We are all still fully affected by the pandemic with various restrictions on our ability to circulate, meet people, exercise, socialise and do our working duties. While this is painful for all us, we have to realise that such procedures are absolutely crucial to minimize the spread of the virus and potentially save lives. By now we must all be familiar with the concept behind “flattening the curve” and we must be able to fully understand the relevance for our society to abide by the new policies introduced to secure public health.
Debates continue around the World, countries struggle to carry out methods and have to continuously adjust policies to make sure that the battered economies can survive while making sure public health remains a priority. Not an easy task for politicians and scientists involved in the decision making process, also when fake news, enthusiastic reports of preliminary trials, excessive optimism for some medical interventions and incredible cures are continuously portrayed in the media. we all want this to end and return to normality, however reality is that it will take time and we need to be individual making sure scientists develop safe and effective solutions.
The world of sport has not been spared of course. For weeks, athletes have been taking care of cancellation of training activities, locking down of training venues, restrictions of access to coaches and support staff, cancellation of competitions. In recent days, some professional sports (in particular Football in Europe) have restarted training and competition activities and reports in the media seem to indicate a surge in injuries. I will attempt to go over this supplying some context, commentary and hopefully relevant information.
Before I make this attempt, it is crucial to state that there is no magic recipe and the only way to support athletes at this time is to secure their health, adopt individual techniques and very carefully consider training interventions. What it is also crucial to state is that the press might overemphasise and over report injuries and illnesses putting a lot of pressure on sports science and sports medicine staff who are taking care of the unknown, just like any medical professional currently taking care of COVID-19. thanks to rapid reporting, knowledge is growing every day and hopefully in few months time, we will be collectively better at supporting athletes and non-athletes in their return to sport. What we know today might change tomorrow and what we deal with today might be different from things we will deal with tomorrow. As a community, we must share knowledge and experiences and help each other in the quest to facilitate a safe return to sport not only for the professional athletes, but also for the general public keen and eager to return to ‘normality’.
What do we know about training during COVID-19?
While studies are ongoing with various international groups trying to collect evidence of the amount and type of training athletes have been performing during the lockdown/isolation/quarantine, we know just by checking out the social media and press reports that training activities have not stopped. everyone has tried to help athletes continue their training with personalised or group training sessions done at home.
Home training is not an easy thing to do as it depends a lot on the space available as well as the access to equipment. Also, in lots of countries, full lockdown procedures were imposed (or are still imposed) which limit the possibility for athletes to exercise outside their homes and/or requires the use of masks or limitations in the distance from home allowed. Therefore, planning training for this situation requires creativity from the coaching staff and ways to engage the athletes individually or in groups to keep the motivation going and be able to sustain such training activities.
Football players have been sharing on social media their efforts.
Football players training at home
Triathletes and swimmers had to improvise with personal pools, tethered swimming and dryland training as well as virtual competitions. Jan Frodeno also managed to complete a full Ironman at home!
Jan Frodeno’s effort was extraordinary to watch
Some track and field athletes managed to build a training facility in their back garden just like Greg Rutherford did before London 2012 and have been able to also compete. enjoy the effort of the top pole Vaulters in the world performing a lot more than 30 jumps over the 5m height in their utmost garden Clash!
Fantastic performances in their back gardens
In general, all athletes have been exceptionally resourceful in their ability to continue some form of training in buy to maintain their fitness to compete also reminding us why they are world class at what they do (the skills shown on this video are amazing, don’t try this at home unless you are as good as the athletes in the videos).
Many teams have also tried to continue group training sessions online using videoconferencing tools in buy to also maintain the team ethos and attitudes while isolating.
Liverpool FC team training session
As you can see from all the videos, the main attributes of all these training sessions are:
Limited space (most exercises are done on the spot and/or with relatively limited movement)
Use of some form of resistance (dumbbells, rubber bands, weights, weighted vests, bottles filled with water/sand etc.)
Little and limited sports certain technical skills
Absence of technical equipment for some sports (think about gymnastics/diving)
Absence of contrast/opponents (think about how challenging is for combat sports but for any sports where interaction with the opposition occurs)
No access to water for lots of in Aquatic sports (not all can afford or have access to a personal pool)
Limited ability to do technical skills at full speed (think about kicking a ball in football, throwing a ball in handball, throwing a javelin, repeating your floor routine in gymnastics, etc.)
So for every athlete, training has been highly challenging so far.
Cyclists are probably some of the few sports people who have been able to replicate a lot of of their training activities thanks to the use of modern smart trainers and have been also able to compete online. however while this is possible, still the challenges of cycling in pelotons and/or on tracks and mountain bike paths require completely different skills which cannot be replicated when your bike is fixed on a smart trainer.
Watch the De Ronde Lockdown edition
For sure, any form of training at home is better than nothing considering that it has been the only way to try to maintain or improve fitness during isolation. So, whoever tried to design engaging training sessions for athletes in this situation a big well done, considering that it is for sure not easy. To the athletes capable of being resourceful and creative also a big well done. we all know and recognise that being away for a long time from your equipment, teammates, coaching staff and training environments is not easy and everyone able to maintain the focus and drive should have recognition. For lots of athletes in fact this long period of absence from their training environment is the longest ever experienced and it is possibly similar to the absence due to big injuries, but I will write a lot more on that later.
What it is also crucial to consider is the fact that while training activities have been done at home once or twice per day (or a lot more in some cases), it is likely that the rest of the time the athletes have been quite sedentary considering that in lots of countries they had to abide to the restrictions imposed on leaving their household. We know from various studies (albeit not on elite athletes) that just few days of sedentary lifestyle can be enough to induce muscle loss, neuromuscular junction damage and fibre denervation, alter insulin resistance, negatively influence aerobic capacity, and induce changes in body mass and body composition. If you want to read a lot more about it, I suggest you read this review published few days ago by my Italian colleagues highlighting all the physiological changes induced by sedentarism. While we know that athletes are different and they were probably able to maintain some degree of high intensity activity, it is likely that the reduction in activity during the day and the alterations in nutritional practices might have influenced their body composition as well as some physiological functions which may be relevant for their ability to return to ‘normal‘ training and competitions routines.
The effectiveness of the training at home initiatives will depend on what the athletes were able to do in terms of the type and frequency of activity as well as the volumes and intensities. Therefore, it is tough to supply generic recommendations on what to do on return to full training. One thing for sure is the technique to be taken might be similar to what is usually observed in pre-season when athletes are examined on their fitness status and programmes are developed accordingly.
What do we know about periods of detraining and human performance?
There are quite a lot to studies published on detraining, however a lot of have been conducted on non-elite athletes and/or with periods of detraining figured out by the complete absence of training for up to 3-4 weeks. What we have been experiencing so far are periods of minimized training in a lot of cases and/or adapted training combined with home isolation. While we go over the possible physiological implications, one must never underestimate the psychological toll this has taken on athletes and as a result this aspect must be taken into account when supporting athletes at home and when they return to training. It is not my proficiency nor the scope of this blog article, but if you want to read a lot more about psychological aspects of isolation, you can read this review on adolescents mental health related to COVID, this work on the emotional impact on healthcare workers with COVID and this exceptional paper on the 520days simulated mission to Mars.
Back to detraining now. When we look at the ability to generate force and Power, there have been some indications that a period of detraining might produce exceptional reductions in well trained American Football and Rugby players. This systematic review suggested that studies indicate that trained athletes can maintain the majority of their strength over short periods of detraining (i.e. 2–3 weeks). other papers have also suggested that elite athletes may be able to maintain maximum strength gains for up to 30 days (3–4 weeks) days after training has ceased (however a lot of studies cited refer to middle-aged or older individuals and/or to carry strength measures).
To me, one of the most relevant papers I always look at when understanding strength training and detraining is this classical paper of Hakkinen and Komi (Hakkinen K, Komi PV. Electromyographic changes during strength training and detraining. Med Sci sports Exerc 1983; 15: 455-60). In this study, they had 14 male subjects (20-30 yr) accustomed to weight training that went through progressive strength training of combined concentric and eccentric actions three times per week for 16 wks and then detrained. While this study was a complete detraining from maximal strength training, it supplies a very relevant introduction of what it may happen in athletes unable to do strength training routines they were used to. In this paper, the authors attributed the reduction in force generating capacity to the minimized neural drive evidenced in the EMG assessment.
More reviews on this and other aspects of training all indicate that periods of detraining (short or long) negatively affect muscle structure and function, the extent of which will depend on the duration of detraining, the individual athlete’s situation and attributes and the extent of detraining (completed lack of training vs. other training activities). In the current situation, it may be possible that athletes are able to maintain (if not improve) their strength and power abilities, supplied they can experience proper training stimuli with enough volume and intensity to stimulate the neuromuscular system. However, this will need to be examined when athletes are back to ‘normal’ training to identify the ones need of a re-introduction of strength and power training activities. While a lot of studies refer to strength training exercises, it is crucial to consider that athletes training at home might have been able to do strength training activities but not high speed movements requiring space (e.g. sprinting, jumping, throwing) at maximal or near maximal speed. In this case, little is known about the effects of detraining on sprinting, throwing speed, acceleration, etc. however the assumption is that if you don’t train such qualities you are likely to lose the ability to do such tasks.
Detraining also affects the cardiovascular system. recent work in semiprofessional soccer players has shown how exceptional the reduction in endurance capacity and repeated sprint ability is just after 2 weeks, but 2 weeks of retraining might bring it back to the previous levels.
A 2 weeks break characterised by detraining seems to be affecting a lot more repeated sprint ability rather than endurance capacity in professional football players. We know that endurance capacity decreases with detraining but VO2 max might be maintained even with only one short 35-min high-intensity bout in well trained endurance athletes. young well trained cyclists were shown to have marked reduction in various physiological parameters ((L · min−1 = −8.8 ± 5.0%, mL · kg−1·min−1 = −10.8 ± 4.2%,), Wmax (W = −6.5 ± 3.1%, W · kg−1 = −8.5 ± 3.3%,), WLT1 (W = −12.9 ± 7.0%, W · kg−1 = −14.8 ± 7.4%,), WLT2 (W = −11.5 ± 7.0%, W · kg−1 = −13.4 ± 7.6%,