SIS - Gradual Return to Play

SIS - Gradual Return to Play

Coronavirus, COVID-19. Pandemic. Lockdown. Weird, strange, and unprecedented times. The most used words of 2020 and I honestly cannot wait until these words are a thing of the past.

I knew that at some point I was likely to come into contact with someone who currently has it, had it or even contracted the virus personally. With that, I questioned whether I would be asymptomatic or symptomatic and present the typical dry cough, loss of smell and taste symptoms. On top of that, I wondered how I would recover from coronavirus both physically and mentally. I have heard mixed stories of athletes not being affected at all by it but others suffering long term effects from having the virus, currently known as Long-Covid.

Before I tested positive for COVID-19, I honestly was not aware that I had it. At the time, I did feel ill and not my usual self, but there were also lots of variables in the mix, so trying to pinpoint a symptom and relate it to the virus was hard, especially when coming out of a big training block.

Let’s start from the beginning on the where, the how, and the when. I was in Livigno in the Italian Alps for an 8-week training block. That was 8 weeks of living and training at altitude of over 1880m, clocking up to 1300 hours of altitude exposure. For those that are not quite sure about living and training at altitude, it adds an additional physiological strain to the body, as there is a decrease in partial pressure of oxygen. In response to this training stimulus your body produces more red blood cells to circulate more oxygen around the body.



Around the 10th of October, I started to feel slightly off. I felt lethargic even after a night’s sleep and straight after each training session, especially in the mornings. Waking up in the morning I knew my recovery was not quite on point, but not enough to be alarmed. As the days went on, I could not shift a persistent headache, however, it was not enough to stop me from training, even though I was having to take Paracetamol every 4 hours to help ease it. My head felt very foggy and most definitely experienced “brain fog” a known side effect from COVID-19. I could feel my motivation starting to slip and a dull suppression in mood was apparent. I just could not get excited or feel the energy I would normally experience before or after a training session. I would have waves of feeling nauseous yet was always feeling hungry. In fact, I was starving, even after I had eaten a meal. I put this down to nearing the end of an 8-week hard training block at altitude and the changes in weather as the temperature dramatically dropped going into the minus whilst out training.



During the 17-18th of October after a long run and brick session I knew that I needed to back off as it had been nearing a week of feeling ‘under the weather’ and when I tried to push on I just didn’t have the energy. It felt as if my tank was empty and I needed to refill but I just did not know at the time how. Although some might say to have backed off earlier, I felt fine in myself, but the body just was not playing ball, a fatigue I could not shift. Sometimes when you are in it, it is hard to see what is happening.

Questioning it – both myself and my coach, Dr Andy Kirkland, came to the conclusion that training was taking its toll and we needed to reduce both training volume and intensity to allow the body to adapt to the training block and recover. I was supposed to race in Turin on the 25th of October, so I was due an easy week to taper into the race. Unsurprisingly, as with most races this year, it got cancelled on the 19th of October, so I decided to head back home to the UK.

On my return to the UK I booked into a drive through test centre to get a COVID test. I did not book because I thought I had COVID-19 but because I was offered a wild card entry to Challenge Daytona – understandably, the biggest race of the year. I was excited to get back and start training. To do this, I had to test negative and get a letter of exemption from BTF as Italy was on the list of countries to quarantine on return into the UK. Having not trained since leaving Livigno I decided a week off regardless was what the body needed. When the test came back positive on the Saturday, I was still a little surprised, but it also put everything into perspective as to why I was feeling the way I was. In some respect I was slightly relieved because I had an answer.

I was then advised by government guidelines to self-isolate for 10 days from a positive test. Great, but then where does that leave me and my training plan? By this time, I was clear of the headaches and nausea, but I still felt tired especially when I woke up in the mornings. I tried a few easy runs and sat on the bike to spin the legs, limiting physiological strain as such though the body, yet my legs were feeling achier than they should be. At this point I decided to reach out to those who had more experience with dealing with COVID-19 from a clinical, physical and athletic perspective. I had two great and interesting chats with Dr Jodie Moss who has a Ph.D. in Endurance Performance and Dr Rebecca Robinson. Both were incredibly helpful in guiding me into the next phase.

The general advice would be 10 days complete rest from onset of symptoms, then a structured Gradual Return To Play Protocol. I found this chart very helpful.

Depending on timings of where you are from testing positive and what symptoms you have, you can also follow guidelines below on how to recover as best as possible.

AFTER 10 DAYS OF COMPLETE REST

Apply 2 weeks of easy training load and speak with your coach on how that would look for you. If you monitor your heart rate during training sessions, keeping a close eye on this in the up-coming weeks will allow you to ensure you keep it in zone 2 or below. If you do not use heart rate as a training tool, use subjective measurements to gauge how easy or hard the session is feeling. Additionally, an easy session should be at a power output or running speed where you can hold a conversation. Depending on your training status, it would be advised to not have long training sessions with your immune system already suppressed from overcoming the virus. After the 2 weeks of easy training load, a slow return to some tempo and light resistance work can be added as well as a small increase in volume. You may experience your recovery between sessions to be delayed and therefore, you are unable to meet the desired power outputs or running speeds as typically expected due to this fatigue from either the virus, the previous session and/or the combination of both.

Before, during, and after sessions are key to focus on your nutrition and hydration intakes. There is no restriction in energy during this time, no fasted training sessions should be happening during the next month at least. This period is all about minimising high loads of physical stress, where your body is already working hard to recover from COVID-19. This is also an important consideration for individuals who have not contracted the virus and are still training during the current pandemic.



Focus on getting a variety and at least 6 to 10 portions of fruits and vegetables every day, lots of whole grains and if you consume animal products include healthy lean cuts of meats and oily fatty fish. If you make smoothies or juices, consider adding turmeric, cinnamon, nuts, and seeds to get in additional benefits to help with feeling fuller and adding some anti-inflammatory foods. SiS Cherry Juice is another additional supplement that helps to reduce inflammation. Lots of anti-inflammatory foods during this period should be the focus to help aid recovery. A general list to follow:

Berries

  • Strawberries
  • Blueberries
  • Raspberries
  • Blackberries

    Fatty Fish

  • Salmon
  • Sardines
  • Herring
  • Mackerel
  • Anchovies

    Fruit/Veg

  • Broccoli
  • Avocado
  • Peppers
  • Mushrooms
  • Grapes
  • Tomato
  • Cherries

    Others

  • Extra Virgin Olive Oil
  • Green Tea
  • Dark Chocolate and cocoa
  • Turmeric

    HYDRATION IS ESSENTIAL

    Ensure that you are hydrated before you start and that you are consuming electrolytes during each session (I have been using SiS Hydration Tabs). I do this by keeping a water bottle by my bed and making sure that when I wake up, I drink before I get on with my day. Throughout the day, keep an eye on your fluid intake and make sure you are drinking frequently throughout the day rather than loads at any one point. I track this by seeing how much I am drinking from my water bottle, how often I go to the toilet. Even the colour of my urine helps me to see my hydration status. If it is cloudy or dark in colour, I know I need to increase my fluid intake.



    ALCOHOL

    For now, I would consider just being mindful of how much alcohol is consumed. Personally, I have cut out alcohol completely until December. A glass of red wine isn’t a bad thing now and again, but when you are drinking more than a glass your body is working hard to break it down and get rid of it…it’s a toxin. Another way of supporting your immune system is to add Vitamin C and a Performance Green, Both of which I have found to be very useful.

    SLEEP

    Focus on your sleep. Think about your sleep hygiene during this time – which is all about what environment you are creating to ensure you get the best quantity as well as quality of sleep. Cooler rooms, eye masks or even keeping your phone away from your bed are small ways you can help to get a better night’s sleep. You might want to consider consuming a protein recovery smoothie or drink before you sleep, I use SiS Overnight Protein.

    Other useful supplements to think about to help support your immune system and aid recovery:

  • Vit D
  • Multivitamin
  • Probiotic
  • Iron
  • Zinc
  • Cod liver oil
  • Magnesium

    ALSO TO NOTE

    Even if you have tested positive with no symptoms (asymptomatic) it is also advised to follow the general guidance and GRTP protocol. Something I was surprised at, but because we are still learning about Coronavirus and the unknown long-term effects, being cautious is extremely advised. So as frustrating as resting can be (I know because I am still waiting to train properly) being sensible now will certainly help long term. Be disciplined.

    WHERE I STAND NOW

    I would say I am pretty much at 85%. Still feeling the effects more so in the mornings from training light but I can feel the body is recovering from both COVID-19 and a long training block at altitude.

    WHAT IS NEXT

    Focusing on all of the above for now. Then over the next few weeks I will sit down to goal set. I am very much looking forward to a winter block – I am going to change up my training and step away from Tri Training until January and look at other areas to get fit. Look out for my next blog where I will be chatting about how to set goals and staying motivated.



    WRITTEN BY SIMONE MITCHELL

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