My comeback from COVID-19
Updated: Jul 25, 2020
I was the fittest I had ever been - ran 50 miles and did two strength sessions per week, had a VO2 max of 57, just ran a 1:27 half marathon and was in training for my fifth marathon - London, where I wanted to try to get under 3 hours for the first time. But then, during the peak of my marathon training, it happened: I got ill. 37 days of fever, 50 days without moving properly and of being in pain. That was my COVID-19 marathon. The illness robbed me of everything and left me with zero fitness, post-viral fatigue, huge muscle wastage and mentally drained. But after six weeks, I very slowly started to feel better and decided that it was time to focus on the way out of this misery and back to where I used to be. I didn't set myself a timeframe for my comeback, am not pushing anything and will listen to what my body has to say. Because during this whole saga, I've learnt that Corona doesn't like to be hurried... I managed once before to overcome all odds after a doctor told me that I would never run again. I know I can do it again!
I will try to share my journey back to running and training as honestly as I can, will talk about the ups as much as about the downs, talk about what worked and what didn't and share how I felt throughout the process. I am aware of how tricky exercising with post-viral fatigue is and I have read of many patients who constantly relapse. But I also read that many try HIIT or go right back to their usual exercise and don't properly build up. So I spent loads of time talking to experts: doctors, physiotherapists, coaches and psychologists, read many papers and studies and will come up with a plan. I will try to take it easy (please stop reminding me of this), and I will fail. I will dust myself off, and try again. Because I'm a runner and that's how I do things.
Week 7 after the onset of COVID-19 / Week 1 of project comeback:
Until week 7, I literally didn't do any form of exercise. I managed to go for two short and slow walks in week 5 but wanted to wait with everything else until my body got stronger. I read of too many COVID-19 patients who rushed back, who went straight back to running and who paid for it with relapse after relapse. After being fever free for a week, I decided to gently commence mobilising my body. I started by just moving around the flat a bit more and I went for one walk (1 mile). Added very easy yoga/stretches once a day towards midweek. After feeling good with all of this, I started to stand on the balance board for 1 minute per day. I love this board as it is a great way to gently activate muscle fibre. The whole week was just gentle activation, no push, no elevated pulse and it felt good. Every time I added a bit more activity, I made sure to rest a lot, take on fluids, continue eating healthy and to take a rest day afterwards.
Week 8 after the onset of COVID-19 / Week 2 of project comeback:
Comeback day one: started the 'workout' with some light stretching. Then spent 2 minutes on the balance board. Started with just standing on the board and added two squats, which I held for around 10 seconds. The highlight was my first ride on the old and crappy stationary bike. Did 5 minutes slowly (2.5km) - it felt AMAZING. I felt a tiny little bit like myself again and could not believe my luck. HR fluctuated between 125 and 145 and it took quite a while for it to come down after the exercise. Made sure to rest for the rest of the day. In the evening, I did some activation/stretching exercise I got from a friend.
Day two: Felt very tired and strained throughout the day but none of my symptoms was worse. So I decided to give my body a rest day. Still can't believe that I need a rest day after cycling for 5 minutes... But I do as my body tells me. I have to accept that the virus has completely wiped me out and that this will take a long time to get back to where I used to be. But I am excited to get there. Did some light stretches in the afternoon and some calf raises to make sure to strengthen my weakest points right from the start.
Day three: I decided in the morning to clean the flat. And given my very little amount of energy, that meant that any exhausting type of workout was off the table. I really have to force myself to be careful with my energy. My athlete's mind tries to intervene and tell me that 5min cycling is nothing and that if I want to come back, I have to push myself. But I know that this approach doesn't count with this illness. So spent 30 minutes stretching instead and took hoovering and dusting as my cardio ;-). A friend introduced me to a couple of 'activating' exercises - exercises that are like light massages of various points in the body that activate muscles or organs.
Day 4: Today I felt strong enough for another workout. I kept it roughly the same as last time - 5 minutes on the balance board and 5 minutes easy cycling, followed by a stretching session. I added some resistance bands to the balance board session and some subtle muscle activation exercise. The end of the video speaks for itself. I can’t put in words how much getting this little bit of my old life back means to me ❤️. Now rest and see how I feel tomorrow. My body is dictating the process. Taking it easy is key. Took a recovery shake after the workout and made sure to have a healthy meal incorporating many natural anti-inflammatories.
Days 5&6: I took two days off exercise to see how my body reacts to the increased activity. Luckily I didn't experience a setback and didn't feel worse at all. Rather the opposite, the exercise was a huge boost and I felt mentally and physically stronger. My appetite returned after all this (I spent two days non-stop eating) and I could feel that my body got what it was missing so much. During those days I just increased general activity (worked more, spent more time on my feet and did some chores). I had a chat with a psychologist specialised in patients with long-term illnesses who works a lot with athletes. She explained to me that my body was experiencing a massive endorphin-withdrawal as I used to train so much before getting ill. She encouraged my slow and careful comeback. My biggest challenge seemes to be my heart. Whilst my breathing was good, my heart rate overall was still quite high. I had a HR of around 75 while just sitting on the sofa - it used to be around 60 in such situations. Also, my morning resting heart rate went up from 52 pre-illness to 65. Whilst some of that is definitely the lack of training, I'm wondering if my heart took a beating. Will discuss this with my GP.
Day 7: I spent a lot of time reading studies and exercise advice for patients with post-viral fatigue and high heart rate, spoke to two physiotherapists and a couple of athletes in similar situations. And I decided to slightly change my approach. Instead of sticking to time limits (5 min of cycling), I designed my exercise heart-rate based. Keeping it low while increasing the length of exercise and intensity seems to have worked for many. So a week after starting my 'comeback' I went for a walk and felt absolutely great. Therefore, I decided to slowly jog for, having a close look at my HR. I stopped as soon as it reached 130 and walked until it dropped below 100, then I started jogging again. If felt INCREDIBLE to do something close to what I call running. But even though I moved with a 7:30min/km pace, it took only around 50-60 seconds to reach 130. In comparison, pre-illness, I easily ran a 5:15min/km pace at that heart rate. To get an idea of my fitness, I ran my usual easy pace (around 5:15) for a couple of seconds and my heart rate shot up to 147 within seconds and would have definitely gone up higher if I hadn't stopped immediately. Shocking, but it's a baseline which I'm hoping to work on over the next months. I completed 2 miles with this walk/jog approach and felt great. HR didn't spike or change afterwards but still stayed generally high as described the day before.
Week 9 after the onset of COVID-19 / Week 3 of project comeback:
Day 8: Woke up feeling generally good. Had loads of energy and for the first time since the start of the illness didn't sleep in the afternoon. HR unchanged so I went for an easy 2 miles walk. Compared to my first walks a couple of weeks ago, I felt strong, almost normal. Didn't have to stop and naturally walked 2min/km faster than two weeks ago. Baby steps. Finished the day with some easy stretching being thankful for the progress, even if it's still very, very slow.
Day 9: Felt good today so decided to do another low HR workout. After some stretching and 10 minutes on the balance board, I spent 30 minutes cycling, constantly making sure to keep my heart rate below 130. Felt really good and HR came down nicely after the exerciser Overall I can already see a small improvement in my fitness, which is promising. The process seems very slow but so far I have been improving without setback and that's the only thing that counts for the moment. Finished the session with some stretching and gave my (non-existent) muscles some TLC with the massage gun. Had a very balanced dinner focusing on antiinflammatory ingredients and had a protein shake after the cycle. I know that I suffered from immense muscle wastage so I'm making sure to keep my body fuelled correctly - even after low impact exercise. Finished the evening off with an Epsom salt bath and a tumeric-cinnamon-latte.
Day 10: Felt generally good but had very little energy. Whilst the low HR exercise doesn't seem to cause a relapse, it still uses a lot of resources. So I had a very quiet day, rested most of it, postponed cleaning my flat and just focused on regaining energy. Did some light stretching and treated my sore muscles with the massage gun. Yes, I had sore muscles. What an amazing feeling!
Day 11: After a very relaxed and quiet morning, I did 10 push-ups and then ventured out to go for a walk and a walk/jog if I felt strong enough. I felt fabulous whilst walking, so after 2km, I switched my Garmin to run (oh how sweet that felt) and started to jog slowly. I followed the same approach as on the first 'running' session: jog until HR reaches 130 and then walk until it falls below 100. I was really surprised to see that I could jog more than 5 minutes in the beginning with an 11min/mile pace (I only found out about any pace afterwards as I only had the HR monitor on my watch face). In comparison, during the last session, I only lasted 1 minute at a 12:30min/mile pace. I really take this as a good sign that my approach seems to be working. I kept the session very short and only did six running blocks (1.5 miles) but am really happy to have moved. It felt absolutely fantastic and these little sessions give me an immense boost in motivation. Initially, I thought that I would be depressed by the slow progress and the for me very slow pace but I am over the moon to be able to do this and to see progress at all. Finished the day with a nice stretching session and a bath.
Day 12: as after every workout, I took a rest day. Felt generally good but a bit tired. Still had some occasional pain in my ribs but nothing new and definitely didn't feel worse. Had a great video appointment with my GP and he decided to have my heart checked properly before increasing my training (he's an athlete himself and understands my journey). But he was happy with my progress so far and told me to continue. Did some light stretches in the evening.
Day 13: had the ECG at the clinic and it was all clear. Did a 35min low HR session on the bike again (keeping HR below 130) and enjoyed it massively. Overall I felt really good and from times to times completely normal and healthy. Also on the bike, I feel that I'm already getting a bit stronger and it showed afterwards that I cycled slightly faster with the same heart rate. Baby steps but progress 😍
Day 14: took a rest day as I worked a lot and could feel that I was tired. Slept a lot and did some light stretching.
Week 10 after the onset of COVID-19 / Week 4 of project comeback:
Day 15: Had very little energy during the day. Slept in the afternoon and rested as much as I could. Felt a bit better in the evening and did some very easy cycling for 15 minutes. Got an amazing surprised from Meglio who sent me a complete recovery package - yoga mat, foam roller, 3 massage balls and 12 resistance bands. That's exactly the motivation I needed.
Day 16: Woke up feeling really good and had loads of energy. Did some light stretching in the sun in the morning and went for my third walk-run session in the afternoon. Walked for a mile to warm up and then started running slowly, trying to keep my heart rate around 130. The first 5 minutes went really well. Then my heart rate shot up as I had to run uphill for a short while. After that, it was harder to control it and I walked whenever the heart rate went up too high. I've lost around 80% of my fitness and pretty much all of my muscle mass. This comeback will take a while. But being out there, hearing my feet hitting the pavement (as slowly as it may be) and feeling the sun on my skin is all the motivation I need.
Day 17: Lots of rest during the day as I felt quite tired. But no increase in symptoms or pains. Late evening I had a surge in energy and decided to do an easy 15min cycle. On the one hand just to get my body moving, on the other hand, to slowly start increasing the frequency of my exercise. So far I rested for a day after every form of exercise. I will now enter the next stage and add a short, very easy exercise the day after a regular/longer exercise. The added session will be a 'recovery session' with little stress on the body. I will observe how my body responds to this and adapt if needed.
Day 18: I went for an evening run. Decided to slightly increase my max Heart Rate and keep it around 140. HR spiked after 4 minutes and I walked for a bit. After my heart rate came down nicely, I resumed the run and finished almost 1.5 miles without walking. Felt really good. Concentrating on breathing and on controlling my heart rate. in two days, further cardiac tests will hopefully give me the green light to push my heart rate a bit more towards the end of the month. Since today, my Garmin shows a training status again. My VO2max has decreased from 57 to 50 and after this easy workout, it suggests 29 hours rest. Baby steps...
Day 19: Rest day. Felt tired but not bad. Body responded very well to the increased session. No heart palpitation, no extreme fatigue - I just felt like the day after a tough workout. And that is what every exercise at the moment is - a proper workout. So I just rested, relaxed and did some light stretching in the evening.
Day 20: Exiting day - did my first strength session with my PT. The last workout I did with him was on 26 March - the day before I developed the fever. I remember saying after that session that I felt like having no energy... No wonder, I was coming down with Covid. Today's workout looked veeeery different from that two months earlier. Ed did an amazing job making sure not to overdo it - tested my range of mobility in the beginning. then he introduced body weight and resistance band workouts and made me start with little reps and resistance. I did go up in the strength of bands in two workouts which felt good. The workout consisted of mobilisation, glute bridges, single-arm banded rows and single-legged glute bridges. We decided to keep the sessions short and only do 30min to start with. I had an eye on my heart rate and it stayed nicely low throughout the workout. I am very happy to have Ed working with me again and to be able to start building up some of that muscle mass I have lost.
Day 21: Took a rest day to see how my body would react to the strength training. Felt good - not overly tired but could definitely feel my sore muscles. Oh how much I had missed this feeling... Overall I'm feeling much stronger. I now work 100% and hardly have to take extra breaks, my concentration is back and I've even resumed studying.
Week 11 after the onset of COVID-19 / Week 5 of project comeback:
Day 22: After a hectic day in the home office and a visit to the clinic for more cardiac tests, I had another strength session with my PT. We currently keep the sessions to 30 Minutes but schedule them twice a week. Ed designed most workouts around my beloved balance board (which Ed actually gave me a couple of years ago as no one used it in the gym but me). The balance board just made my body work a bit harder while activating the small muscle fibres. I could really feel how much strength and endurance, balance and flexibility I lost - but it was great to feel my muscles burning again. Had an eye on my heart rate and had to sit down a couple of times between the workouts. I'm still trying not to push it too much. But especially during the workouts standing on the balance board, my heart rate shot up to approx 150 a couple of times. It came back down nicely right after but I not to get it go up that high and stepped back or rested whenever it did. Time will tell if this will level and the heart rate come down again. But I can definitely see very positive progress and I can’t wait to take the next baby steps.
Day 23: Most active day so far. Cycled 4.5km to Battersea Park to meet a friend for a walk-run session. My friend had Covid-19 too and we supported each other through the illness. It was so good to see her again in person and to socially distant run together.
The bike ride was very stressful and my heart rate was through the roof throughout and at one point even reached 170. Therefore I was quite vary running right afterwards. But after around 10min walk my HR came down and we started running. Did 5min run/5min walk x7 - the longest session I have done to date. We took it nice and easy and my HR stayed nicely around 135 during the running sessions. took a cab back home and made sure to relax for the rest of the day - even had an hour nap in the afternoon.
Day 24: Rest, rest, rest. Felt very tired throughout the day and had a tight chest - but not bad. Made sure to rest a lot and postponed my PT session and cleaning my flat. Had blood tests done at the clinic which was my last test before the appointment with the cardiologist. Hoping for positive results tomorrow.
Day 25: Time for another strengthening session with my PT Ed. We focused on exercises I could do lying down or keeping my body low as we figured out that my heart rate stays lower like that. The session was mainly targeted at glutes, back and core muscles. Small movements with resistance bands and balance. Let me tell you small movement doesn't equal easy. Loved the session and felt strong throughout. HR stayed mainly low but shot up when I did a couple of press-ups in the end so will have to have an eye on that in the future. In the evening I had a long call with the cardiologist. All my tests came back fine. But my high heart rate is worrying him so I will have to do more tests. He's fine with me continuing the way I have been exercising (on very low heart rate) for the time being. He also warned me that it might take up to 6 months until I can properly train again. A hard pill to swallow. But he also told me that he doesn't see any reason why I shouldn't fully recover and get back to where I was before the illness. This is what I'll focus on. I can do 6 months if that means that I can fully train again.
Day 26: Rest day. I actually didn't feel too tired, which is a great sign. Nevertheless, I took a rest day. The only activity I did was walking up the 50 flights of stairs to my flat after picking up a delivery. I stopped a lot and in order not to make it a workout, I made sure to keep my heart rate under 100.
Day 27: Run day 😍. I still struggle mentally with the fact that I can't just run every day. I consciously vary my workouts throughout the week but as I am very cautious, I'm not yet doubling up, which means that I only get to run 1-2 a week. The great thing is that I cherish theses sessions even more. I opted for a slow low heart rate continuous run and did my 2-miles loop and managed to jog it without a walk break for the first time with an average HR of 135. Although I'm running, the pace doesn't feel natural to me and I miss my 'real running feeling' a lot. So I couldn't resist and just ran 100 meters in a 5:17min/km pace (which is my old recovery pace) and just loved the way my body moved and my form adapted to what I am used to. Theses 100m gave me the motivation I needed. It is really difficult for me, having to hold back with everything I do. I am naturally a person who always pushes myself and I get energy out of that.
Day 28: Felt good after the run and went ahead with my PT session, testing again if my body tolerates two consecutive active days. Ed make sure that my heart rate stayed low and designed a great upper body and core workout. All workouts lying on the floor seem not to influence my heart rate much. Standing and moving workouts on the other side, cause it to spike quickly and I need to be careful with them. Felt good throughout and could actually feel, that I was slowly getting stronger.
Week 12 after the onset of COVID-19 / Week 6 of project comeback:
Saturday: rest day. Sunday: I met friends in a park for a socially distant picnic. Jogged 2km to a toilet and back and then did a 2.5miles walk-run from the park to the office to clear out my desk. The run didn't feel comfortable, my HR was very high - I walked every time it went above 130 - and my Garmin said that I was still losing fitness. But I didn't feel bad after the run and didn't have new or increased symptoms. Monday: did a core workout on my own and a low HR cycling session of 30min. Tuesday was rest day. Wednesday: I trined with my PT again, focussing on my legs. We made sure to keep my HR below 130. Thursday: Went for a 2.5miles evening run at an average of 10:15/mile. Tried to keep my HR below 130 but didn't manage fully. Just felt very frustrated by the fact that I still couldn't run at any normal speed... Started to take 10% CBD oil 3x 2 drops a day as another athlete recommended this. apparently it can help to lower the HR... Friday: had the Cardiac MRI and got a 48hour holter monitor fitted. Cardiologist asked me to do a workout each day so he could see what my heart does. So I did a PT session in the evening and 20min on 130bpm on the bike.
Week 13 after the onset of COVID-19 / Week 7 of project comeback:
Saturday: did my first 5km. Tried to keep the HR down and walked a couple of times. Average of 9:54/mile. Sunday: Met my friend and fellow Covid recoverer Lynsey at Battersea Park for a walk-run session. We did 4.9miles in a 1h walk-run session (5min on/3min off). Clearly exhausted from the day before - HR too high and I felt very tired even though we took it very easy 😞. Slept a lot in the afternoon. Monday: Rest day - very much needed. Due to the holter monitor, I worked out on four consecutive days which I felt very clearly. Slept a lot and gave my body as much rest as possible. Tuesday: Strength session with my PT focusing on my glutes and arms. Ed made sure that I build up all muscle groups in my body as I had lost strength everywhere. Finished the session with 20min easy on the stationary bike. Always keeping my HR low. Wednesday: I needed to have the feeling of running properly and not only jogging slowly. So I for once ignored my HR and just ran to feel. I managed the first 5km without stopping and just sneaked under 30min (9:27/mile). Average HR of 152bpm. Even though I felt guilty for not keeping my HR low, I was over the moon and beyond happy to have felt the joy of running I had been missing for such a long time. And the cherry on top: my Garmin showed the training status productive for the first time. It felt like something had happened in my body - as if it had switched from recovery to build up. Thursday: Went for another 5km, running purely to feel. managed to run it quicker and on a lower HR, the first clear sign of my body building up. Friday: did another full-body training session with my PT. Definitely getting stronger. Got the diagnosis from the cardiologist. All good besides the elevated HR. Prescribed meds (Ivabradine) but gave me the all-clear and told me that it was ok, to start pushing the HR higher. For me, this marked the start of project Blue Line: getting back into marathon shape!
Week 14 after the onset of COVID-19 / Week 8 of project comeback:
Saturday: Rest day. Sunday: Another walk-run session with my friend Lynsey, slowly building up the miles. We did 7.4 miles with intervals: 10min run, 3min walk, rest 6min run/2min walk. I wanted to see how my Hr reacted to sprints and what my legs would say to them... So I ended the run with 3 strides x 20 sec (3:10/3:10/3:01/km)) - first time I sprinted since falling ill. Felt amaaaaaazing! Monday: Rest day. After more miles and higher HR, I decided that my body needed rest. Tuesday: Did another strength session with my PT and an easy 10min on the stationary bike. Wednesday: Rest day. Training on higher HR meant to rest more so I took another rest day to give my body the time to recover properly. Thursday: I went for a great run in the rain. did 4.87 miles and felt really good. Average HR 150 but definitely ran quicker than before. Friday: PT session with ED focussing on upper body and core.
Week 15 after the onset of COVID-19 / Week 9 of project comeback:
Saturday: easy 30min run - my first run on my training plan. My coach Jordan and I decided to start proper training again. I'm so thankful to be able to work with her again. Especially as I know that she will make sure that I don't overdo it. Started to take the ivabradine heart medication. Sunday: Another build-up session with Lynsey. We focussed on time on feet and did a 1.5hours walk-run session, ending with 3x 20sec strides in the end. Could see a massive change in HR - but didn't feel comfortable sprinting as my HR just wouldn't go up enough. Monday: Rest day. After a very bad night due to the HR meds, I decided to stop taking them - I just didn't feel comfortable. My HR was low again and I wanted to see if it stayed that way without the meds. Tuesday: Warmed up 15min on the bike. Then did a 30min strength session with my PT, followed by 30min easy on the bike to cool down. Wednesday: Went for a 30min easy run and ended on 3x20 sec strides. VO2max mack up on 50 (was on 57 when falling ill and down to 47 when starting the comeback). Thursday: rest day. Friday: 1h Strength session with my PT, focussing a lot on balance and core strength. Also did 30min easy on the stationary bike.
Week 16 after the onset of COVID-19 / Week 10 of project comeback:
Saturday: 30min run plus 3x20sec strides. Getting much stronger and faster. Managed an average of 8min/mile while feeling really good. Sunday: Walk-run session with Lynsey. Did 1h20 - taking it easy as we both felt a bit tired. Added two 20sec strides at the end. Monday: Rest day. Tuesday: 15min warm-up on the bike, 30min strength session with my PT (glutes and shoulders) and 30min easy cycling. Wednesday: 45min run with 3x 20sec strides. Felt stronger and HR definitely coming down. Thursday: Rest day. Friday: first 'live' PT session in the park. Until that day, I only worked out with Ed online. So we decided to give a socially distant workout in the park a go. Absolutely loved it. Also did 30min easy on the bike.
Week 17 after the onset of COVID-19 / Week 11 of project comeback:
Saturday: 45min easy plus 4x30sec strides. Felt strong and in control and just absolutely loved it. Did 6.5 miles at 8:42/mile. Sunday: walk-run session with Lynsey. We planned to do 10miles and did so with 10min run, 2min walk intervals. had a nice coffee afterwards. Wanted to take the bus home but it was packed and many weren't wearing a mask. So I decided to walk-run home, adding the mileage of the day up to 20km. Monday: rest day. Felt really good after the 20km but needed to recover. Tuesday: 10min warm-up on the bike, 30min PT session and 30min easy on the bike to finish the workout. At lunchtime I jogged 1.5miles into town to get lunch. Wednesday: First Club Run with the Dulwich Runners since Covid. The club organised small group runs and I joined my mates Ebe, Tom and Naomi for 8.5miles at 8:37/mile. Also did 4x20sec strides. Thursday: Rest day. Friday: 1.5miles jog to park, 1h PT session at an outdoor gym with Ed, 1.5miles jog home and 30min on the bike to cool off. Absolutely loved the day.