Hendrik Wagner’s European Handball Championship appearance against Sweden earlier this year lasted barely five minutes. The 24-year-old managed three, four attacks and one goal before complaining of breathing problems. The European Championship debut was over prematurely for the German backcourt player. He later said he “lost his breath”.
Wagner was ill only recently. And he had spent seven days in isolation due to being infected with Corona. Did his assignment come too soon?
Wagner had a ‘slight scratch on his throat’
The German Handball Federation (DHB) is convinced that they did everything right. National coach Alfred Jeslason’s team had to deal with 16 players who tested positive for the virus during the European Championship, says team doctor Philip Luebke. All courses were ‘light, without exception’. In addition to being an orthopedic and trauma surgeon, DHB brought an internist and a cardiologist to the team to take care of the injured players.
Wagner had a “mild itchy throat” during the injury, but had no complaints other than that. After the free test, the cardiac ultrasound and ECG were unremarkable. That is why it was decided to “daring to test endurance in the field too”.
Thus, DHB met the requirements of the International Federation of Championships – but not the common recommendation in Germany, says sports cardiologist Martin Halle. According to the return to sport protocol, athletes should wait two weeks before returning to full training. “Now I’ve seen during the trial period that it probably goes down from 14 to 10 days,” says Halle, MD, medical director of preventive sports medicine and sports cardiology at the Technical University of Munich.
“This very rapid infection, three days later and then straight back to high-performance sports – I don’t think it’s true.”
Sports Physician Martin Hall
In the past two years of the pandemic, Haley has treated many recreational and professional athletes for COVID-19. Even if the sessions remained mostly light, there were always post-recovery complaints ranging from constant fatigue to lung and heart problems.
Corona disease has two phases
A sports cardiologist explains the problem of starting too early by saying that corona disease mainly consists of two stages. “In the first phase, the test result was positive. About a week later, my immune system causes a second reaction. This means I can be negative again from the test, but I have the second reaction, which is something I don’t underestimate.”
Doctors advise caution and patience
Some organ changes did not appear until after a delay, consistent with an unbounded inflammatory reaction. Myocarditis, for example, is sometimes seen only after a few days, Halley says. Early detection may not allow a diagnosis at all.
Therefore, according to Halley, doctors recommend a cautious start: at least seven days a break from sports, then a slight introduction, after 14 days of full training again. If the infection persists without problems. On the other hand, the European Handball Federation EHF was enough for five days of isolation and two negative EM tests, which were marked by many cases of Corona, to return if the player obtained a medical clearance.
Pressure and false ambition can be dangerous
“The aim of the EHF was to get the players back on the field as quickly as possible, and of course to get the top players back on the field as quickly as possible,” said DHB team doctor Lübke. The German Handball Federation has tried to find a “temporary solution” by subjecting itself to additional investigations. The team’s withdrawal was out of the question for DHB for economic reasons.
Haley knows this problem well from his daily life. He understands that up to a point. But he says stress and false ambition can be dangerous — and even life-threatening if the heart is involved. Even an underestimated lung disease can cost a professional at least one of his career. If you enter too early, you risk permanent damage.
“Of course it’s a job,” Haley says. “There’s a lot of pressure from the club, from the federations, and maybe from the athletes themselves.” “The regulating person is actually the doctor, who has to be standing there and saying, ‘It’s not possible. You have to protect the patient.'”
Recreational athletes start very early
Most athletes are responsible and can assess their bodies well. But in the entertainment sector in particular, Doctor is seeing time and time again that people start again too early and too intensely.
Halle also considers this to be dangerous given that there is a lack of support in the amateur sector. Not everyone can perform a comprehensive examination after illness. Many also go through the infection without even knowing it.
Cardiologist advises: Listen to your body
So Halley advises amateur athletes to exercise caution. “If you have a minor infection or only test positive, I would say you can fully exercise again after two weeks. So a full week break, then three or four easy days, from day 10 it’s a little more intense. After two weeks I can To do it all again.”
On the other hand, if the illness is accompanied by a cough for several days and thus the lungs are infected, Haley advises taking an extra week of rest. In the event of a heart injury, there is a strict ban on sports for at least three months.
When you start, Haley says you should definitely pay attention to what your body is feeling, following cues like slight dizziness, pounding heartbeats, or pressure on your chest. If you’re thinking while running: “Oh my God, I’ve been doing better for three or four weeks. My heart is pounding or even I have irregular beats. These are all indications that I should see a doctor.”