Over the past six months, the loss of sports seasons and consistent training schedules, has resulted in a de-training effect for many student and adult athletes, which could have an unfortunate and lasting impact on our student athletes and adults by increasing the risk of injuries when they are finally able to return to play. While it’s great that schools are making an effort to find creative ways for their student athletes to play, the combination of compressed seasons, limited ability to practice, and Covid-19 related deconditioning, could result in greater numbers of sports injuries.
With gyms and schools closed, and adults and kids working and attending classes from home, Covid-19 has not only added stress and fear to our lives, it has for many also added to our waistlines. Parents and kids are spending hour after hour in front of screens in meetings and lectures. In my sports medicine clinic, I commonly hear teens and young adults admit to 6, 8, and even 10 hours per day on computer screens. Additionally, from talking to my adult patients, most would confide that they’ve gained weight over the past 6 months either from exercising less, sitting in front of a screen, eating more, and even drinking more. With the loss of school and sports, many of my teen patients admit to spending more time in bed, often joining their zoom classes a few minutes after their alarm goes off. Normally active student athletes, are now getting little if any “steps” during the day, and spending more time than ever in front of various screens zooming, playing video games, doing assignments, facetiming with friends, etc.
While we remain optimistic that many of these restrictions are temporary, and that eventually kids and adults will be able to resume more normal school, work, and recreational activities, we can’t help but be concerned about the negative effect Covid-19 is having on our physical health both in the short and long term. In medicine, study after study reveals the physical, emotional, and mental benefits of regular physical activity, for people of all ages. From the very young to our seniors, the inactivity and isolation resulting from social distancing can have negative effects on our wellbeing. Having an awareness and making an extra effort to stay active and connect with others safely is vital for the health of our brains and bodies.
What can we do to reverse Covid-19 related deconditioning, and prevent sports injuries?
Some general recommendations are: eating healthy, exercising regularly even if only briefly, getting plenty of rest, avoiding stress eating, avoiding unhealthy snacking, and avoiding drinking sweetened or alcoholic beverages.
A more specific answer depends on several factors: the specific sport, the age of the athlete, and the athlete’s baseline fitness.
First, the good news is that if you were active before Covid-19 and benefited from a good baseline fitness level, you can recover your fitness back to pre Covid-19 levels relatively quickly. The bad news is that if your activity levels have been in a state of decline for more than 6 weeks, you will need to take extra time to ramp back up to pre-Covid levels of exercise in order to regain much of that cardio and strength again and avoid injury. Studies show that very little fitness is lost if an athlete misses 2 weeks of aerobic sports activity, however, additional down time can result in loss of aerobic fitness and strength.
For example, an athlete in the age range of 15-22 who enjoyed a solid baseline fitness pre-Covid 19, but had limited access to soccer fields and practices for several months, will likely need 4-8 weeks of consistent aerobic and sport specific exercise progression, to get back the fitness that was lost during the Covid-19 lockdown. The good news is that the more fit the athlete was pre-Covid 19, the quicker they will be able to regain their aerobic endurance once consistent training begins.
Soccer, basketball, cross country, swimming, track, and other endurance sports have similarities in this regard. Tackle football has an aerobic component, as well, but relies on additional strength and explosive power.
Studies looking at weightlifting have found that strength can be maintained for 4 weeks after stopping weightlifting before more significant detraining and strength loss occurs over weeks 5-16 and beyond. In these studies, weightlifters were still moving around and going about daily activity. We know that if they had been confined to bed rest, they would have likely seen the detraining effect earlier.
At Sports Health Northwest, I sometimes get asked “Why do muscles look smaller after a brief period of a few days to a couple weeks of detraining?” Muscles store glycogen and water and if the glycogen storage is not needed, muscles can look smaller after a few days of not working out. However, water and glycogen return to the muscle once workouts resume giving them an appearance of being larger. I also hear “What effect does de-training have on flexibility?” Studies have shown that stopping training for 4 weeks can reduce flexibility by 10-20% in teens and young adults.
The loss of endurance, strength, and flexibility resulting from sitting, zooming, and less access to sports and activity, can increase the risk of injury for student and adult athletes. It is essential to recognize the value of getting back in shape before playing sports, and not playing sports in order to get back in shape. In order to gradually build back fitness and be ready for the winter sports season (and beyond), I recommend 4-8 weeks of lead time, or pre-season training. This should include some form of aerobic (cardio) exercise most days of the week, as well as, strength training, and flexibility training 2-3 times per week.
This will benefit us by lowering the risk of sports related injuries as our student and adult athletes get back to more team and outdoor activity. We also benefit from the stress relieving brain and body benefits from regular physical activity. Committing now to eating better, exercising regularly, and avoiding excess drinking can also help get us through the remaining months of 2020 and as an added bonus, help reduce the additional holiday challenges to our waistlines and stress levels.