Return to play (RTP) after Covid-19

Return to play (RTP) after Covid-19

by Emma Carney (AUS) -
Number of replies: 0

Dear Athletes,

Welcome to World Triathlon athlete emails for 2021!

Today’s email we are going to take a look at the extreme importance of RTP following a Covid-19 infection.  The information contained in this email should be read by every athlete, regardless of infection or not.

In March 2020, my email provided some guidelines around the Covid-19 pandemic period.  At this stage the world was heading into its first lockdown period, and the advice remains relevant today.  The main difference now, is that we are all 12 months into living with the disruption Covid-19 has brought to our lives.  We have all learnt to adapt, social distance, remain vigilant with regard to hygiene, understand the importance of online learning and interaction with others over face to face and the utmost importance of following the guidance of the medical orders and laws relating to your area and region of the world.  Today it remains true our most protective measure of curbing the waves of Covid-19 outbreaks is social distancing.  

It has been, and continues to be a very testing and trying time, while we remain frustrated our lives are not as we used to live. The full article can be read here.  

Ensure you always follow the guidelines of reputable sources such as – 

·       Your Local Government

·       World Health Organisation’s (WHO) guidance on COVID-19: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technical-guidance

·       The International Olympic Committee's (IOC) COVID-19 updates: https://www.olympic.org/athlete365/coronavirus

·       National Federations may provide information as well.

While we had all hoped we would leave the Covid-19 pandemic in 2020, we still have much to do as individuals and communities as we return to a new normal.  With the hope of a race schedule returning in late 2021, it is important you do not rush into hard training, if you are exposed to Covid-19, regardless of how minimal this exposure may be.

 

As an athlete it is vital you adhere to your government’s rules and regulations, and you must also respond if you do become infected with Covod-19.  Here is why…

Generally, exposure to Covid-19 can be categorised into 6 groups – 

1.     No symptoms or evidence of Covid-19.

2.     Asymptomatic (no symptoms) with a positive Covid-19 test result.

3.     Mild symptoms to Covid-19, requiring doctor advice and self-isolation.

4.     Moderate symptoms, requiring inpatient hospital treatment.

5.     Severe symptoms requiring inpatient treatment in ICU without the use of a respirator.

6.     Severe symptoms requiring ICU treatment and artificial respiration.

COVID-19 is a systemic disease affecting the circulatory system and all organs, particularly the heart and lungs. Therefore, if you have been exposed to Covid-19 to ensure a safe return to training then racing, you really must have a comprehensive clinical evaluation (ie, cardiac and respiratory).  Given the nature of the virus, the demands of even light triathlon training loads on the respiratory, heart and vital organs and the extent of the unknowns regarding Covid-19 any exposure to Covid-19 really should have a medical clearance to minimise the risk of long term damage to yourself.

The World Triathlon Medical Committee have released guidelines on the safe return to training and then competition following a COVID 19 infection.  It is extremely important you take the time to read this documentation, as it is widely known Covid 19 can be associated with severe acute and probably also chronic damage to your health. The body is affected in not only the lungs but also the cardiovascular system, the central and peripheral nervous systems, skeletal muscle, as well as the liver and kidneys in an acute phase. Following an infection it is expected your exercise capacity will probably be limited especially by impaired gas exchange as a result of diffusion impairment and of the pulmonary fibrosis. The risk of myocarditis exists in a mild course or even for asymptomatic COVID 19 patients, and could be associated with sudden cardiac death.

The World Triathlon Medical Committee outlines that following a COVID 19 infection, an evaluation of the athlete by a medical professional for consideration of return to activity and competitive sport (RTP) i3 required. The severity of the disease, particularly fatigue, appears to affect the duration of the recovery.

Furthermore, the World Triathlon Medical Committee states that exercise should not resume if the player is symptomatic with, but not limited to, persistent fever, dyspnea at rest, cough, chest pain, or palpitations. Clinicians should advise patients to return to activity in a slow gradual manner.

With a careful return to exercise and RTP, World Triathlon Medical Committee have developed the following algorithm.  It is important to understand the importance of a safe return to exercise, followed by a safe return to competitive sport (racing).

 

In the meantime, as lockdowns around the world continue, aim to remain on top of your mental health - look after yourself, be flexible in your plans and try to take each day at a time if things are becoming difficult for you to manage.  Uncertainty is something you have to face in a race outcome, so practicing controlling your mind and your thoughts in times of adversity can be practiced now.  

I had a coach who used to remind me continuously that sport and racing had its ups and downs.  His favourite quote was - 

‘Always remember every day may not always be good, but there is good in every day’.

The full World Triathlon Medical Committee document can be found here

Stay well.

 

Emma