For 25-year-old Emily Mellen, running is everything. So when hip and knee pain started flaring up during her runs, she knew one thing for certain: She wasn't giving up her sport without a fight.
The COVID-19 pandemic has impacted several domains of our society. From work, to school, to social outings, our day-to-day life has been significantly altered adapting to this “new normal.” The world of sport has been no exception. As public health concerns begin to ease, many athletes are eager to return to their prior level of competition as quickly and as seamlessly as possible. However, closures of gyms and training facilities have all but halted traditional training and many athletes are left deconditioned relative to their pre-pandemic status. Consequently, it is much easier for athletes to push too hard and too fast as facilities begin to reopen, increasing their risk for injury. Fortunately, new guidelines are in place to ensure measured and safe return to sport.
Phase 1: Warm-up
Week 1-2: The first few weeks back to activity should treated as “pre-season” training. In this stage, the goal is to prepare the body for movement by gradually resuming exercises in a thoughtful, methodical way. Individuals should focus on low to moderate intensity exercise such as cycling, light jogging, and bodyweight strengthening. This training regimen should be tapered to approximately 20-25% of the athlete’s pre-pandemic fitness level. This applies to the frequency, intensity, volume, and repetition of exercise. For example, if the individual was running 40 cumulative miles a week prior to quarantine, the athlete should begin at 8-10 miles per week during the first 2 weeks back to training. Other factors to modify might be speed (1 minute slower than normal mile pace), surface (level, predictable terrain), and weather (low heat and humidity).
Phase Two: Captain’s Practice
Week 3-5: The next phase of conditioning should include more resisted exercise and sports-specific training. Consider this phase the “captain’s practice” of returning to sport where the athlete might not be quite prepared to start the season, but ready to begin more focused training.
Moderate to high intensity workouts are appropriate at this phase but workload intensity should not progress more than 10-20% each week. Athletes should not practice more than once a day, and training should not exceed three hours each day to avoid overtraining. Exercises to consider at this phase include resisted strength training such as free weights, resistance bands and machines,as well plyometric and agility exercises. Sport-specific skills such as ball handling drills, stick work, and game-like play are also initiated at this stage to better prepare for competition.
Phase Three: Let the Games Begin!
Week 6-8: At the 6-8 week mark, athletes should begin resuming their traditional training regimen.Working closely with their coaches, strength and conditioning staff, and athletic trainers, programs should replicate pre-pandemic levels of participation. Full participation in competition is also appropriate and the athlete should feel strong and confident in their ability.
Heat and Humidity
Many athletes have been training at home and indoors due to facility closures and haven’t adequately acclimated to climbing summer temperatures. When returning to exercise outside, consider ramping up slowly. It can take the body 10-14 days to acclimate to dramatic changes in temperature.
HIIT training and Immune system response
Very high intensity training workloads have been associated with temporary changes in the individual’s immune system making them more susceptible to illness. Wipe down equipment before and after use, avoid high-fives/fist bumps with teammates, and wash your hands regularly.
- Phelan D, Kim JH, Chung EH. A Game Plan for the Resumption of Sport and Exercise After Coronavirus Disease 2019 (COVID-19) Infection. JAMA Cardiol. Published online May 13, 2020.
- Dores H,Cardim N. Return to play after COVID-19: a sport cardiologist’s view. British Journal of Sports Medicine. Published Online First:May 7, 2020.
- COVID-19 Reopening and Return to Play Resources. American College of Sports Medicine website. Accessed June 21, 2020.
- United States Olympic & Paralympic Committee Coronavirus Updates. Team USA website. Accessed June 20, 2010.