As the coronavirus continues to spread throughout the world, the running community is far from immune. As the virus is relatively new, there are limited studies on the effects of Covid on physical exertion. An additional challenge to establishing conclusive data is the wide range of both symptoms and the duration of those symptoms experienced by those who have been infected. Even among healthy runners, these variations are present. Some with the virus test positive but remain asymptomatic while others develop long-term complications. These variations can leave runners unsure how to return to training after a Covid diagnosis. My goal in writing this isn’t to dive into the scientific research, because there isn’t enough research available to draw strong conclusions yet. I would however, like to share my experience contracting Covid as a runner for those who have questions or are currently dealing with Covid or Covid-related complications.
A quick side note for runners who have tested positive. First and foremost, you’re not alone! In a time of decreased human interaction, it’s tough to feel further isolated during quarantine when all interactions are cut off and (heaven forbid) you can’t run. Make sure to reach out to friends and family for support. It can also feel upsetting to inform others of your diagnosis. Most people I told immediately asked me where I contracted Covid, which made me feel as though I had done something wrong. I had no answer because my husband and I interacted with very few people, didn’t know anyone who tested positive, and always wore masks in public. Know that the rate of contagion and spreadability of this virus are also not fully understood, and although safety precautions help tremendously, it is still possible to contract Covid no matter how careful you are.
Signs and Symptoms
I tested positive for Covid on November 23rd of 2020. On November 21st I set out for a long run like I do most Saturdays. I was a month out from the elite-only Marathon Project and in the best shape of my life. The scheduled run for the day was an 18-mile long run with the first 8 miles easy, then an 8 mile progressive tempo, then 2 miles easy. I couldn’t put my finger on it but I didn’t feel quite right during the warm-up. Then again, I’d had crummy warm-ups before so I didn’t think too much about it. During the tempo I felt increasingly fatigued and, though I hit paces, it felt far more challenging than it should have. I remember finishing the run and sitting down on the side of the road because I was so lightheaded. I know workouts aren’t always perfect so I chalked it up to a bad day and didn’t consider that I might be getting sick. In retrospect, I wish I’d worn my GPS watch for that run because I suspect my heart rate would have been much higher than normal and I might have caught on sooner. That night I slogged through a 3-mile shakeout run and felt completely exhausted during and even after the run. I was quick to accredit it to the challenging workout and went to bed. I woke up the next morning incredibly sick. I was achy and feverish with a pounding headache and couldn’t move from the couch all day. Running was out of the question. Because it was Sunday I couldn’t get a Covid test and signed up for one the next morning.
That next day I felt a little better so I hoped it was only a cold. The next few days I felt great and on Wednesday, I was able to do my scheduled workout of 8 x 1k which felt amazing. I was still cautious and ran by myself on a road I knew would be empty but I was relieved and felt certain my test result would be negative. However, later that day I lost complete sense of smell and taste and shortly after received my positive Covid result. My heart sank (in small part because I wouldn’t be able to taste Thanksgiving dinner). My husband and I quarantined and I called my sister Sarah who coaches me to tell her the news. We discussed what I should do moving forward and because I felt great and had no lingering symptoms we decided I could keep training (running in isolated areas where I wasn’t around people). Then Saturday rolled around. I had another long run, this time 20 miles with no quality work. I did wear my GPS watch this time, though I didn’t check my heart rate during the run. The first half felt a little sluggish and I was tired. As the miles progressed I felt worse and worse. I was so fatigued it was a challenge to put one foot in front of the other and my pace slowed considerably. I remember wanting to quit but knowing I couldn’t because I would have to walk back to the start. I knew something was wrong. When I finished and got back home I uploaded the data from my watch and was absolutely shocked.
For some perspective (because everyone’s baseline is different) my resting heart rate is around 40 beats per minute (bpm) and on an easy run my heart rate falls into the range of 120 bpm to 130 bpm. When I race my heart rate is around 160 bpm and sometimes near the end of a race it will get up to a max of about 180 bpm. For that “easy” 20-mile long run my heart rate averaged 166 bpm with a couple high points around 190 bpm. My heart responded as if I was running 20 mile race. Something was indeed wrong. I’d like to say I stopped training that instant, but being only a few weeks out from an incredible race opportunity I’d trained so hard for made the decision difficult. Hoping it was a fluke, I attempted easy runs the following couple days with the same result in heart rate. However, this time I kept a close eye on my watch and stopped each run short when my heart rate climbed above 160 bpm. It was at that point my coach and I called my season. I knew it was the right decision but I was still devastated. We decided I would take a week and a half to two weeks completely off and then see if I was recovered.
Returning to Running
To give an idea of my typical return to training after a break, I usually jump into 20-30 miles the first week progressing to 60-70 miles by 4 weeks with light workouts starting at the 3-week mark. At my peak training I run between 100-120 miles/week. (Keep in mind it has taken me years to build up to this and my body typically responds well to high mileage). My return since taking a break after Covid has been quite different. My first week back I ran (drumroll please)… 4.5 miles. No, that decimal point isn’t a typo. I attempted a couple of runs, both slow and on flat pavement, both of which I had to end before the 3-mile mark because my heart rate quickly increased above 160 bpm signaling that I needed more rest. The next week I nearly doubled that mileage with 8.5 miles, still slower than normal and flat. I ran 3 days, being sure to space them out, and felt slightly better with my heart rate staying below 150 bpm. The next week I was down at sea level and felt significantly better (I live and train at 7,000 ft). I even ran on trails with some incline for the first time. I continued keeping a close eye on my heart rate and checking in with how I felt, and I was able to run 30 miles that week. The next week, back up at elevation I was able to run 35 miles for the week (though on a run in which I attempted some elevation, my heart rate climbed too high and I had to stop). This past week was my fifth week of training, and I’m feeling close to normal and running close to my pre-Covid easy run paces. I hit 45 miles for the week, all of which has been easy mileage with no hard running. Working with my coach, we plan to continue this gradual increase eventually adding in speed work as long as I remain symptom free.
My return to training after Covid hasn’t been perfect but I’ve certainly learned a lot. In sharing this, I hope others can learn from my experience. There are a few take-aways I want to highlight for runners and coaches to consider when returning to training.
- First, healthy runners can be just as susceptible to Covid as the general population. Sometimes being fit gives us the illusion we’re immune to illness. Although exercise can improve our immune system it does not make us bulletproof. Safety is just as important for runners.
- Another consideration is that many runners will push and train through a cold or mild sickness with no consequences. Covid should not be treated this way. It’s not healthy or smart to train while symptomatic no matter how mild the symptoms. I had to take this advice myself when my only symptom was an increased heart rate and I wanted to keep running!
- There are other symptoms like fatigue, shortness of breath, and chest tightness which can remain for weeks, even months after Covid. Running while symptomatic can prolong the body’s healing process and delay recovery.
- There is also a chance (though not enough evidence yet to be conclusive) that running while symptomatic can cause long term lung and heart conditions. It’s simply not worth the risk.
- An additional consideration when returning to training post-Covid is that paces may need to be considerably slower and hills may be more challenging than usual. It took weeks before I was able to run uphill, and I’m just now hitting my normal paces.
- Almost all runners have a GPS watch and it can be a great tool to track heart rate. If you don’t have a GPS watch you can stop every 5-10 minutes and check your pulse manually. I actually prefer to do this every once in awhile to verify the accuracy of my watch.
- The final and most important consideration is if symptoms persist after Covid, it’s advisable to see your doctor for additional testing, especially before returning to running.
Our body enables us to run and it’s important to honor and take care of it. Taking the necessary time to recover and heal from Covid or any other illness will ensure you can continue to enjoy running, and stay healthy for the long haul.
Georgia Porter is a coach with Team RunRun. To learn more about her or to work with Coach Georgia, check out her coaching page.