Sport after corona disease: When can I start again??What professional and amateur athletes must pay attention to after a corona disease? When can you start again. With which signals of the body caution is necessary? A sports physician provides answers.
by Hendrik Maaben and Anne Armbrecht
Hendrik Wagner's stint at the European Handball Championships earlier this year against Sweden lasted barely five minutes. The 24-year-old managed three or four attacks and a goal before complaining of breathing problems. The European Championship debut was thus prematurely ended for the German rear player. He had "no air more, he said later.
Wagner had been ill only a short time before. He had spent seven days in isolation due to a corona infection. Came its use too early?
Wagner had only "a slight scratching in the throat"
The German Handball Federation (DHB) is convinced that they have done everything right. The team of national coach Alfred Gislason had to cope with 16 positively tested players during the European Championship, tells team doctor Philip Lubke. All the courses were "mild without exception" been. In addition to him as an orthopedist and trauma surgeon, the DHB had also brought an internist and cardiologist into the team to care for the affected players.
Wagner had only "a slight scratching in the throat" during the infection had, but otherwise no complaints. After the free test be heart ultrasound. ECG had been unremarkable. That's why they decided to "dare a stress test on the playing field as well".
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The DHB complied with the guidelines of the international federation for the tournament – but not with the recommendation commonly used in Germany, says sports cardiologist Martin Halle. According to the so-called return-to-sport protocol, athletes should wait two weeks before they return to full training. "It's been seen now over time of experience that it's probably already that you can go down from the 14 days to 10 days", Halle, medical director of preventive sports medicine and sports cardiology at the Technical University of Munich, said.
"This very fast – infection, three four days later then immediately again in the high performance sport – I do not consider correct. Hall has in the past two years pandemic many free time-. Professional athlete treated himself for Covid 19 disease. Even though the course of the disease was mostly mild, after recovery there were always complaints ranging from persistent exhaustion to lung and heart problems.
Corona disease progresses in two phases
The sports cardiologist explains the problem with starting too early with the fact that a corona disease essentially runs in two phases. "In the first phase I tested positive. After a week or so, a second reaction is triggered by the patient's own immune system. That is, I can be negative again from the test, but I have this second reaction, and that is also not to be underestimated."
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Doctors advise caution and patience
Some changes in organs are delayed due to the indeterminate inflammatory reaction. A heart muscle inflammation, for example, can sometimes only be seen after a few days, says Halle. A too early examination would then possibly not allow a diagnosis at all.
That's why, according to Halle, doctors advise a cautious start: at least a seven-day break from sports, then a gentle introduction, then full training again after 14 days. If the infection went without problems. In contrast, five days of isolation and two negative tests were enough for the European Handball Federation EHF at its European Championship, which was marked by numerous Corona cases, to come back when a player received medical clearance.
Prere and false ambition can be dangerous
"The EHF's goal was to get the players back into the game as quickly as possible and thus, of course, to get top performers back on the field quickly", according to DHB team doctor Lubke. By imposing additional examinations on themselves, the German Handball Association has tried to find an "interim solution To find. A withdrawal of the team was out of the question for the DHB for economic reasons.
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Halle knows this problem only too well from his everyday life. He also has understanding for this up to a certain point. But prere and false ambition can be dangerous, he says – even life-threatening in the case of heart involvement. An underestimated lung disease can also cost a professional at least his career. If you go in too early, you risk permanent damage.
"It is of course a job. There is a lot of prere from the club, from the federations, maybe from the athletes themselves", says Hall. "The regulating person is actually the doctor, who must also stand firm and say: It just doesn't work. One must protect the patient. Most athletes are responsible, he says. Could also assess their body well. Especially in the recreational area, the physician sees it again and again that people start again too early and with too high intensity.
Halle also thinks it's dangerous because there's no support in the amateur area. Not everyone can have a complete check-up after an illness. Many go through an infection without even knowing about it.
Cardiologist advises: listen to the body
Halle therefore also advises amateur athletes to be careful. "If I had a slight infection or only tested positive, I would say you can do full sport again after two weeks. So one week completely break, then three, four days loose, from the tenth day a little more intense. After two weeks I can do everything again."
If, on the other hand, the illness was accompanied by several days of coughing and thus lung involvement, Halle advises an additional week of rest. In the case of heart involvement, there is even a strict ban on sports for at least three months.
For the start itself Halle says, one should absolutely pay attention to the body feeling, after signals such as light dizziness, throbbing of the heart or prere on the chest feel. When running, for instance, think: "My goodness, I was much better off three or four weeks ago. My pulse beats upwards or I even have irregular beats at times.