Long covid effects and starting a TR plan

What’s your take on starting a TR training plan, probably adaptive, when Long Covid symptoms are still in effect weeks after Covid illness?

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It’s really hard to say as the symptoms vary a lot - everything from a bit of a headache to pericarditis. I’ve had significant post covid fatigue issues for 2 years but can train around it if I manage things well.

From talking to a few folk with long covid, absolutely everyone has tried to start back and been really surprised how much it’s taken out of them. Keep your ambitions in check and take it really easy easing yourself back in. The best advice I got was to stop thinking of bike riding as training for a while and just do it for mental health. Made me really focus on just going out and listening to the birdsong and not worrying at all about getting faster.

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New to TR. I waited for a few weeks after I started working out again to start my plan. Looking back I think I could have started earlier but was worried about pushing too hard and going backward in my recovery. Those first few workouts were rough. After 3-5 workouts I was feeling stronger and think I should have started earlier.

I wouldn’t. What are your symptoms, and how long ago was your acute illness? What have you been doing since then?

Acute stage ended 7 weeks ago.
Symptoms started 2 weeks after with acute weakness, shortness of breath and a heart rate that didn’t respond to increase in activity and stayed low.
Went through a physician check and blood work just last week and all came back positive with a mild trace of white cells indicating the illness.
No cardiologist thus far.
Long covid symptoms have eased in the past two weeks.
When running feels ok.
When biking HR stays low at 60-70% and it doesn’t feel comfortable even being in the 80% range and it’s even difficult getting there.
I’m running twice a week 8k each at or around zone 2 and instead of MTB 2 training sessions with intervals and 1 volume I’m doing two rides at a comfortable effort 2-3hr each.

I had COVID about 4 weeks ago, in bed for 5 days. Once flu/cold symptoms subsided, chest pain started and still exists today moderately throughout day, heightened by moderate activity (i.e. 15 min ride at 20% FTP, core work, anything more than a chill walk). Have been in and out of hospital for testing and IVs - all heart and lung tests have come back normal, so at this point noone really knows what to do other than “wait it out”. Not sure if even moderate rides will slow down recovery, or not - they definitely help with the mental side.

Anyone have any experience similar, tips for improvement, or experts in this field to get into contact with?

Science doesn’t know yet.
It seems like there is ample evidence of higher long lasting effects regarding the cardiovascular system.
Many have it and with most, not all, their effect lasts only a few short weeks after the acute stage.
For some longer.
The nature of the symptoms is not yet known regarding lasting effects and/ or changes to mortality.
Sadly, from checks and inquiries I have made and from so few answers here…the bottom line is:
nobody actually knows and all we can do is wait it out.
If it doesn’t feel right then it isn’t right.
At least until there is some medical evidence with good statistics relating to more than a few narrow cases with advice to the broader population.

Coaches I’ve checked with don’t know what to advise and are also encountered with a broad array of long lasting symptoms that differ in severity and duration from one trainee to another.
Their advice is simple: stride along according to how you personally feel and don’t push it if you feel your body feels weak, in one aspect or another.

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Thank you for the reply. Somehow, this is comforting. It is unfortunate not having any answers, but can take comfort in the fact that that isnt my doing and all I can do is (1) hope things improve (2) listen to my body and (3) continue to look for answers in hope that someone finds them.

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I can’t offer much in the way of suggestions but this sounds really similar to my path.

I had COVID early in January this year (was double-vaxxed at the time) and got hit hard initially with ful symptoms. 7 days later I developed chest pains and due to still being in the holiday season, had to wait another week for my cardiologist to see me and run tests. All came back clear but still had chest pain so the assumption was either myocarditis or pericarditis that has reduced in inflammation by the time I was tested.

My cardiologist gave me the all-clear to start a transition back into training.
I ended up waiting it out about 6 weeks from initial infection and then started back on the bike very slowly - dropped FTP from 300 to 260 and started with 30m indoor Z2 rides.

Since then, I’ve got most of the way through SSB LV I but I still get some chest pain during the day - no pain on the bike though.

My plan is to reduce any expectations I have about getting FTP back up or being ready for any events and just to keep listening to my body. I like being able to train indoors during all this as it gives me to comfort to know that if I’m not feeling ok, I just get off the bike and there’s no pressure to have to try to ride home.

I’m also looking for more answers about why I still have chest pain as I’d never had it in my life beforehand.
Sorry I can’t give any more suggestions to help your situation

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Very comforting, reading a lot of this sounds like i wrote it haha. I have been hearing similar things about at some point you just have to start easing back in. My Dr. has me taking Naproxen (Aleve) right now, as that could be a solve to any minor inflammation, hoping that works. Mentally I think that is a smart strategy expectation wise.

Naproxen 500 for inflammation?
That isn’t old school.
It’s ancient and rarely in practice nowadays due to it’s serious GI and kidney adverse reactions.
That and a high intensity sport are a combination I would not advise.
I would consult with my cardiologist for his input regarding myocarditis treatment, if he thinks that’s the correct path.

I got covid for the second time mid January. And didn’t get on the bike back until 3 weeks after the acute stage. Even with my RHR very high. Tested 15% lower on the ramp test. I started SSB1 MV, First week was a drag, very hard. I had difficulty finishing every workouts. But by the end of the over-under got really easy. I retested FTP on sunday and it went up 8%. First week at the new FTP was hard. By the the third week I was marking every workouts as easy. Though I changed the sunday SS for for 1:30 endurance.

By week 4 I had TR estimate my FTP. It went up another 7%. And I kept feeling better and better. AIFTPD Gave me another 8% increase at the end of SSB1. Doing good so far. Workouts between easy and hard.

So it’s been a good progression… I’m still 11% down last year’s peak. But I might reach it by the end of SSB2.

Just listen to yourself lower your expectations, and ride mostly by feeling. There’s no shame in cutting a workout short. Or doing less than prescribed.

You should enjoy the small stuff. Faster recovery between intervals. Lower RHR by the weeks. Nailing that scary workout.

Doing an endurance ride and realize your HR never went over what you wold have expected.

One thing was clear to me I was never able to predict how a workout would go until a good 20 to 30 minutes in. Some workouts felt impossible to achieve after the first interval only to realize at the end of the last one that I could have gone on and on.

The reverse is also true. Sometimes I felt like I was going to nail the workout easily only to strugle 15 minutes later.

Don’t sweat it enjoy the process. AT looks very good at presenting and adjusting workout difficulty so the next one is challenging and achievable.

And the combination of AT, PL and AIFTPD is a bliss. I love it. It’s better than me at predicting what I can achieve.

Interesting, I had similar thoughts - was advised to take the 500 but have instead been doing the over the counter 220. Based on my echocardiogram and holter, there is no myocarditis - if any inflammation, it is likely really minor which is why it was recommended. Figured it wouldnt hurt to try for a week.