In October 2015 I was busy training for the Heysen 105km ultramarathon. After successfully completing several long distance events over the previous few years I had ramped up my training to be as prepared as possible for the Heysen. Training had been going really well, I wasn’t carrying any injuries and I was feeling strong and in the best running condition I’d ever been. The goal was to complete this event with a good mate, Barry. I’d paid my entry fee, we had Barry’s wife to crew for us and I had organised all of my nutrition and equipment for the day.
Then, just over a week before the event my 2 ½ yr old daughter became unwell, we spent a night in hospital mainly as a precaution and it turned out that she had Influenza A. The next day I also started to show the signs and symptoms of the flu. We spent the next 3-4 days on the couch together resting up and taking it easy. About 3 days before the Heysen 105 I was mostly clear of symptoms, no more fever, the muscle aches had gone, no headache. I was back to feeling well.
So I debated whether I should still do the race. My wife told me it wasn’t a good idea. From my work with other athletes, I have a fair idea of how long recovery from ultra-marathons takes (usually 4-6 weeks). I guessed that running an ultra after having the flu might extend that recovery to 6–8 weeks. But considering the time, effort, and money I had put into preparing I thought I’d give it a go. I decided that the extra few weeks it might take to recover was worth the risk, and I hoped that I’d be able to complete the event and do well.
I told myself, my wife and my mate Barry that we would take it easy to start. If things were going well then we would keep going. If things weren’t going well then I would pull the pin and stop early. I was willing to take a risk but I wasn’t willing to work myself too far into the ground.
Then, just over a week before the event my 2 ½ yr old daughter became unwell, we spent a night in hospital mainly as a precaution and it turned out that she had Influenza A. The next day I also started to show the signs and symptoms of the flu. We spent the next 3-4 days on the couch together resting up and taking it easy. About 3 days before the Heysen 105 I was mostly clear of symptoms, no more fever, the muscle aches had gone, no headache. I was back to feeling well.
So I debated whether I should still do the race. My wife told me it wasn’t a good idea. From my work with other athletes, I have a fair idea of how long recovery from ultra-marathons takes (usually 4-6 weeks). I guessed that running an ultra after having the flu might extend that recovery to 6–8 weeks. But considering the time, effort, and money I had put into preparing I thought I’d give it a go. I decided that the extra few weeks it might take to recover was worth the risk, and I hoped that I’d be able to complete the event and do well.
I told myself, my wife and my mate Barry that we would take it easy to start. If things were going well then we would keep going. If things weren’t going well then I would pull the pin and stop early. I was willing to take a risk but I wasn’t willing to work myself too far into the ground.
So it came to event day. Barry and his wife Bev picked me up early in the morning so we could make our way to the start line on time. In most ways it was a wonderful day. The weather was good for an ultra if maybe just a little on the hot side. The trails were in good shape. We were sharing the trail with friends. The aid stations we came to were full of friendly people and Bev was providing excellent support.
However, right from the first handful of kilometres I could tell that my body wasn’t quite fully recovered. The first sign was my heart rate. I had been tracking my heart rate during my training. I knew what to expect for various levels of effort and various paces. From fairly early in the event my heart rate was sitting higher than it normally would for the effort and pace we were running. But other than that I was feeling pretty good. For the first 30km or so things continued on much the same. Heart rate a little high but otherwise feeling good.
Between the 30km and 40km marks was much the same. The only slight difference was that the weather was warming up a little and much of our time was out in the open so I was feeling a little warm. Then around the 40km point I started to feel a bit light-headed. So I decided it was time to stop. It was another couple of kilometres to get to a road so that I could get picked up. I stopped after 41km and 5 hours 20 mins of moving forwards.
This pace and distance were not too different from some of the training runs that I had done in the lead up. The rest of the day I was tired and hungry but otherwise feeling okay. It took a few days for my legs to recover but they weren’t too bad either. I thought I had made a good choice stopping early, and that I would recover as planned and then train for another event.
Unfortunately that isn’t what happened.
Over the next few weeks my energy levels and capacity continued to drop. I had regular headaches, significant muscle ache and my mental capacity was diminished. I would get to a point each day where my body and mind would tell me they’d had enough. My whole body would hurt, I would struggle to follow a conversation and couldn’t drive. I just had to stop and go to bed. These were my ‘fatigue shut downs’.
I went to the doctor and found out I had Post Viral Fatigue (sometimes called Post Infectious Fatigue). It was highly likely that this was the result of me returning to too much exercise too soon after a viral illness. There were some supplements that I could take that might help but mostly I was told it was just going to take time.
This went on for months. I would scrape my way through a part-time workload. I wasn’t able to do anywhere near as much around the house. My parenting struggled. My relationships struggled as I stopped almost all social activity. I stopped running. My doctors told me that compared to others I was actually doing pretty well and it was likely that my high levels of fitness going in had meant that I was still able to get through part-time work.
After a few months things started to improve but the improvement was frustratingly slow. After the first few months I had been able to return to full-time work and a tiny amount of running but was still regularly experiencing ‘fatigue shut down’. At about 6 months I was able to add a little more back in and started having energy for a few more social engagements and was getting less ‘fatigue shut down’.
Then the improvement slowed even more. From about the 6 month mark improvement was so slow that it was kind of like watching your children grow, you don’t really notice it in the moment but every once in a while you look back and think, ‘gee that’s a bit different’.
In total, it took me two and a half years to recover.
Since fairly early on in the process of this recovery, I have shared this story freely at every opportunity, as I want others to make a better choice than I did. I thought that the choice I was making was maybe adding a few weeks to my recovery. I had no idea that it would change my life for years.
Now, as more and more people get COVID, I find myself worried that there will be others who, like me, think they have recovered. Like me, return to too much exercise too quickly and then, like me, go on to experience Post Viral Fatigue.
So stay tuned for Part 2, where I have compiled the current advice on how to approach a return to exercise after COVID.
However, right from the first handful of kilometres I could tell that my body wasn’t quite fully recovered. The first sign was my heart rate. I had been tracking my heart rate during my training. I knew what to expect for various levels of effort and various paces. From fairly early in the event my heart rate was sitting higher than it normally would for the effort and pace we were running. But other than that I was feeling pretty good. For the first 30km or so things continued on much the same. Heart rate a little high but otherwise feeling good.
Between the 30km and 40km marks was much the same. The only slight difference was that the weather was warming up a little and much of our time was out in the open so I was feeling a little warm. Then around the 40km point I started to feel a bit light-headed. So I decided it was time to stop. It was another couple of kilometres to get to a road so that I could get picked up. I stopped after 41km and 5 hours 20 mins of moving forwards.
This pace and distance were not too different from some of the training runs that I had done in the lead up. The rest of the day I was tired and hungry but otherwise feeling okay. It took a few days for my legs to recover but they weren’t too bad either. I thought I had made a good choice stopping early, and that I would recover as planned and then train for another event.
Unfortunately that isn’t what happened.
Over the next few weeks my energy levels and capacity continued to drop. I had regular headaches, significant muscle ache and my mental capacity was diminished. I would get to a point each day where my body and mind would tell me they’d had enough. My whole body would hurt, I would struggle to follow a conversation and couldn’t drive. I just had to stop and go to bed. These were my ‘fatigue shut downs’.
I went to the doctor and found out I had Post Viral Fatigue (sometimes called Post Infectious Fatigue). It was highly likely that this was the result of me returning to too much exercise too soon after a viral illness. There were some supplements that I could take that might help but mostly I was told it was just going to take time.
This went on for months. I would scrape my way through a part-time workload. I wasn’t able to do anywhere near as much around the house. My parenting struggled. My relationships struggled as I stopped almost all social activity. I stopped running. My doctors told me that compared to others I was actually doing pretty well and it was likely that my high levels of fitness going in had meant that I was still able to get through part-time work.
After a few months things started to improve but the improvement was frustratingly slow. After the first few months I had been able to return to full-time work and a tiny amount of running but was still regularly experiencing ‘fatigue shut down’. At about 6 months I was able to add a little more back in and started having energy for a few more social engagements and was getting less ‘fatigue shut down’.
Then the improvement slowed even more. From about the 6 month mark improvement was so slow that it was kind of like watching your children grow, you don’t really notice it in the moment but every once in a while you look back and think, ‘gee that’s a bit different’.
In total, it took me two and a half years to recover.
Since fairly early on in the process of this recovery, I have shared this story freely at every opportunity, as I want others to make a better choice than I did. I thought that the choice I was making was maybe adding a few weeks to my recovery. I had no idea that it would change my life for years.
Now, as more and more people get COVID, I find myself worried that there will be others who, like me, think they have recovered. Like me, return to too much exercise too quickly and then, like me, go on to experience Post Viral Fatigue.
So stay tuned for Part 2, where I have compiled the current advice on how to approach a return to exercise after COVID.
This blog post and the following post do not cover any material regarding ‘Long COVID ’or Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS). Multiple sources are reporting that there can be significant overlap between these two conditions. It is my opinion that in each of these circumstances it is vital that there is a good medical team involved. Our clinic has a long history of assisting/working with people with ME/CFS and I believe we are in a unique position to be able to support those suffering ‘Long COVID ’(along with other health professionals), and to assist them in returning to health.
Author: Jonathan Schubert Senior Sports and Musculoskeletal Physiotherapist
Jonathan is a highly skilled and experienced Musculoskeletal and Sports Physiotherapist, having graduated from the University of South Australia in 2006 with a Bachelor of Physiotherapy, and his Masters in Sports Physiotherapy and a Masters of Musculoskeletal Physiotherapy, from LaTrobe University in 2016.
Outside of the clinic, Jonathan spends several hours per week as a clinical educator for UniSA’s physiotherapy students, and enjoys running, cycling and spending time with his family. Jonathan loves to help his patients optimise their movement, live pain-free, and achieve their health goals. He has a special interest in running, football, cycling and gymnastics.
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