetes, cardiovascular disease, etc), please consult your doctor for further medical assessment.

References:

Elliott N, Martin R, Heron N, et alInfographic. Graduated return to play guidance following COVID-19 infection British Journal of Sports Medicine 2020;54:1174-1175.

Caterisano, Anthony Co-Chair1; Decker, Donald Co-Chair2; Snyder, Ben Co-Chair1; Feigenbaum, Matt1; Glass, Rob3; House, Paul4; Sharp, Carwyn5; Waller, Michael6; Witherspoon, Zach2 CSCCa and NSCA Joint Consensus Guidelines for Transition Periods: Safe Return to Training Following Inactivity, Strength and Conditioning Journal: June 2019 – Volume 41 – Issue 3 – p 1-23 doi: 10.1519/SSC.0000000000000477

Filed under: COVID-19

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