Running away from COVID-19

Apr 20, 2020

For many South African runners, the unthinkable has happened: The Comrades Marathon has been postponed and there is no word on a new date. Even worse, runners are confined to their own homes, away from their precious tarmac and trails!

So, time to hit the couch and wait this one out, right? Not so fast…

Exercise and resistance to infection: A J-curve response

Through decades of excellent research into the immune systems of athletes, we actually know rather a lot about the risk of upper respiratory infections (like COVID-19) in the athletic population. What the research clearly shows is that athletes should strive to be like Goldilocks when choosing how much exercise to do during the pandemic: not too much, not too little, but just the right amount. Couch-dwellers who do no exercise at all are more susceptible to infection than people who exercise regularly. In other words, exercise increases the strength of your immune system through various adaptations and makes you less likely to catch the infection. Importantly though, push it too far into the realms of overtraining and chronic fatigue and your immune system will suffer, making you more prone to the infection than someone who does no exercise at all!

Exercise and infection j-curve

As we know, most severe cases of COVID-19 occur in people with pre-existing medical conditions such as diabetes, heart disease and lung disease. Exercise may therefore secondarily lower your risk of severe COVID through the prevention of chronic diseases. Furthermore, there is more recent evidence that exercise may be able to decrease the risk of ARDS. ARDS is a severe complication of COVID-19 and a leading cause of death in those who succumb to the disease. Being fit and healthy is definitely preferable to being unfit at a time like this, so don’t hang up your running shoes just yet.

Finding your ‘just right’

It is clear that we need to be aiming for that moderate exercise zone, but what does that mean? Unfortunately, I can’t prescribe a one-size-fits-all exercise plan for the COVID-19 crisis. What constitutes moderate exercise load for you might push another athlete into overtraining. It all depends on what sort of exercise loads your body is accustomed to. One thing is for sure, this should not be the time for you to break PBs for weekly training hours or start with twice daily high intensity sessions. General guidelines for most people might mean 30-60min of low to moderate intensity exercise, 5 or more days per week.

If you are looking for something more specific, try using the RPE scale to guide your training. RPE stands for ratings of perceived exertion and is a self-assessed measurement of exercise intensity. Making regular mental assessments of your RPE and keeping it below 7 is a great way to ensure that you aren’t stressing your body too much. A heart-rate monitor can also be used for this purpose. A heart rate of less than 80% of your heart-rate maximum (75% for less fit athletes) can guide moderate intensity exercise. An athlete training at moderate intensity should still be able to hold a conversation. If your breathing becomes too laboured for this, you may be tipping into a high intensity zone.

RPE scale

Runners want to run

The trails and tarmac are out-of-bounds and it is important to respect this rule during lockdown. A lucky few runners have access to a treadmill at home or live on a property that can accommodate some lap running. Those of us living in smaller homes may need to be a little more creative. A new generation of driveway runners have emerged on Strava showing just how determined some people are to continue pounding some pavement. Our own Ryan Sandes even completed 1 463 laps of his property to complete a 160km run (almost certainly knocking his immune system down a rung).

We needn’t and shouldn’t go to those extremes however and there are ways to stay active even in the smallest of apartments. Rope-skipping and indoor cycling are great ways to keep your cardiovascular fitness without being able to run. There are an amazing number of apps and YouTube channels out there with various workouts to keep even the biggest fitness addicts happy. I would love to see some runners use this period as an opportunity to work on some of the strength and biomechanical issues they may have through structured rehabilitation and strength training. Your friendly neighbourhood physio or biokineticist would love to do a video consultation with you and prescribe some suitable exercises. Who knows, with some consistent work, you may come out of this crisis a stronger and more injury-resistant runner than you started.

For now, stay home, stay safe and look forward to your renewed appreciation of running outdoors when we finally get through this trying time.

Dr Jarrad Van Zuydam

Jarrad is Sports Physician at Netcare Waterfall SOS in Midrand, Johannesburg. He has worked with various sports teams at university and provincial level and has a special interest in edurance sports medicine. Follow Jarrad van Zuydam on Twitter @JarradVZ or read more about Jarrad here.

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