Return to Play During a Pandemic

Introduction

The COVID-19 pandemic has affected the lifestyle of people around the world. Athletes of all levels, be it at school, recreational or elite level, have all been affected by lockdowns and various restrictive measures used to curb the spread of COVID-19. In many cases this may be the longest period away from structured training within the various sporting disciplines.

Although athletes of all levels have been able to train at home, these training activities and different exercise regimes are vastly different from the norm and it is highly unlikely that these methods of training are able to replicate match or competition demands. When considering return to play during a pandemic it is important to factor in the limitations of training from home and to identify the risks involved in returning to training and competitions. It is therefore important to develop appropriate athlete and sport specific return to play strategies.^[1]

A safe progressive return to play strategy should consider^[1]:

• The duration of lockdown/ isolation/ quarantine
• The health status of the athlete (for example is the athlete affected by Covid-19 or not?)
• The complexity of the sport
• The overall content and training load of training activities/exercise regimes during home isolation/lockdown

Generic return to play principles may be applied across sports to develop return to play strategies, but keep in mind that there are specific considerations needed for different sports. These are determined by the performance demands and training content.^[1]

One of the strategies that countries around the world have adopted to safeguard public health, is the prolonged period of reduced or no access to sporting facilities. This led to a reduction in regular training sessions and competitions. Therefore, considerable care should be given on how to facilitate return to play, taking into consideration the athlete’s optimal performance levels, while still reducing the risk of injury and illness during these unprecedented times.^[1]

Absence from regular sports training may cause detraining of several physiological, psychological and technical/tactical aspects which influences sports performance.^[1] Detraining can be defined as “the partial or complete loss of training-induced adaptations in response to cessation of training or a substantial decrease in training load.”^[2]

Factors that may influence the condition in which an athlete return to training activities are^[1]:

• Level of activity that athlete was able to maintain
• The volume, intensity and type of training performed
• Nutritional habits during lockdown
• If the athlete had contracted COVID-19 and the severity of symptoms

A framework for return to training has been designed and published in the Aspetar Guidelines: Returning to Sport during the Covid-19 pandemic.^[1] This framework follows an admission process of gathering information needed to develop an individualised return to play strategy.

Impact of COVID-19 on Athletes

The COVID 19 pandemic has significant effects on athletes. These include^[4]:

• Physical deconditioning
• Altered sleep patterns
• Worsening nutrition
• Uncertainty on Return to Sport
• Feelings of depression

It appears that athletes are well informed about the disease, but they still need to be provided with reliable, evidence-based resources. Recent research highlights the importance of closer medical, nutritional and psychological support to athletes during and after lockdown.^[4]

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