Returning to Training and Racing After Covid19, an Update
As the pandemic began to tighten its grip, the United States and the world began to enter lockdown. Meanwhile, professional sports leagues including Major League Soccer (MLS), Major League Baseball (MLB), National Hockey League (NHL), National Football League (NFL), and the men’s and women’s National Basketball Association (NBA, WNBA) were already planning the massive undertaking of getting back on the field so we, the fans, could watch. This planning and execution came at great expense and was meant to keep their most important assets, people, as safe as possible.
Through no small feat of science, technology, and a bit of arm-twisting, many sports leagues were able to use their own economic well-being to put athletes back in play. The NBA, with an annual revenue of $9 billion was the first to demonstrate that Covid19 was able to be tamed with their “Bubble.” It worked and, more importantly, it gave others the confidence to try it themselves.
The Tour de France was the first time since the Spanish Flu that a Grand Tour had been attempted during a public health emergency. Many people doubted the ability of the ASO to execute a “race bubble” effectively but they had more than $217 million in reasons to make it successful.
There is some easy-to-find literature that showcases how the NFL was able to leverage their $15.26 Billion annual revenue to pull off a complete competitive season with only a few interruptions. The thoroughness of the protocols is mind-boggling. Between August 9 and November 21 (15 weeks), the 11400 players and staff were administered 623,000 tests, with most being tested 6 days per week. That’s basically a nose swab with your daily morning coffee. If someone were to test positive, the NFL would do extensive contact tracing, quarantining (in fancy hotels) and more testing. They made mask wearing mandatory with stiff fines and penalties if the mandates were disregarded (anyone remember that game when Denver didn’t have a quarterback?). They also did extensive education about risky behaviors with NFL staff and players as well as massive upgrades to the ventilation systems in all of the spaces.
These protocols saved the NFL season and demonstrated that it was possible to produce a sporting season with minimal disruptions. This also served as a model which NCAA basketball was able to leverage to give us March Madness in 2021 (I won my bracket, did you?).
Even with all these protections, players still got Covid19. But the outcomes were far from catastrophic.
Earlier this year I provided concise and effective guidance for a coach as they guide an athlete’s return to training following infection with Covid19. That article can be found on Training Peaks here. However, when determining best practices, treatment and outcomes are both of utmost importance.
Those same professional sporting leagues mentioned before, MLS, MLB, NHL, NFL, WNBA, and NBA, executed an effective return to play/ training (RTP) model that included using an advanced and extensive cardiac testing protocol. The goal of this extensive testing and retesting was simple: to detect and assess inflammatory heart disease in professional athletes with prior Covid19 infection and to use the established guidelines to safely guide the athletes as they return to play.
The outcomes of the RTP protocols were exceptional. Of the 789 confirmed cases 30 athletes necessitated additional screening with 5 athletes needing to be restricted from play. To date, no adverse cardiac events have occurred. Not a single one.
But what is this extensive testing and screening protocol and how available is it to anyone that is not active in a professional sports league? Tests include: IgG Test, PCR Test, Troponin Test, Electrocardiogram (ECG), Echocardiogram (Echo), Cardiac MRI, and Stress Echo. If you’ve ever had a reason to be involved with any cardiac care you know that these tests are expensive and time intensive and not scalable for the general sporting population. In short, this level of care is only possible for these sports leagues because they spend immense resources on the health of their most valuable asset to ensure that those assets stay valuable.
Professional sports leagues have a combined billions of dollars of resources at their disposal and an abundance of team health professionals along with advanced medical care. The fact that they were able to effectively utilize the most up to date Covid19 treatments in a way that avoided any cardiac events and the public relations blowback that would have resulted is a testament to science and medicine but also to how much we wanted or needed to watch professional sports during the pandemic.
But none of that matters if you’re aren’t currently an athlete in those professional sports. The rest of us live in a reality where scans need to wait for days and results take weeks and the hospitals are both full and empty at the same time. We should do everything we can to avoid Covid19 and any potential for cardiac events (Remember that they don’t run national news stories on the random masters rider that has myocarditis from Covid19). Stay vigilant until you can take yourself “off the Covid19 playing field” with a vaccine. Once that happens, life is a little less anxiety-filled and the sky gets a little brighter. Until then, stay safe and know that we’re almost through this… hopefully.
Resources:
- Implementation and Evolution of Mitigation Measures, Testing, and Contact
Tracing in the National Football League, August 9–November 21, 2020 - Prevalence of Inflammatory Heart Disease Among Professional Athletes
With Prior COVID-19 Infection Who Received Systematic Return-to-Play
Cardiac Screening - Coronavirus Disease 2019 and the Athletic Heart
Emerging Perspectives on Pathology, Risks, and Return to Play
About the Author: Adam Mills MSED, RCEP has raced at the elite level since 2002 and graduated with a Masters Degree in Exercise Physiology from the University of Kansas in 2005. His true talent comes with his ability to combine his vast experience with his knowledge of sport. He is indeed a student of science, sport, athletic performance, strategy, and tactics. He continuously educates himself by keeping up to date with current research trends and methods in sport and his clients have reaped the benefits from this work with over 17 national championships in 11 disciplines on two continents. Adam is able to incorporate these attributes on a daily basis to help his clients reach and exceed their goals whether they are a beginner or a seasoned professional. Learn more about Adam and Source Endurance here.