Of bicycles
COVID-19’s impact on health is a rapidly evolving situation. For the most up-to-date information, check sources like the Centers for Disease Control and Prevention (CDC) regularly. This story will be updated as more information becomes available.
Trey Richardson did not feel well.
He and his wife did a lunch ride on some secluded paths behind their house. About 45 minutes after the ride, they worked their way up to climb a ‘no big deal’ he’s done a million times. This time he could barely make it to the top.
‘It was hot and humid, and I did not feel well. But I thought I was just having one of those off-days you have when the weather is depressing, ”said Richardson, a 48-year-old former competitive cyclist who lives in Woodstock, Georgia.
‘But the last climb up … I had this strange short breath, and in the end I was like f —, I can not breathe. My heart was pounding and I had to stop for 10 minutes. We came back to the house and my wife said, ‘You need to make an appointment to see a cardiologist,’ ‘he said.
She did not have to tell him twice. Richardson’s father died of heart disease at 61. Although the tall rider never had a cardiac issue, he knew he had a genetic predisposition. That he planned a battery of heart tests with a sports cardiologist at Emory University Hospital in Atlanta. But first he got a COVID-19 test.
The nurse called the next day with the result: positive. “I was stupid,” Richardson said. “I was the poster boy of staying home.”
His cardiologist, who also received CODID-19 test results from Richardson, called him shortly thereafter to advise him not to drive and not to exercise, Richardson said.
“[My sports cardiologist] said athletes become symptomatic as a result of the natural and normal inflammation in their heart and lungs caused by moderate to intense activity, ‘Richardson continued. “After that ride, I struggle with breathing every time I try to do something. I would feel fine about 85 to 90 percent, but as soon as I did any kind of easy activity, like walking across the yard or going up stairs, I would be oxygenated and exhausted for hours. ‘
In short, exercise can make COVID-19 less. For cyclists and other active people who generally turn to physical activity to increase circulation and feel better faster when they are a little under the weather, this is new and urgent news, says Jordan Metzl, MD, a doctor of sports medicine at Hospital for Special Surgery in New York.
“This is against my personal exercise philosophy that burpees cure almost everything and the advice I have given for 20 years that it is okay to exercise through minor illness symptoms,” says Metzl. “COVID-19 plays by different rules when it comes to sports and exercise.”
Here’s what you need to know.
Be careful about listening to your body now
Exercise is still heel important for your health. Not only does moderate, regular activity keep your immune system strong, but it also helps prevent the underlying conditions that may increase your risk for more serious coronavirus complications such as obesity, high blood pressure, and diabetes.
Specifically, research finds that regular exercise can reduce the risk of acute respiratory distress syndrome (ARDS), a potentially fatal complication that affects between 3 and 17 percent of people who come down with COVID-19.
So keep moving perfectly, but pay attention to how you feel. As athletes, we all have a lot of experience setting up the signals that our bodies send to us. Don’t just blow persistent fatigue like a bad day. “You have to be a very good bodybuilder right now,” Metzl says.
Be especially aware of unusual symptoms, adds Sunal Makadia, MD, LifeBridge Health Director of Sports Cardiology in Baltimore.
“Check with your doctor if you have shortness of breath, chest pain, palpitations, such as a fluttering or rapid heartbeat, lightness, swelling in the legs, muscle aches, and / or unexplained fatigue,” says Makadia. “Even if you are suddenly unable to keep up with your regular training partners, that is a red flag to stop and test.”
“Check your heart rate monitor, if you use one,” says Makadia. “If you get your heart rate beating unusually early in your ride or have difficulty reducing your heart rate, this is a sign that you should check with your doctor.”
Covid19 symptoms
According to the CDC, people with these symptoms may have COVID-19. If you think you have COVID-19, stop exercising and get tested.
Fever or chills
»Cough
»Shortness of breath or difficulty breathing
»Wurgens
»Muscle as body
»Headache
»New loss of taste or smell
” Sore throat
»Congestion as a runny nose
»Nausea as spit
»Diarrhea
Even mild cases of COVID-19 can damage your heart
Being healthy, fit and strong can help you prevent some of the more severe symptoms of COVID-19 like ARDS, but it does not make you immune to some of the more debilitating effects of the disease. And even if you only come down with a mild to moderate case, you are still at risk for myocarditis, inflammation of the middle layer of the heart wall, which can weaken the heart and lead to heart failure, abnormal heartbeat, or even sudden death.
This can happen even if you have no symptoms. In a recent study published in JAMA Cardiology, German researchers performed heart MRI tests on 100 adults taking COVID-19. About half of them had mild to moderate symptoms and 18 percent never had symptoms. Although the test was performed two to three months after her diagnosis and none of her had experienced heart symptoms related to the new coronavirus, 78 of her had structural changes in her heart, and 60 had myocarditis.
Ironically, athletes may be at particular risk for this complication, because intense activity during active infection – even if you show no symptoms – can cause the virus to replicate faster, Makadia says.
“During training, you increase your cardiac output. If you are infected, this can in theory increase the viral replication in the heart muscle. If that happens, the higher viral load could increase your risk of cardiac damage in the form of myocarditis, arrhythmias, and heart failure, ”he says.
It is important to stop exercising immediately at the first sign of potential heart symptoms and to check with your doctor, advises Makadia.
Metzl agrees. “We had a dedicated athlete and CrossFit enthusiast in her early 30s coming up with COVID-19 when the pandemic hit New York. She was suffering from fatigue and lethargy and thought she would go for a run to feel better. She died of a heart attack. She was young and healthy and had no pre-existing cardiac history. It is very important to be conservative with COVID-19, ”he says.
Blood clots are at risk
An equally frightening COVID-19-related cardiovascular concern is blood clotting such as deep vein thrombosis (DVT) – something active people may also develop more often in part because of our low resting heart rate, which can pool blood in our throats when we sit for extended periods of time, like a long car ride. Dehydration and injuries also increase the risk.
“We know that very intense exercise increases inflammation and affects clotting, even if you have no other risk factors. That may be the reason why some people who travel to marathons and other races and sit in cars a few hours later have a higher rate blood have clotted, says Makadia.
COVID-19 also causes an increase in clotting and inflammation, he says. “The athletic population should be concerned about coagulation, because it is related to COVID. Hydration is important as well as early testing if you have COVID-19 symptoms so doctors can check clotting proteins in the blood. ”
Although you want to take it easy and avoid working out if your COVID-19 is positive, low-intensity activity such as walking, or at least avoiding prolonged sitting, you can provide some protection against DVT.
Calf pain, swelling, and / or tar are red flags to control. “Again, you have to pay attention to everything that is unusual,” Metzl says. ‘I cared for a cyclist who developed blood clots in both legs due to COVID-19 and had to amputate almost one of her legs. Now is the time to be extra careful and not blow symptoms. ”
Stop practicing for At least Two weeks
If you have been diagnosed with COVID-19, or you have symptoms or not, you should not exercise for at least two weeks after receiving your positive test, says Makadia. “If you to do have symptoms, you should avoid exercising for two weeks after your symptoms have disappeared. ”
“The real concern is that people may have a biphasic reaction,” Makadia says. “You can get symptoms and then after a few days you feel that you have recovered. But then a lot of people have a recurrence of symptoms, and it’s that second bolt that can be really tricky. That is when they become significantly less. We want to avoid that second game. That’s where that two-week recommendation comes from. ‘
After that two-week period, you may need additional tests as you look to resume your normal activity, Makadia says. “Your doctor may perform follow-up tests such as blood tests to check if your heart is affected by the virus, as well as other tests such as an ECG, an echocardiogram, and possibly a stress test.”
Returns to activity slowly after COVID-19
No one wants people to stop practicing for good. Everyone wants people who had COVID-19 to start exercising safely again. That’s why doctors like Metzl have started creating guidelines for the medical community to follow as we work our way through the pandemic.
“Everyone is unique and this disease affects everyone uniquely and can affect the whole body in different ways, so there is no absolute algorithm for activating the new one, as there is for a distributed ankle,” Metzl, who wrote a recently published review article with the title Considerations for returning to exercise after mild to moderate COVID-19 in the recreational athlete. “We just need to help people to gradually return to activity step by step.”
As a general rule, people who have COVID-19 should be closely monitored, especially in the first three to six months, as they return to exercise programs, Metzl and his co-authors conclude in the study. “This applies to athletes who have had COVID-19 to some degree,” Metzl writes.
If you have had a mild case, advise Metzl and his cohorts to work with your doctor and follow a gradually guided activity modification plan as per the 50/30/20/10 rule developed by the National Strength and Conditioning Association and Collegiate Strength and Condition Coaches Association Joint Committee.
In that plan, the first week back, you resume activity at a level that is reduced by at least 50 percent of your normal exercise load. For example, if you drive 10 hours a week, you should adjust to just 5 hours a week, spread evenly over seven days. The following week, if all goes well, you can start again at a level that is 30 percent lower than normal weekly total, followed by 20 percent the following week, and 10 percent the following week.
As for Richardson, he was officially cleared of COVID-19 on August 12 and although he is less tired, his symptoms still suffer.
“I work with my sports cardiologist, and we’re starting slow,” Richardson said. The next steps are setting up a battery of tests including a stress test and cardiac imaging to examine if and how COVID-19 has affected his heart. ‘Once we have the results of [the tests], we’re leaving. ”
You might as well go over
