Returning to sports post COViD-19

Thankfully the majority of people that contract COViD-19 will survive and for a significant number it will only cause mild symptoms if indeed any at all. However, as you will be aware this is a disease of the respiratory system and there is a lack of clarity at present as to the possible long term effects. This is particularly pertinent for the Endurance Athlete where Aerobic capability is heavily depended upon. 

Given that Endurance Athletes are the population I work with, I felt it was important to think about safe ways to return to training (and eventually competition) post infection. In this post I summarise what I learned and will update as more information becomes available.


At time of writing there is scant guidance (from the governing bodies) regarding athletes returning to sport post infection. The focus appears to be from the “industry” perspective as to how they would like practitioners to resume activities.

Fortunately the British Journal of Sports Medicine have given this matter some thought and published a very useful guide “The Graduated Return To Play Protocol”.

Original BMJ Sport Medicine Article

I would stress that the advice in the published article is calibrated to a performance athlete who experienced a mild to moderate illness. I would suggest that in this context “Performance Athlete” could be taken to be Elite level athlete. And moderate illness certainly falling short of any form of hospitalisation. Probably better to set the bar low and equate moderate to “required no medical intervention”, some paracetamol was all that was needed to get through it.

Given the cardiovascular demands of running and run fitness training, if you were not an Elite Athlete before your infection, then I suggest it is important to add significant additional time to each step in the Return To Play Protocol. If your illness required medical support then, as with returning to training after any medical condition, you should absolutely check with your Dr first and seek medical advice.

Starting Back

Prior to commencing the Graduated Return To Play Protocol the following conditions should be met as an absolute minimum:

  • At least 10 Days of Rest from the onset of symptoms, or diagnoses if no symptoms present
  • Ceased taking any form of treatment treatments (including over the counter paracetamol)
  • At least a further 7 days completely symptom free, AFTER ceasing to take any form of treatment.

Build up slowly

The protocol describes a series of steps, which start from a reintroduction of only walking with no increase in heart rate, through recommencing easy running / cycling at lest than 70% max HR and then the slow increase of frequency, then duration and finally intensity. The following infographic is linked from the BMJ site and describes the progression in a very accessible way.

In Summary

It seems clear that we are still in the early stages of understating the possible implications of this virus on Endurance Athletes. What is also clear though, is that unlike returning from the normal range of injuries, where “return” is often FAR TOO MUCH and FAR TOO SOON, in this case it would be very wise to take a much more cautious approach and be very vigilant of any unusually performance metrics during the return phase.

About Ed

Ed Stivala is an England Athletic qualified Event Group Coach specialising in Endurance Events. This is the most senior coaching qualification currently awarded to Coaches by England Athletic. His practice specialises in performance coaching for runners: online or face to face. He also hold qualifications in Personal Training, Nutrition and Swim Instruction.


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