Sports after Covid: Recreational athletes should keep this in mind

Mr. Wolfarth, you advise not to exercise as soon as you recover from the corona infection as before. why?

Bernd Wolfarth:
Even after an acute infection is over, inflammation can still be present in the body and affect the organs. In addition, accelerating stress fuels these processes. Anyone who takes off too quickly may sustain permanent damage to the lungs, kidneys, liver, brain, or heart.

What grace periods must convalescence be observed in order to fully recover?

Wolfarth:
Patients who have had mild or no symptoms should recover for at least seven to fourteen days. This means abstaining from intense physical exertion and stress, drinking excessively, getting enough sleep and not taking any medication that suppresses symptoms. Then it’s important to listen to yourself: Do I really feel resilient? Or do I run out of breath quickly and my muscles get tired? Only those who are completely asymptomatic and who feel truly fit can start exercising again.

What applies to patients with a severe course?

Wolfarth:
It depends on which organs are affected. Surviving pneumonia requires at least four weeks of exercise rest, and myocarditis three to six months. Before these patients begin training again, a thorough sports medical examination should be performed. This includes rest, tension, and, depending on previous findings, also echocardiography. The doctor can also perform a breathalyser analysis to measure actual athletic performance and check for potential damage to the lungs and heart. If all these results are not noticeable, then the body can be gradually loaded again.

Do medical exams also make sense in mild cases?

Wolfarth:
It’s actually not necessary for athletes who don’t have an underlying disease like diabetes or high blood pressure. If you want to be on the safe side, you can pull yourself up. For example, with an EKG at rest and a blood test.

Those who are fully vaccinated usually have a milder course of the disease. Does vaccination also help avoid subsequent damage?

Wolfarth:
The case study on this is still weak. However, all empirical data indicate that vaccinated people are affected less frequently by complications and serious diseases. The risk of developing myocarditis also appears to be much lower in people who have been vaccinated.

What should be considered when returning to sports?

Wolfarth:
The most important rule is to never start from zero to a hundred, but to take it slowly. Recovering athletes should initially adjust the workload to a decrease and increase the load gradually and only carefully. In 95 percent of cases, previous performance can be restored.

Can you outline an entry plan?

Wolfarth:
The first three days begin with light daily activities. Instead of jogging, it is enough to go for a walk for 15-20 minutes, jog or cycle for short distances on the ergometer. It should always be possible to hold a conversation, otherwise the pace is too high. Yoga and light strengthening exercises such as some push-ups or squats are also recommended. If the first few days go well, the load can be increased little by little. For example, extend your walking more or switch from walking to light jogging. Movement sessions can now last between 30 and 60 minutes. Important: As soon as you feel tired, you need to take a break.

Some people with corona suffer from Long-Covid disease. What applies to them?

Wolfarth:
Here too, we still lack good data. Symptoms such as fatigue, shortness of breath, trouble concentrating and dizziness that persist for a long time make it difficult to regain fitness again. However, exercise helps relieve symptoms. So patients should be active every day if possible, for example, initially walking for ten minutes. With a step-by-step plan like the one I’ve outlined, you can gradually build your body again. Massage, yoga and meditation are also beneficial for many.

When can training become more intense?

Wolfarth:
As soon as one to two weeks after starting sports. Balanced breathing is a good, simple subjective cue for healthy exertion. Athletes who determine their training heart rate with a fitness tracker (an electronic measuring device on the wrist) can also use a so-called heart rate as a rough guide. It should usually be 60 to 70 percent of your maximum heart rate.

At what heart rate should you see a doctor?

Wolfarth:
It happens that patients still have a resting heart rate of up to ten beats and a compressive heart rate of up to fifteen beats higher two to three months after their coronary disease. This may be indicative of a complex course and should be medically clarified.

When else is caution required?

Wolfarth:
There are warning signs you should take seriously: Am I having noticeable shortness of breath? Do I feel pressure, tingling or pain in my chest? Do I have an unusual headache or severe heart palpitations? With such signs, the lungs or the heart may still be sick. Then the athletes have to stop training and should go to the doctor.

One hears a lot about athletes suffering from myocarditis after contracting COVID-19. How big is the risk?

Wolfarth:
I would like to stress that these are absolute exceptions and there is no need to panic. The so-called myocarditis occurs in only 0.5 to three percent of cases and is clearly noticeable by the signs described. Anyone who steps forward with caution when returning to sports usually has nothing to fear, and is often as fit again as quickly.

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