As COVID-19 restrictions in the UK are gradually lifted, the repercussions of lockdown on our health will take a long time to be fully understood.
Looking out of my kitchen window at the visible increase in runners, walkers and cyclists over the past few months, it would be easy to assume that not everyone has been at home crafting the perfect banana bread, and that lockdown had led to an increase in physical activity. However, a set of data from Sport England showed that 41% of those surveyed, reported doing less activity than before lockdown. It also revealed that those with a longstanding condition or illness were less likely to be regularly active than those with no longstanding condition or illness.
So, which training camp did you fall into over the past few months? Did you use the time to rest, recover and complete Netflix? Maybe your work meant that you have been as busy as ever? Did the kids being at home mean that any moment to yourself was better spent with a cup of tea and a lie down than going for a run?
Returning to training after a long break or reduction in normal activity levels can potentially put you at increased risk of injury. There is no available evidence to show how much muscle strength decreases over the course of 12-16 weeks “detraining” (the length of lockdown), particularly in recreational athletes or gym goers. However, we can look to elite sport for some clues about the implications of breaks in training.
One study from 2013, into the effects of long detraining periods in elite rugby and American football, found a 19% decrease in overall strength in breaks from training between 10-16 weeks and a staggering 40% reduction in shoulder strength (McMaster et al, 2013). Worth bearing this in mind before loading up the barbellwhen gyms re-open.
More recently in the Bundesliga, Germany’s premier soccer league, there were 12 major injuries on the first weekend of action after the pandemic, with 62% of these being muscular (Mason, 2020). Teams in the Bundesliga have struggled to get their injury rate under control in the first month of return to play. The warning signs are there to return to exercise steadily, particularly if you enjoy high intensity training. Going back in where you left off is a sure-fire route to potential injury. Make sure to factor sufficient recovery time into your programme.
Maybe you have taken advantage of your spare time and improved your fitness levels? In the last blog, Alex discussed how to gradually and safely increase training workload. Training load is individual and should be progressed slowly. Overtraining results in overuse or “too much too soon” injuries. Examples include tendinopathies, muscle strains and stress fractures.
There is also the consideration of the virus itself. If you have had it, you will most likely have noticed that you are more short of breath and fatigued as you try to get back to normal. This is certainly something I have been hearing from clients during online consultations over lockdown. A recent small study of Italian patients who had recovered from Covid-19 found that shortness of breath and fatigue were persistent symptoms in 87.4% of cases studied (Carfi et al, 2020). The Chartered Society of Physiotherapy has guidance on the road to recovery here: https://www.csp.org.uk/public-patient/covid-19-road-recovery.
Even if you have stayed in the peak of fitness throughout the pandemic, some research suggests that prolonged strenuous training can be associated with temporary depression of the immune system lasting “hours to days”. This can increase vulnerability to viruses, including Covid-19. Their conclusion was that limiting training sessions to less than an hour at working at 80% of your maximum capacity may help to reduce this effect and therefore susceptibility to the virus. (Toresdahl and Asif, 2020)
The Covid-19 social study being carried out by UCL has identified that 60% of people surveyed intend to be more active as lockdown eases. With the limited data available and whichever fitness camp you are emerging from, here is our guide to returning to exercise safely and reducing your risk of injury. As ever if you have any concerns or niggles that you have been ignoring, please consult one of our expert physiotherapists. Prevention is better than cure after all!
Image: C.Sampson - Infographic created 20.07.20
Carfi, A. Research letter. Persistent symptoms in patients after acute Covid-19. July 2020. Available from: https://jamanetwork.com/journals/jama/fullarticle/2768351
McMaster, D.T., et al., The development, retention and decay rates of strength and power in elite rugby union, rugby league and American football. Sports Medicine, 2013. 43(5): p. 367-384.
Mason, J. The Bundesliga Blueprint: early lessons from the return of German football. 2020 May 20; Available from: https://www.trackademicblog.com/blog/bundesligablueprint.
Sport England. https://www.sportengland.org/know-your-audience/demographic-knowledge/coronavirus#research
Toresdahl, B and Irfan Asif., 2020. “Coronavirus Disease 2019 (COVID-19): Considerations for the Competitive Athlete.” Sports Health: A Multidisciplinary Approach, 12(3), pp. 221–224