Hendrik Wagner’s appearance at the European Handball Championship against Sweden earlier this year lasted almost 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 full-back. He was “out of breath” longer, he later said.
Wagner had only recently been ill. He had spent seven days in isolation due to a corona infection. Did his assignment come too soon?
Wagner had only “a small scratch in his throat”
The German Handball Federation (DHB) is convinced that they have done everything right. National coach Alfred Gislason’s team had to cope with 16 players who were tested positive during the European Championships, says team doctor Philip Lübke. All courses were “without exception mild”. In addition to him as an orthopedist and trauma surgeon, DHB had an internist and cardiologist on the team to look after the affected players.
Wagner had only “a slight scratch in the throat” during the infection, but otherwise no complaints. After the free test, cardiac ultrasound and ECG were not remarkable. Therefore, it was decided “also to dare an endurance test on the track”.
DHB thus met the international federation’s requirements for the tournament – but not the recommendation that is common in Germany, says sports cardiologist Martin Halle. According to the Return-to-Sports protocol, athletes must wait two weeks before returning to full training. “It has now been seen through the experience period that it is probably the case that one can go down from 14 to 10 days,” says Halle, medical director of preventive sports medicine and sports cardiology at the Technical University of Munich.
“This very fast – infection, three four days later and then directly back to high-performance sports – I do not think is right.”
Sports physician Martin Halle
In the last two years of the pandemic, Halle has treated many recreational and professional athletes for Covid 19 disease. Although the course mostly remained mild, after recovery there were always complaints ranging from persistent fatigue to lung and heart problems.
Corona disease has two stages
The sports cardiologist explains the problem of starting prematurely with the corona disease basically having two stages. “In the first phase, I tested positive. After about a week, my own immune system then causes a different reaction. That means I may be negative again from the test, but I have this second reaction, and it is also not to be underestimated. . “
Doctors advise caution and patience
Some changes in organs first became apparent with a delay, corresponding to the indeterminate inflammatory response. An inflammation of the heart muscle, for example, can sometimes only be seen after a few days, says Halle. An examination that is premature would then possibly not allow a diagnosis at all.
Therefore, according to Halle, doctors recommend a cautious start: at least a seven-day break from the sport, then a short introduction, after 14 days of full training again. If the infection went without problems. In contrast, five days of isolation and two negative tests were enough for the European Handball Federation EHF to return if a player received medical clearance at his European Championship, which was marked by several corona cases.
Pressure and false ambitions can be dangerous
“The goal of EHF was to get the players back on the field as quickly as possible and of course to get the best players back on the field as soon as possible,” said DHB team doctor Lübke. The German Handball Federation tried to find a “temporary solution” by subjecting itself to further investigations. A withdrawal of the team was ruled out for DHB for financial reasons.
Halle knows only too well this problem from his everyday life. He understands that to a certain point. But pressure and false ambition can be dangerous, he says – even life-threatening in case of heart attack. Even an underestimated lung disease can cost a professional at least his career. If you enter too early, you risk permanent damage.
“Of course it’s a job. There’s a lot of pressure from the club, from the associations, maybe from the athletes themselves,” said Halle. “The regulator is actually the doctor, who has to be steadfast there and say: It just can’t be done. You have to protect the patient.”
Especially recreational athletes start too early
Most athletes are responsible and can assess their bodies well. Especially in the leisure sector, however, the doctor sees again and again that people start too early and with too much intensity again.
Halle also considers it dangerous because there is a lack of support in the amateur sector. Not everyone can get a complete check up after an illness. Many also go through an infection without even knowing about it.
Cardiologist advises: listen to your body
Halle therefore also advises amateur athletes to be careful. “If I had a mild infection or was only tested positive, I would say you can do full sport again after two weeks. So a full week break, then three or four days easily, from tenth day a little more intense. After two weeks I can do everything again. “
If, on the other hand, the disease was accompanied by several days of coughing and thus an effect on the lungs, Halle advises to take an extra week off. In case of heart attack, there is even a strict sports ban of at least three months.
Once you get started, Halle says, you should definitely pay attention to how your body is feeling, following signals such as mild dizziness, a beating heart or pressure on the chest. If you think while running: “Oh my god, I felt much better three or four weeks ago. My heart rate beats faster or I even have irregular beats. These are all indications that I should go to the doctor. . “