DeLeslyn Sullivan slogged along the spinning belt of her NordicTrack treadmill, slowly pulling one foot in front of the other.
She could do this. She was a triathlete. An Ironman finisher. A 46-year-old, tough Georgia woman who had spent more than a decade running, swimming and cycling just because she loved it.
She wasn’t fast, but she was strong. Well, she had been strong.
Seven days earlier she’d been curled up on her couch, fighting off COVID-19. Now she wanted to show her coach, Lesley Paterson, that she was ready to hit the workouts. Certainly she could walk on the treadmill in her home office.
I feel better now. I can do this. I’ll just see how long I can go.
Then her body showed her what COVID had done.
Almost immediately, DeLeslyn was exhausted. She stopped for breaks, climbed back on the treadmill, stopped again, plodded along and refused to quit.
One foot. In front of. The other.
Two hours and two minutes passed. And when she stopped, she saw how far she had gone: 1.52 miles.
More than two hours to do something she usually breezed through in 20 minutes.
Defeated, DeLeslyn collapsed onto a bed feet from her treadmill.
How am I going to explain this to Lesley? she wondered.
Fall brings some of the biggest events for athletes like DeLeslyn. The Ironman World Championship, the marathons in Chicago and New York City – all of them call to ambitious amateurs who see completing in one or more of these marquee events as a personal badge of honor. But this year, many of them are struggling with a new kind of training regimen: recovering from COVID.
Some are pulling out of events. Others are straddling the line. Others are determined to push through, no matter how rough they feel.
That’s exactly what doctors don’t want.
“Every runner should understand there will be another day,” said Dr. George Chiampas, medical director for the Chicago Marathon. “There will be another marathon.”
When athletes get COVID, everything changes. The deadly virus, even the mildest cases, can leave behind insidious side effects. Chest tightness, breathing trouble, incessant coughing, brain fog and exhaustion are rampant. No one knows who will get what or how long it will last.
But unlike other ailments athletes regularly suffer – torn ligaments, broken bones, sprained ankles – there is no universally accepted, scientifically-based treatment to help them recover. Healing is often a matter of trial and error.
For any athlete, top notch or back-of-the-pack, every training day lost to COVID is misery.
DeLeslyn, who caught COVID just weeks before her annual training camp with her coach in San Diego, was overwhelmed with fear.
Two hours and two minutes to go - 1.52 miles?
She laid on the bed and thought: I’m never going to be back.
Becoming a runner in her 30s
DeLeslyn was always sporty, but never a runner.
After playing volleyball in high school, she won an athletic scholarship to Central Alabama Community College. Running was only for conditioning or punishment. Never for fun. She wasn’t good at it, she didn’t like it and it felt terrible.
But the years went by and the pounds packed on and DeLeslyn wanted a change. She was 33 when she joined Weight Watchers and started running again.
So one day in 2008, she stepped on her treadmill, the one she inherited when her dad got a new one and basically used as a clothes hanger. It was so old and battered, it didn’t even register distance or pace. All it told her was time.
Every morning about 5 a.m., DeLeslyn slowly ran while watching the local news. Everything hurt. Lungs, hips, knees. It had been a long time.
She told no one what she was doing. What if she failed?
Eventually, she was running 90 minutes at a time. The weight fell off. And when she finally told her coworkers what she was doing, one of them dared her to do a 5k, a popular 3.1-mile race.
She took the dare. And everything changed.
DeLeslyn was awed by the vast range of people surrounding her at that race, the different ethnicities, ages and body types. Mothers pushing strollers. Speed demons. Walkers. She felt no judgment, only support.
“I had a 90-year-old woman who couldn’t stand up straight blow by me,” she said.
She made friends with other runners. She loved the endorphins, the sense of pride that came from working hard. It was fun.
Two years later came another dare, this one from her spin class teacher: do a sprint triathlon.
The race was a 400 yard swim, 12-mile bike ride and 5k run. Why not? She could ride a bike. She could certainly run. She knew how to swim.
Except she actually couldn’t swim. Not competitively. Not only was she last out of the water – she had to drag herself back to shore using the buoy line set up to mark the boundaries of the course.
But she finished. And she was hooked.
Over the next 12 years she tackled dozens of triathlons, five or six marathons and too many half marathons to remember. Three times, she conquered one of the most grueling races of all - the Ironman Triathlon, a 2.4-mile swim, 112-mile bike ride and a 26.2-mile run that can take up to 17 hours to finish.
And while she was not a professional, or even elite, athlete, she prepared the same way many amateurs do for big events, hiring a coach to help her with workouts, motivation and discipline.
Then, on Jan. 2, she found out she had COVID.
She never thought she would. She’d gotten the vaccine. She was in great health. She worked from home. But when her husband got it, so did she.
For two days, DeLeslyn laid on the couch, wrapped in her favorite fleece blanket, watching 90 Day Fiance on TV as COVID hit her with exhaustion, body aches, a massive headache and a 101 degree fever. She ate healthy foods – vegetables, proteins, fruits – and hoped to heal soon. Within a few days, the symptoms faded.
She felt fine. Great, actually. With one exception.
“I would get winded walking across the room,” she said. “I would have to sit down.”
By now, Paterson, a five-time world champion triathlete from Scotland who coaches athletes in person and across the country through training apps and phone calls, knew something was wrong with her athlete. DeLeslyn’s workouts, tracked through an exercise app, always popped up red when she didn’t do them. And DeLeslyn wasn’t doing them.
Then came the 2 hour and 2 minute, 1.52-mile walk.
OK, Paterson said. New plan.
How to treat athletes recovering from COVID
Some athletes need a new plan when recovering from COVID, said J. Tod Olin, a pulmonologist and director of the Exercise & Performance Breathing Center at National Jewish Health in Denver. They have to change their goals, listen to their bodies, understand their limitations and be patient.
The more they push it, he said, the longer it takes to recover.
“It’s more about participation, tiny, tiny, tiny gains, but more importantly, not having a setback,” he said.
Most people with post-COVID symptoms do recover, he said. The problem is that there hasn’t been enough data-driven research to know the best ways to help people recover faster. There are guidelines, he said, but they are mostly based on observations from other doctors.
So Olin treats each patient based on their individual needs. First he goes for the low-hanging fruit. If an athlete can’t breathe, maybe they actually have asthma and never knew it until Covid weakened them. If a client’s heart rate has increased since the illness (in typical athletes, a lower resting heart rate is a sign of cardiovascular fitness), he suggests they don’t measure progress that way or keep their heart rate at a certain level. If the patient is weak, he suggests different workouts or rest.
But athletes don’t always think that way.
“Their identity is dependent on the pushing,” Olin said. “They pride themselves on the ability to defy the odds.”
An athlete's reasons for competing can also affect how they handle their training, said Chiampas with the Chicago Marathon. The Windy City’s race route is flat and, because of that, runners often go there aspiring to set personal records. Many also run for charity or in honor of a loved one who died, putting pressure on themselves to go on, Chiampas said.
If they’re not fit to run, they shouldn’t, he said, because “26.2 miles is not something to be taken lightly.”
People still hurting from COVID need to dial back their efforts and stop worrying so much about the numbers on the clock or smartwatch, he said.
But athletes live by the numbers. How fast they can run. How much they can lift. How long they can swim. Pace, pounds, pool lengths. They’re not just numbers. They’re wins and losses, strengths or weaknesses. They’re the difference between a spot on the podium or a place in the crowd.
And the same determination and discipline that makes athletes strong can also hurt them, Olin said.
“They’re going to hear what they want to hear and do what they want to do and they all think it doesn’t apply to them.”
Fearing she'd never fully return
But DeLeslyn’s coach knew better.
Since the virus hit hard in 2020, she had seen plenty of athletes catch and recover from COVID. Paterson – who runs Braveheart Coaching with her husband, Simon Marshall, a performance psychologist – knew it took time and patience. She knew DeLeslyn would battle frustration and sadness and fear that she’d never fully return to the sport that had brought her such pride and so many friends.
Paterson wouldn't just have to coach DeLeslyn’s body. She’d have to coach her mind.
We’re clearing your workout schedule, she said. We’re taking this day by day.
The sessions were short and focused on strength-based workouts. They stayed away from high intensity aerobic workouts so they wouldn't stress her immune system further.
DeLeslyn also began taking her two chocolate labs, Tucker and Harper, for walks at the local high school at 5 a.m. She’d last maybe 15 minutes, sit down, catch her breath, watch the dogs play, then start walking again.
She blamed herself for getting sick.
If I were stronger. If I had lifted weights. If I had run harder.
Paterson was ready for that. Her rule for all her clients: When you start to feel sorry for yourself, you’ve got five minutes. After that, game over.
“You’ve got a stopwatch on it,” she said.
Paterson had been through it herself. She’d struggled with Lyme disease, anxiety, depression and injuries. She knew athletes could sabotage themselves with negativity. They worked through the chapters of Paterson and Marshall's book, "The Brave Athlete," which focuses on the mental side of sports. They talked about DeLeslyn’s confidence, how she felt about herself as an athlete, about her achievements and passion for the sport.
Workouts were based on how DeLeslyn felt, not what the numbers said. Little goals, little wins, were designed to give her shots of exercise-induced dopamine that would keep her motivated. When DeLeslyn became too fixated on her high heart rate, Paterson made her put tape on her watch so she couldn’t see the numbers.
Even through the frustrating days, the ones where she slogged through workouts she once mastered, DeLeslyn never thought about quitting.
And slowly, she got better. She stopped needing naps during the day.
On May 13, about four months after catching Covid, DeLeslyn met her training partner at the YMCA for a swim workout. She checked her schedule to see what Paterson had planned for her.
One hundred-yard sprints, along with some long sets. A tough workout.
It had been years since she’d pulled herself to shore on that buoy line during her first triathlon, and DeLeslyn still struggled in the water. Now COVID had slowed her down even more. While her training partner could handle a hundred-yard sprint in a minute 30 seconds, DeLeslyn needed almost twice that long.
Things had gotten better over the last few months but, today, she just wasn’t in the mood.
Pouting and grumpy in her multicolored bathing suit and aqua swim cap, DeLeslyn stepped into the water. The first couple of sprints weren’t bad, so she pushed herself harder, muscles aching as she propelled herself across the length of the pool over and over. When she finished her sprint, she tapped the wall, stopped her watch and squinted at her time.
Then she pulled up her goggles and looked again.
“What?” she shouted. “What is this?”
She showed her training partner.
“Oh my God,” her friend yelled. “Who are you?”
One minute and 42 seconds.
As the two shouted and celebrated, DeLeslyn felt a sense of peace come over her. The fear was gone.
Everything’s going to work out, she thought. She was back.
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This article originally appeared on USA TODAY: Catching COVID before a marathon or triathlon: Can you recover in time?