I totally understand, being isolated, housebound and knocked off your feet for a while from testing positive can really impact your training momentum. And missing a few days, or more (depending on where you live of course) you might be eager to get back out there, lace-up and hit the ground running (pun intended).

But WAIT! Take a look at what the scientific research is saying because we’re more likely to get injured… yikes!

The study

December 2021 a research study was published concerning the COVID 19 effects on the musculoskeletal system (MSK) and its implication of increased injury prevalence among runners.

In total, 1947 runners tested, with an average age of 45 (standard deviation of 12 years) and 56% were women (that makes 44% male). A total of 1435 were negative for COVID-19, whereas 123 runners self-reported having positive confirmations of COVID-19: 100 of them received positives from a lab test, the remaining 23 were diagnosed positive by a medical professional without the laboratory tests to confirm.

The testing began March 2020 (that’s also almost 2 years of data in the deep depths of COVID) and 427 runners reported an injury that prevented running for at least 1 week (38 of the 123 who reported with COVID and 389 of the 1435 negative runners).

The result?

“Runners who self-reported a diagnosis of COVID-19 had a higher incidence of injury compared to those who did not” 1.66 times more likely to run themselves into an injury”.

Comparing negative and positive COVID-19 injuries, those testing negative had higher reports of:

• Bone injures (9%)

Whereas positive COVID-19 runners reported higher injuries of:

• Joints (10.5%)
• Nerves (7.9%)
• Other – not MSK related (31.6%)
• Unknown diagnosis (13.2%)

The most prevalent injury amongst those who tested positive for COVID-19 – muscle, tendon and facia injury’s (34%)

Returning to running after COVID-19

The symptoms reported with positive COVID-9 runners were:

• Asymptomatic (17%)
• Mild (41%)
• Moderate (39%)
• Severe (requiring hospitalisation) (2.4%)

However, these new symptoms were reported on returning to running after recovering from COVID-19:

• Shortness of breath (36.6%)
• Palpitations (9.8%)
• Chest pain (2.4%)

What does this mean for runners returning to running, post positive COVID-19 results?

Well, more MSK injuries were reported by those who also reported laboratory-confirmed COVID tests. The study can’t differentiate if the injuries were directly related to COVID-19 or from the break-in training from the illness and isolation rules etc. It highlights that these runners who took up to a few weeks off training, due to their symptoms (and the rules) may have impacted their fitness levels, VOX max, mental state, breathing rhythms.

And although all you want to do when you’re ill is bed rest, this study (albeit old) has suggested VO2 max decline (a common measure of cardiovascular fitness) can decline by as much as 17% after 10 days of bed rest (or isolation). However, some studies also implicate bed rest causes a more detrimental drop in VO2 Max for those with higher fitness levels than those of beginners or lesser fitness.

The gems of the study tell us what to look out for: Shortness of breath, palpitations and chest pain. Being body aware is one of the most important things we can do, not just as runners but general healthy human beings blazing through life. If these symptoms pop-up, go and speak to a health professional.

Be kind to yourself, if you’re struggling at first. Remember to take it easy!

How exactly do I return to running after COVID-19?

Your body has done tremendously well to fight off the virus, and it is tired. The best thing you can do is progress slowly. Mentally, you are likely to struggle to even be motivated to get back out there, let alone to push your training (so don’t push it!).

British Journal of Sports Medicine published a wonderful infographic to help athletes return to sport post-COVID-19 infection.

The key points are:

• Must be able to walk 500m on flat without breathlessness
• Be 7 days symptom-free before starting
• Less aerobic intensity to start my help progress quicker (golf, walking, cycling)
• Monitor your resting heart rate (a heart rate monitor or your fitness watch can do this for you)
• Monitor your sleep, are you getting enough of it?

Running is high impact, the forces required to propel you forward take up a lot of energy and effort, so fartlek, run/walk interval style training, opting for a flat treadmill session, elliptical or even a bike ride can help improve your fitness and adjustment back into hardcore running.

Remember, it’s normal to feel sore after working out (even if it isn’t normal for you) your body is getting used to exerting itself again, so If you have muscle soreness, take it easier the next day, and get back to it the day after. A little self-compassion is going to go a long way here to get back to your top running form.

But hey if you can’t run, you can read all about it, find new ways to train, talk to other runners, opt for hikes or try other sports instead for a few weeks: the possibilities are endless!

On top of it all, if your COVID-19 case required hospitalisation or caused heart problems, please DO NOT start exercising without the permission of your doctor or sports Physician – to be on the safe side.

Welcome back to running, friend. Have fun!