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Safely Returning to Athletics after Lockdown

July 30, 2020

The impact of COVID-19 on athletics can’t be overstated. Professional and collegiate sports of every kind ended their 2019-20 seasons early, and have postponed reopening. Youth sports ended when schools closed in March, and while the New Jersey State Interscholastic Athletic Association (NJSIAA) recently issued return-to-play guidelines that include on-time starts for the fall season, it also emphasizes that “all dates are subject to change.” Personal fitness took a hit as well – club sports were cancelled, gyms were closed, and the Centers for Disease Control and Prevention (CDC) has guidelines even for jogging and cycling during the pandemic.

To help us understand how to return to athletics safely, Damion Martins, MD, medical director of Sports Medicine at Atlantic Health System and a team physician with the New York Jets, and Matthew Martinez, MD, director of Atlantic Health System’s Sports Cardiology Program at Morristown Medical Center, discussed the issue during a recent Community Conversation on Facebook.

One piece of advice they both emphasized is to be patient. As gyms and sports leagues reopen, pace your return to physical activity to offset the effects of de-training. As youth and collegiate athletics look to their fall seasons, athletes should understand that individual practices will be slower to accommodate physical distancing and other guidelines, and that the guidelines themselves are likely to change with new data.

Returning to athletics after inactivity

As New Jersey emerges from lockdown, there’s still a lot that isn’t known about the SARS-CoV-2 virus. Much of our data on it comes from the most symptomatic cases, which aren’t necessarily representative of how the virus will affect individuals and groups as they return to athletics.

The safest path forward is conservative. If you become infected or have had an infection, no one knows exactly how your personal performance will be impacted, or what the exact risks are to your interactions with teams. Schools, clubs, and even professional leagues are still trying to understand how to maximize training while minimizing the risks of contamination. This means changing some old habits, such as practicing with less contact and in smaller groups as opposed to a full team.

Monitoring performance and fitness can offer important clues about potential problems related to COVID-19, especially for more vulnerable populations. To do that, however, you need to know your baseline fitness, which usually changes after a period of inactivity.During periods of inactivity, an athlete’s cardiovascular fitness – his/her body’s ability to deliver oxygen to working muscles – disappears relatively quickly. A few weeks without exercise creates a noticeable decrease in VO2 max – the volume of oxygen your body uses during exercise. After three months, elite athletes can lose as much as 50% of their VO2 max.

Muscles are a little more resilient, but still begin to atrophy in as little as three weeks.

To reduce the likelihood of injury when returning to athletics after a period of downtime, that lost fitness needs to be rebuilt in a planned, systemic way. The Collegiate Strength and Conditioning Coaches Association has published guidelines for the safe return to training after inactivity. Called the 50/30/20/10 Rule, it guides the athlete through several weeks of lower volume exercises to build back up to peak performance.

The moral demands of shared fitness spaces

Whether you’re playing on a middle school team, competing as a professional athlete or something in between, many of the issues around sports during the pandemic are the same. The more contact you have with other athletes, and the more touchpoints you share with them, the greater the risk of exposure.

One solution that athletics of all levels can implement is training in pods and squads of fewer than 10 athletes. Another is increased focus on conditioning training without contact, staying physically distant by six feet or more, and training outdoors. If you’re running, then increase the distance between you and other runners from six feet to 12. And if you’re cycling, increase that distance even more.

Still other guidelines include touchpoints – like sitting on a bench still bearing someone else’s sweat marks. Even players in noncontact sports like baseball have to be careful. As the Major League reopens, for example, its new guidance forbids pitchers from licking their fingers between pitches.

For more individualized sports, such as tennis or golf, it will be easier to train, practice, and even compete during the pandemic. While they still share some touch points and proximity can be an issue, they are lower risk than football, basketball, or even baseball. In those team-centric sports, even sitting on the benches or in the dugout is problematic.

Student athletics and team sports

When it comes to student athletics – high school and middle school – the NJSIAA has published guidelines on Phase 1 of its return to play guidelines. Following these guidelines, summer workouts can begin as early as July 13.

These will include new screening procedures, staggered arrivals and departures, and workouts limited to 90 minutes.

When a school begins Phase 1, they must complete 14 days of workouts following those guidelines, before they can move to Phase 2, which is also 14 days.  But these are moving targets, the NJSIAA website is the best resource for updated guidelines.

Parents with concerns should ask their coaches about the new screening procedures and safeguards. Make sure safety measures include temperature checks and wearing masks. Ask about the availability of hand sanitizer, how social distancing will be implemented, and whether or not locker rooms will be open.

And then understand your personal risk, and the risk to people living in your home. If someone older or at-risk lives in the home, then that might impact the decision on when it’s right for your child to return to play.

Returning to the gym

As of early July, New Jersey hasn’t set a date for indoor gyms to reopen. Individual training sessions , however, began on July 2, and some gyms are offering outdoor classes.

As we return to those spaces, Dr. Martinez still recommends continuing to exercise outdoors and at home whenever possible. When going to the gym is the only option, ask about their policies regarding COVID-19, be mindful of new sanitation and social distancing practices, and take some ownership in your part in that.

To limit exposure to yourself and others, show up to the gym prepared to exercise and leave when you’re done. Clean the equipment – not just the benches, but all touchpoints – both before and after use. Bring your own towel and water bottle. Don’t use the water fountain, and don’t use the gym as a place to socialize; part of physical distancing means that locker rooms and fitness machines aren’t places to congregate.

Our pastimes will return – but will also be different

While New Jersey is still weeks away from a return to high school athletics, and the re-opening of gyms is still up in the air, people are naturally concerned both about their fitness and their favorite pastimes.

Unfortunately, COVID-19 is still such a mystery that no one is yet sure how best to return to play. Nationwide, leagues of all stripes – from professional to elementary school – are dealing with the same issues: how to test, how to handle touch points, how to exercise with masks on, how to deal with a case on the team.

As leagues and gyms reopen, we all need to understand and take responsibility for our role in minimizing everyone’s risk. That means adhering to guidelines about sanitation, social distancing, and mask wearing.

It also means understanding that patience is going to be part of the new normal. Practices are going to look different. Schedules are going to look different. And guidelines are going to be updated.