When Should I Return to Play After Having COVID?
Have you been recently diagnosed with COVID-19 and are now symptom free?
Still hesitant to return to the sport you love?
Then this is the blog post for you!
Illness from COVID 19 can cause a range of medical complications with long term consequences. While our understanding of COVID-19 continues to evolve, it is evident that symptoms persist following an acute infection for many individuals regardless of their previous activity levels.
We know that recovery can vary depending upon on the severity of the infection, premorbid conditions, and other factors. However, this reason should NOT be the excuse that is stopping you from going back to the sport or activity you enjoy.
The purpose of this blog is to provide guidance regarding individual return to play following an infection with COVID-19. Elliott et al (2020) released graduated return to play guidelines, which serves as the reference for this blog. It is aimed at athletes with mild to moderate symptoms of COVID-19. If you were previously diagnosed with COVID-19 and have medical conditions such as diabetes, heart diseases or renal diseases, it is recommended to have a medical assessment before returning to previous activities, especially sport.
When should you consider your return to activity?
10 Days rest from onset + At least 7 days symptom free + currently off all treatment (e.g. paracetamol)
There are a total of six different stages of progression, and it should take about 17 days before you should look to commence return to playing/competing. It is important that you continue to monitor your post viral fatigue symptoms throughout. If any symptoms occur (e.g. excessive breathlessness) while going through these stages, you must return to the previous stage and progress again after a minimum of 24 hours of rest symptom-free.
Stage 1
Activity: walking
Objective: allow recovery time, protect cardiorespiratory system
Allow yourself to stay 10 days minimum in this stage
Stage 2
Activity: walking, light jogging, stationary cycle
No resistance training
Ensure the Max heart rate percentage doesn’t exceed 70%
Duration: Less than 15 minutes
Objective: gradually increase heart rate
Important to allow yourself to have 2 days minimum to stay in this stage
Stage 3
Activity: walking, light jogging, stationary cycle, could start introducing some running drills (e.g. changing directions)
Ensure the max heart rate percentage doesn’t exceed 80%
Duration: no longer than 30 minutes
Objective: increase heart rate gradually and manage post viral fatigue symptoms
Important to allow yourself to have a one day minimum in this stage and continue to monitor post viral fatigue symptoms
Stage 3B
Activity: walking, light jogging, stationary cycle, could start introducing some running drills (e.g. changing directions)
Ensure the max heart rate percentage doesn’t exceed 80%
Duration: no longer than 45 minutes
Can introduce skills/tactics
Important to allow yourself to have a one day minimum in this stage and continue to monitor post viral fatigue symptoms
Stage 4
Activity: normal training activities: both aerobic/aerobic trainings
Ensure the max heart rate percentage doesn’t exceed 80%
Duration: no longer than 60 minutes
Objective: restore confidence and assess functional skills
Important to allow yourself to have 2 days minimum in this stage and continue to monitor post viral fatigue symptoms
Stage 5
Activity: normal training activities and continue to progress
Stage 6
Return to competition
Other key considerations
Prior to starting the playing protocol, the individual must be able to complete activities of daily living and walk 500m on the flat without excessive fatigue or breathlessness
Individuals should have at least 10 days of rest and should be 7 days symptom-free before commencing the protocol
Things you could monitor throughout your activities:
Resting heart rate (using a iWatch or Fitbit to track)
Sleep
Stress
Muscle soreness
Important:
It is essential to maintain a healthy and balanced diet and good hydration. If symptoms worsen or persist beyond 7 days, medical attention is required.
Reference: Elliott N et al, Br J Sports Med October 2020 Vol 54 No 19