For runners recovering from COVID-19, slow and steady wins the race

When Allyson Moore contracted COVID-19 earlier this month, her symptoms were unpleasant, but bearable.

"I just felt really crummy for about three days,"the Ottawa physiotherapist recalled, comparing the experience to having "a bad cold."

It wasn't until Moore, 31, ventured out for her first walk that she noticed something else.

I'm shifting my expectations, so I'm just going to do the best that I can, given the circumstances.- Allyson Moore

"I had to stop after 10 minutes and catch my breath, and I'm used to running 20 to 40 kilometres a week, so it really was a wake-up call," said Moore, a triathlete who's also training for the Ottawa Race Weekend half marathon at the end of May.

A few days later, her other symptoms gone, Moore attempted her first post-COVID run.

"Same shortness of breath, and I also found my heart rate spiked way higher than it normally would, which was really kind of shocking, just showing that my body really wasn't back to 100 per cent,"she said.

Fatigue, breathlessness

Moore's experience turns out to be quite common among runners of different ages and abilities, many of whom are just starting to get back to their training schedules after being laid low by the latest Omicron variant.

"Athletes by and large when they get COVID don't get it as bad, but because they go out and run and do stuff like that, they certainly notice it because they test themselves,"explained Dr. Jonathan Hooper, an anesthesiologist and intensive care physician at The Ottawa Hospital, and the Race Weekend's longtime medical director.

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According to Hooper, fatigue is the top complaint among runners and other athletes who are trying to pick up where they left off, followed by shortness of breath and a racing heart. For most, those impediments tend to dissipate as they continue training, but some struggle longer than others.

"Some people, it just wears off over a period of time, and other people are carrying this around with them for a long period of time,"Hooper said.

Phil Marsh, regional and events manager at Running Room in Ottawa, said nearly every runner he knows who's been through the COVID wringer has fully recovered within a few weeks, including a 50-year-old who's about to compete in the Boston Marathon.

"Within three weeks he's probably right back now to where he was in his Boston preparation,"said Marsh, who also coaches runners through both the store's running clinics and other clubs.

Long-haul numbers 'pretty shocking'

On the other hand, Marsh also described one "super fit guy" in his 30s who's still struggling with shortness of breath and other symptoms months later.

Hooper said those long-haul cases might not be so rare, citing clinical evidence indicating as many as 60 per cent continue to experience significant symptoms three months later.

One-third to two-thirds of people three, four months later are not back to baseline- Dr. Jonathan Hooper

"That's a pretty shocking number when you think about it one-third to two-thirds of people three, four months later are not back to baseline."

Hooper said there's added concern over the link between COVID-19 and myocarditis, a potentially dangerous inflammation of the heart muscle, which he called "really, really rare,"but still cause for vigilance.

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It's that uncertainty over long-term outcomes that's perhaps most worrying for some runners, and has many wondering how to safely resume their training.

Gradual approach is best

While most "return-to-play"guidelines focus on controlling the further spread of COVID-19, when it comes to the question of when it's wise to resume training, the consensus among medical professionals is that a gradual approach is best.

Hooper said runners who experienceda mild case of COVID-19 should wait at least seven days after their symptoms subside, then resume training at about 50 per cent of their pre-COVID load. After that, they should apply the gradual "10 per cent rule"until they're fully recovered, he said.

"You should slowly be getting better over a number of weeks, and how many is that? Four to six? Six to eight? It's hard to say. If you go out and you're just not getting better at all and really dragging your butt around, then you'd want to go in probably sooner and get checked out,"Hoopersaid.

Runners who suffered through moderate or severe symptoms might want to see their doctor even before venturing back out, particularly if certainsymptoms persist.

"If you are having palpitations or any kind of chest pains, then I would be back seeing my doc saying, 'Hey maybe we need to do some more tests before I start pushing my body even more,'because you'd sure hate to have something lethal happen,"Hooper said.

Those tests could include an electrocardiogram (ECG) and in some cases an MRI, however Hooper encourages most runners to simply listen to what their bodies are telling them.

"I imagine there's got to be a certain percentage of that group that's had COVID and are not back to normal and maybe trying to push themselves a little bit too hard and too fast,"he said.

Adjust your expectations

Hooper said Race Weekend organizers are keeping a close eye on the current wave of COVID-19, which appears to be spreading rapidly, but sending fewer peopleto hospital.

He's encouraging Race Weekend participants to be realistic about their personal running goals.

"People that just [say], 'I can run a 1:40 half marathon,'or whatever it is. No, you can't, and they find out the hard way,"Hooper said. "If there's a whole bunch of people out there with some degree of COVID that bothers them when they push themselves too hard, yeah, that's that could be ugly."

Allyson Moore said she's taking that advice to heart. Moore was aiming for a personal record at the end of May, but now says she just wants to do the best her body will allow.

"I'm shifting my expectations, so I'm just going to do the best that I can, given the circumstances,"she said. "I think just getting back and having fun racing is the first thing. It's better to stay healthy and not risk injury by trying to overtrain to catch up."