The Art and Science of fitness | Returning back safely to running and exercise

I had my Covid-19 appointment in May 2020. I was depressed for a couple of weeks with the viral infection, followed by two more weeks of recovering from weakness. This experience made me realize that getting up to go to the bathroom was like running an ultramarathon.

I made my first run attempt in October, exactly two years ago, when a lot of people were succumbing to Covid-19. So it was more of a psychological challenge than a physical one. He would struggle to run even a single kilometer in one go. To put it in perspective, I ran 30-40 km every Sunday before the lockdown was imposed. So I had to practice what I had been preaching to everyone else: Focus on each breath and each step and learn to let go, instead of stiffening. It felt like I was back in my early stages of running.

It was my first-hand experience of the challenges newbies face when starting to exercise. Although I had access to a lot of theory, I had a hard time putting it into practice. He would plan each night for the next morning’s race, but then he would make excuses. Covid-19 made me nervous like never before.

Around the same time, several reports said that people who had recovered from Covid-19 had myocarditis, that is, inflammation of the heart muscles, which put them at high risk of having a heart attack, even more so while they exercised, played or ran. -COVID-19.

From my own experience and what we know about Covid-19, which is still not enough, my advice to athletes and runners has been to err on the side of caution. If you’ve ever had a mild episode of Covid-19, don’t rush back to an active lifestyle. Don’t start where you left off. Listen to your body about how hard it can work without working too hard. When in doubt, take it easy over the next few weeks, gradually rebuilding it. For a month, don’t bother increasing the intensity.

Learning to move slowly, for me, was a blessing in disguise.

It took me two months before I managed to run a full 10K. It was important to me to run, not only because running has physical benefits, but because running is my passion and my love: it is always there for me, it never judges me.

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In recent months we have heard of unusual deaths during races or in gyms. Due to fears induced by covid-19, there has been much talk in the medical fraternity about screening everyone who wants to run, go to the gym or play sports to identify those who are at higher risk of sudden death. When one person collapsed and died at the Delhi Half Marathon, he was one of more than 11,000 participants in the event who ran 10 and 21 km. Imagine if every person at the event had to be tested!

The 11th edition of the American College of Sports Medicine (ACSM) Exercise Testing and Prescription Guidelines recognizes the value of routine medical screening procedures, such as medical evaluation and exercise testing, in asymptomatic low-risk individuals. risk, not proven. There is insufficient evidence for even routine cardiovascular screening to prevent the most common cause of sudden death in asymptomatic young sports enthusiasts.

One thing we are taught in medical schools is that we must treat the patient, and reports alone do not tell the whole story. Physicians dealing with athletes and sportspeople need to understand them and the activity they are involved in, rather than just reading their reports. A classic example is an idea of ​​”maximum heart rate” to determine how hard someone can and should push. It is often quoted as “220 minus your age,” which further refers to the American Heart Association. There is a basic flaw with this formula because it is assumed that all people of a certain age have equally healthy hearts and can tolerate the same amount of physical work. And that’s why your sense of exertion becomes an important feedback mechanism on how hard you should push yourself. This formula might work for the sick, but definitely not for the active.

So if we don’t all need to line up for testing, then do we? The responsibility lies with us.

It is important to also recognize that common things commonly happen. Many people have taken up running and other forms of exercise during the lockdown. Many of them had no sports training or restarted after a long hiatus. They enjoy exercising, more with simple movements like running because, perhaps, like me, they find it meditative.

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The ACSM Exercise Testing and Prescribing Guidelines state: “Vigorous physical activity, particularly when unaccustomed and performed by inactive and unfit persons, may acutely increase the risk of sudden cardiac death and/or acute myocardial infarction. of myocardium in people with known or occult cardiovascular disease.

While this sounds like common sense, the problem is that we’re missing our rhythm. We started off too quickly, rapidly increasing mileage and speed, and entering too many events – a classic recipe for disaster.

In the Delhi Half Marathon, more than 44% of the participants who ran 21 km ran the last 6 km at 8 minutes per kilometer, and more than half of the participants ran the last 5 km at a pace (minutes per km) more than a minute slower than they ran the first 5 km. That’s lower than a brisk step for anyone who goes for a walk regularly. They started too fast, not knowing how to pace themselves, and then started paying for it later, exposing themselves to serious medical conditions. If they had planned their pace better and trained well, more important than finishing faster, they would have enjoyed the last half or quarter of the race as well. Just think of those who started running so fast that they took 4 minutes less per kilometer when they got to the finish line.

Then there are some who push too hard at the beginning, who have a desire to run faster than they are capable of on race day, it may be because they were forced to take a break due to injury or illness, or those who simply never he had the physical condition and training to perform at that level. It might surprise you to learn that these are the people who are more likely to get into trouble than the slower ones who are literally walking around the park for the last 1/4 of the race distance.

When put into such dire situations, no amount of testing and research, no amount of planning on the part of the race organizers and no amount of competition on the part of the medical support team can do anything. You need to plan and train accordingly.

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So the first piece of advice is: If you’ve been inactive, don’t have any known chronic conditions, and want to start running, don’t start running. Start with walking. Even if you have been very inactive, start at a slow pace of 12-15 minutes per kilometer, gradually increasing your walking time. You could start with 15-30 minutes. Give yourself 6 months to progressively increase your standing time and pace, rather than signing up for a running event. Add strength training and breathing exercises to your routine, too. At the end of the day, breathing will keep you alive and muscle strength will allow you to move comfortably. And at all times, smile. This will help you relax your muscles, instead of straining.

In previous columns, I’ve covered how heat, humidity, and overhydration play a role in things going wrong and play their part in serious incidents that occur in athletes. People who haven’t done these distances and then are taking a long time, need to be consuming energy too. That also has to be thought about. As for water, don’t drink gallons of water at every aid station, as this can backfire, as over-hydration is much more fatal during races than dehydration.

Instead of blaming event organizers and management, and hoping doctors will pull a miracle out of the hat, we must first train smart, rather than train hard to begin with. Of course, organizers shouldn’t have records in place as most people don’t appreciate how bad things could go if they suddenly attempt these distances.

At the end of it all, we must remember that what the world faces today is not that we should be wary of moving. It’s just that we don’t move enough.

Keep walking and smiling.

Dr. Rajat Chauhan is the author of MoveMint Medicine: Your Journey to Peak Health and La Ultra: Couch to 5, 11 & 22 kms in 100 days

He writes a weekly column, exclusively for HT Premium readers, that discusses the science of movement and exercise.

The opinions expressed are personal.

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