ENDURANCE TRAINING AND ITS IMPORTANCE IN IMPROVING HEART HEALTH
The phrase ‘my heart is beating out my chest’ is given new meaning to you as you come to a stop. You don’t just understand it, you are currently living it. Words you once saw as hyperbole are now a reality, with each LUB-DUB of your heart seemingly threatening the solidity of your rib cage. You’re entirely drenched in sweat that drips, nay streams, down from your hair all through your sports tee, giving it a colour gradient that wasn’t there before. ‘This gradient is the attire of winners’ you think to yourself between laboured breaths and large chugs of water. And you’re right, because you’ve pushed yourself harder and further than ever before, and that’s what winners do. Whether you’re a runner, a swimmer, or a biker, you have shared in this beautiful feeling that comes post endurance training. A well deserved sense of pride washes over you as you watch yourself put in the work required to achieve your goals. You’re feeling stronger and more physically able, the endorphins in your brain have you on cloud nine, and you know your mirror is going to start showing you what you want to see.
But better than all of this is the invisible improvement you’re making. Heart disease is the leading cause of death worldwide, and you are out there improving your heart health every time you lace your shoes up or don your swimsuit. It is reported that people who engage in endurance training regularly show lower rates of disability and an average life expectancy that is 7 years greater than their physically inactive counterparts[i][ii].
With all this considered, it makes complete sense that those of us who get into endurance training want to keep pushing ourselves. We compete with ourselves, trying to better our fastest time or our greatest distance. We compete with friends and family, using social media or certain training based platforms (who can forget the part of the pandemic that had everyone uploading their daily runs). We compete and push ourselves because that is what training is at its core. I challenge you to find a gym that doesn’t have a quote like “The pain you feel today will be the strength you feel tomorrow” printed across its walls. As cheesy as it sounds, it makes sense, right? The more effort you put in, the greater the reward you reap.
But that’s not particularly scientific, is it? Certainly, this innate sense of positive impact is good enough for most of us, but the medical community needs something more empirical.
And so, we’re going to look at a medical article[iii] published by the Mayo Clinic that addresses exactly this question, empirically.
IS ENDURANCE TRAINING ACTUALLY GOOD FOR YOUR HEART?
The short answer. Yes.
No surprises there.
The paper states that “physical exercise, though not a drug, possesses many traits of a powerful pharmacological agent”.
The concept is simple – there is a reason doctor’s have always prescribed regular Endurance Training to patients with a variety of conditions. Engaging in daily physical activity allows the body to go through certain physiological changes that prime it for effective prevention or treatment of some of the most prevalent heart issues known to the world. Some chronic conditions that are significantly improved through Endurance Training are hypertension, heart failure, obesity, depression, diabetes, and coronary heart disease. The paper actually lists 13 different physiological changes brought about by endurance training that each directly reduce one’s risk of Coronary Heart Disease.
So, do we leave it there?
Certainly not. The paper continues with Endurance Training as a drug analogy to explain a simple caveat. You CAN OVERDO it. When it comes to actual medication, this is quite obvious to us, isn’t it. You’re not going to empty a bottle of Ibuprofen into your throat just because you have a particularly bad headache, will you?
Endurance Training works the same way.
In the words of the Doctors themselves ‘As with any pharmacological agent, a safe upper-dose limit potentially exists, beyond which the adverse effects of physical ET may outweigh its benefits.’
Let’s find out what the safe upper and lower limits are then.
HOW MUCH ENDURANCE TRAINING IS GOOD FOR YOUR HEART
Over 415,000 participants were observed across 12 years in a prospective cohort study[iv] to see whether less than the recommended amount (150 min/week) of exercise can have life expectancy benefits. Participants were placed into 5 groups depending on time spent training per week, with mortality risks and life expectancy calculated for each.
The Results. In comparison with the ‘Inactive’ group the ‘Lowest Activity’ group showed 14% reduced risk of all-cause mortality, and a 3 year longer life expectancy. This group exercised for approximately 15 minutes a day. Each addition of 15 min/day of training reduced all-cause mortality by 4%.
In some sense this proved that, up to an hour, increased time spent training did increase the health benefits accrued. What it also showed is that the most significant jump was found between the inactive and lowest activity groups, highlighting that even 15 minutes of training a day can significantly improve your heart and general health.
Another similar observational study[v] looked at 52,000 adults and found that runners had a 19% lower risk of all-cause mortality compared with nonrunners. The trend they found was that the mortality curves were always U shaped when charted against distance, speed, or frequency. In simple terms, when a study reports a U-shaped curve it means that there is the lowest incidence of disease in the middle ranges, with peaks in both the lower (Inactive) and upper (Over exertion) ranges. Running distances of about 1 to 20 miles per week, speeds of 6 to 7 miles per hour, and frequencies of 2 to 5 days per week were associated with lower all-cause mortality, whereas higher mileage, faster paces, and more frequent runs were not associated with better survival.
So, there we have it, empirical data on the ideal training ranges.
ENDURANCE TRAINING WHEN YOU ALREADY HAVE A HEART CONDITION
The human body is very complicated, and that means that any ranges offered (as above) are guidelines created based on expected averages. Everybody works differently, and so everyone will see moderately different results even when training exactly the same. So, is all the information provided accurate for those with pre-existing heart conditions, given the ideal range of training is most important to this community of Endurance Trainers.
One study assigned 60 male patients who had Coronary Heart Disease to two groups – either they engaged in Endurance Training for 30-minute sessions, or they did it for 60.
The results. The 30-minute exercise sessions produced less oxidant stress and improved arterial elasticity, whereas 60-minute sessions worsened oxidant stress and increased vascular stiffness. While you do not need to know the specifics, this effectively showed that the lower activity duration (different from inactivity) actually provided greater benefits specifically in relation to heart health.
So, though a lot of people in such situations assume they need to go above and beyond to correct their heart issues, the evidence points to the contrary. Endurance Training for those with Coronary Heart Disease is most effective if they can calculate the ideal duration and exertion, and pushing their limits in this regard may actually be counter-productive.
WHAT NOW?
All of the information provided essentially boils down to one thing – Endurance Training is a fantastic way to treat or prevent heart health issues, but it is only effective when used in the correct amounts.
Fortunately for us we live in the age of modern technology, and with it almost anything is possible. There are a number of devices that provide you with a range of information that helps calculate and set these correct amounts of training, while also making sure you do not go above it.
Do you feel like you’re going through a post covid fatigue? Your energy levels are not what they were and you’re finding it difficult to motivate yourself to exercise like you used to? According to studies, you’re definitely not alone!
Covid-19 disrupted our way of life considerably over the last few years. But one of the most significant impacts we have noticed is the way it has changed our approach to health.
During the first few months of the lockdown, stay-at-home orders, closures of parks, gyms, and fitness centres made it difficult for us to continue with our fitness routines.
Heart Health Concerns: What the Data Shows
Data from studies done in early 2020 revealed that physical activity levels dropped dramatically in many countries. This was determined by analysing more than 19 million smartphone-based (ref. link), step-counting measurements taken over 1 year. Another study in 2021, found that people who used to have steady walking, running, and cycling habits before the pandemic, decreased their activity levels considerably.
As we start off 2022, with a new vaccine, a steadily declining number of Covid cases and easing up of restrictions around the world, people are now ready to go back to the way things were. Devices such as a heart rate monitor are gaining a steady following.
But, this may be more challenging than we realise!
HOW DOES POST COVID FATIGUE AFFECT OUR LONG-TERM FITNESS LEVELS?
Although Covid19 is a respiratory illness that affects the lungs first, studies have shown that it can cause long-lasting effects on our overall health.
Studies show (ref. link) that more than one-third of people affected by Covid could develop signs of Post-acute sequelae of COVID-19 (PASC). Another study revealed that post covid fatigue and body pain after exercise were the most common symptoms, even after 7 months of the initial infection, as shown in the figure below.
Perhaps the most significant complication of the covid19 infection is its ability to directly affect our heart.
MYOCARDITIS CAUSES AND COVID: WHAT WE KNOW
Research has shown that the virus does infect and damage cardiomyocytes or heart muscle cells, and interfere with their contraction. The inflammation in heart muscles is called myocarditis and it is known to occur even in patients who only had mild symptoms. 15% of the athletes (ref. link) at a US-based university developed myocarditis after Covid, while another study revealed that 78% of the people evaluated had cardiac involvement when they were infected, and nearly 60% of them still showed ongoing myocardial inflammation.
In addition, studies also showed (ref. link) that there were increased risks of atrial fibrillation, sinus tachycardia, sinus bradycardia, ventricular arrhythmias, and atrial flutters. Data revealed that dysrhythmias were 1.69 times more likely to occur, even 12 months after an acute Covid 19 infection, when compared to control groups in the study.
MYOCARDITIS SYMPTOMS: HOW DO YOU RECOGNISE THE SIGNS?
Patients with acute viral infection may initially have headaches, body aches, joint pain, fever, a sore throat or diarrhoea. Later on, they could also experience chest pain, shortness of breath, at rest or during activity, swelling of the legs, ankles or feet and fatigue.
Another effect of myocarditis is irregular heartbeats or arrhythmias. A study reported that 78.7% of myocarditis patients experienced ventricular arrhythmia. It is believed that myocarditis causes direct damage to the membranes of the cardiac cells and disrupts the electrical conduction needed for regular heartbeats. The inflammation around the heart muscle may cause swelling, fibrosis and scar formation which also leads to irregular beats.
HOW WOULD YOU DIAGNOSE MYOCARDITIS?
Cardiac markers (ref. link) or enzymes like troponin [cardiac troponin I (cTnI), cardiac troponin T (cTnT)] and N-terminal pro–B-type natriuretic peptide [NT-proBNP]) are elevated and can be determined with simple blood tests.
An ECG may also show abnormal wave patterns like bundle branch blocks, QT prolongation, premature ventricular complexes, and bradyarrhythmia, along with ST-elevation or PR depression.
The American Heart Association (AHA) recommends further testing for people who experience signs of myocarditis using more advanced cardiac imaging methods such as an echocardiogram or cardiovascular magnetic resonance (CMR).
HOW SOON AFTER HAVING MYOCARDITIS CAN YOU EXERCISE?
The European Society of Preventive Cardiology (ref. link) recommends that people who had myocarditis should begin to exercise if they are free from symptoms, have a normal 12-lead ECG, echocardiography, and exercise testing with no abnormal patterns seen in Holter ECG monitoring as well.
Frequently Asked Questions :
What are the tests to diagnose myocarditis?
The most common tests for myocarditis include chest x-rays, electrocardiogram, Echocardiogram, heart biopsy, and MRI scans. CDC recommends that anyone recently vaccinated seek medical attention at the earliest if they develop any of the myocarditis symptoms.
What myocarditis signs and symptoms should you be aware of?
Chest pain, shortness of breath, and a fluttering or pounding heart are the most common signs or symptoms of myocarditis. The lack of specific symptoms makes the detection and treatment of myocarditis challenging.
Can Myocarditis recur?
Most conditions of myocarditis are known to be self-resolving. In some conditions, myocarditis can recur. It usually recurs due to various inflammatory conditions such as autoimmune disorders.
What Can You Do to Prevent Myocarditis?
Maintain a healthy lifestyle to treat, recover, and prevent myocarditis. Apart from that, avoid close contact with anyone suffering from flu or other respiratory infections.
What Are the Treatment Options for Myocarditis?
Myocarditis causes and severity determine the treatment options. While anyone suffering from mild myocarditis might be advised rest at home, anyone with heart failure symptoms might require medication and hospitalisation.
*The information contained in this blog is provided on an as-is basis with no guarantees of completeness, accuracy or usefulness. The content in this blog is not meant to be a substitute for medical advice, diagnosis, or treatment. All content is meant for informational purposes only. This blog contains copyright material, the use of which has not been specifically authorised by the copyright owner.
Football fans worldwide were stunned when Denmark’s midfielder, Christian Eriksen, collapsed on the field during a European Championship match. One of America’s toughest CrossFit trainers, Bob Harper (ref. link), a regular on the fan favourite TV show, the Biggest Loser, suffered a major cardiac arrest. Algerian soccer player Sofiane Lokar passed away at the age of 30 years, after collapsing on the field because of a heart attack.
We know that heart disease has been rising over the last few decades. According to the CDC in the United States (ref. link), 1 in every four deaths is due to cardiac disease, with over 610,000 people dying each year. Cardiovascular diseases remain the leading cause of mortality and morbidity in Europe (ref. link). with nearly 6 million new cases diagnosed every year.
So why did reports of these deaths in the news take us by surprise? What made these cases stand out? This group of people who suffered from cardiac disease were young and physically fit. These rising numbers are understandably worrying. It questions the things we tend to believe about heart disease- that it’s a disease of the elderly, that you should be safe if you exercise and that your annual health check-up will surely pick up signs of heart damage early enough.
Heart disease may be more complex than we thought it was. Here are 5 Things you need to know about its evolution so that you can do your part to care for your heart!
1. Heart disease doesn’t discriminate
Both men and women share risk factors for heart disease like genetics, diabetes, obesity, sedentary lifestyles, unhealthy diets, smoking, stress, and excessive alcohol intake. However, women also suffer from certain diseases like endometriosis, polycystic ovarian disease (PCOD), and high blood pressure during pregnancy. This, in turn, increases their chances of heart disease.
2. Heart Attacksare just the tip of the iceberg!
Heart disease encompasses a wide variety of cardiovascular conditions.
What Types of Heart Disease Do You Need to Know About
Arrhythmias, which are irregular heart rhythms. The most common ones are atrial fibrillations or ventricular fibrillation, which we may perceive as heart flutters. They may be picked up when we monitor our ECGs or heart rates while exercising.
Atherosclerosis, which occurs when the walls of our blood vessels begin to harden
Cardiomyopathy, which causes the heart muscles to harden or weaken so that its unable to pump blood effectively
Congenital heart defects, which are irregularities in the heart structure that are present from birth
Coronary heart disease, or ischemic heart disease, is caused due to the buildup of plaques in the heart’s blood vessels, usually made up of fat or cholesterol. This buildup blocks blood flow to the heart muscles, causing the classic symptoms of a heart attack.
Heart infections may be caused by bacteria or viruses and severely compromise cardiac function.
3. Thin doesn’t always mean a healthy heart
A condition called TOFI – Thin Outside, Fat Inside, has gained prominence in recent years. Although people with obesity or fat under their skin do have higher chances of heart disease, people with larger quantities of visceral fat surrounding their internal organs are also equally at risk.
These people may look thin from the outside, but studies have shown that they tend to suffer from cardiac disease. Research from Mt. Sinai Hospital (ref. link) revealed that women with pericardial fat (or fat around their hearts) were even more likely to suffer from heart conditions.
4. Chest pain is not the only symptom of heart disease
The most common presentation of heart disease is a heart attack or ischemic attack, where people first complain of chest pain or discomfort, followed by building pressure in the chest, breathlessness, or nausea. On the other hand, women commonly complain of jaw pain, back pain, dizziness, anxiety, disturbed sleep, and indigestion. The most frequently missed sign of heart disease is stomach pain in the upper part of the abdomen that could be mistaken for acidity or gas.
People with arrhythmias may complain of a fluttering or racing heartbeat, a slow pulse, or fainting spells. At the same time, those with cardiomyopathy may have fatigue, bloating and swelling as their primary symptoms.
5. Routine one-time tests may not be able to pick upheart diseaseall the time
How is heart disease diagnosed?
The most common tests we hear about when it comes to heart disease are :
ECG or electrocardiograms record your heart rate and rhythm while diagnosing problems with the electrical activity of the cardiac muscle.
2D-echo or echocardiograms use ultrasound waves to produce a picture of your heart and its chambers and estimate how well it’s functioning
Stress Tests evaluate heart activity while you are made to walk or run on a treadmill
Holter monitors are strapped onto your chest to study heart rhythms over long periods (sometimes 24-48 hours)
CT Scans or MRIs of the heart to visualise the blood vessels and chambers
Blood tests for cardiac biomarkers like Troponin levels, creatinine kinase, CK-MB, and myoglobin are released into the bloodstream when the heart is damaged or stressed. Lipid tests can give an estimate of your blood cholesterol levels.
Invasive tests like cardiac catheterisation and coronary angiographies involve inserting a catheter into your heart vessels through the groin arteries and injecting a dye into the delicate vessels to give a detailed x-ray image that can pick up blockages or other abnormalities.
Many of these tests are part of the annual health checks that we sign up for. However, abnormalities in your heart using these tests can only be picked up if you are already experiencing symptoms of heart disease. By that time, it may already be too late. This is why continuous real-time monitoring of heart activity is a great way to keep track of your heart health.
Studies have shown that lifestyle changes can help you prevent heart disease. Research from Harvard University estimated that those who do not smoke and engage in regular physical activity with a healthy diet lowered their risk of heart disease by nearly 50%.
Frequently Asked Questions
What are the symptoms of heart disease?
Heart disease might be silent and remain undetected until you experience signs of a heart attack. You might experience arrhythmia or heart failure as well, with symptoms including chest pain or discomfort and heartburn.
What are the risk factors for heart disease?
It has been observed that high levels of blood pressure, cholesterol, and smoking might be the key risk factors for heart disease. Apart from that a number of lifestyle choices including obesity, physical inactivity, and unhealthy diet might put you at a higher risk of heart disease.
What are the early signs of heart disease?
Chest pain (between the neck and your abdomen) is one of the most common signs of heart disease. While some people might feel excruciating pain, others might experience mild discomfort. Fatigue, shortness of breath, palpitations and uneven heartbeats are other signs.
How to check your heart health regularly?
You can determine your heart health by going in for regular tests including echocardiogram that is used to determine the cause of heart murmur. An Electrocardiogram monitors the changes in heart rhythm and an MRI can assess the heart structure and function of the heart valves.
What are the best heart disease prevention tips?
It is recommended that you follow a heart healthy lifestyle to protect your heart. Get moving and aim for activity ranging from 30-60 minutes to stay fit; eat a heart-healthy diet and manage your stress levels to prevent heart disease.
*The information contained in this blog is provided on an as-is basis with no guarantees of completeness, accuracy or usefulness. The content in this blog is not meant to be a substitute for medical advice, diagnosis or treatment. All content is meant for informational purposes only. This blog contains copyright material, the use of which has not been specifically authorised by the copyright owner.
Atrial fibrillation (AF) is one of the most common heart arrhythmias affecting at least 1% of the (ref. link) population. Atrial Fibrillation is caused by the abnormal functioning of the impulse conduction system of the heart. Essentially, arrhythmias are an irregular heartbeat that occur when the electrical signals that coordinate the cardiac cycle are disrupted. Atrial fibrillation belongs to a class called supraventricular arrhythmias, which refers to one that originates from the upper ventricular area. It is the most common cause of cardiac stroke. Studies (ref. link) show that the risk of ischemic stroke for people with atrial fibrillation is 3 to 5 times higher than for people without the condition.
Read on to learn about the warning signs of Afib and the reasons it may occur. In addition there’s a section highlighting its occurrence in athletes, and how continuous monitoring can be useful to understand and track episodes.
1. What does an Afib Episode feel like?
You may notice a skipped heartbeat and then feel a thud or thump, followed by a racing heartbeatfor some time after.
You may experience palpitations or a fluttering sensation in your heart
You may sweat or experience chest pain, similar to a heart attack.
Your pulse is erratic or weak.
You may feel dizzy, weak, tired, or breathless.
You may not have any symptoms and have an episode of silent AFib.
If you have experienced symptoms like these, it is essential to tell your doctor about them and ask about tests to determine if you have atrial fibrillation or any other cardiac arrhythmia.
2. Why does Atrial Fibrillation occur?
The atria are the heart’s collecting chambers. Regular electrical signals help push blood efficiently from the atria into the lower pumping chambers (the ventricles). From the ventricles, blood is pumped to the rest of the body. In Afib, the electrical signals are fast and disorganised, with impulses ranging from 300 to 600 beats per minute (ref. link).
This causes a rapid and irregular heartbeat, and the heart may not pump as efficiently. While AFib can appear in a structurally normal heart, it can also be a sign of underlying cardiac conditions.
3. What are the different types of AFib?
Atrial fibrillation is known to occur for varying lengths in different people. They may be categorized as:
Paroxysmal AF : This type of AFib usually lasts more than a day but less than a week. Symptoms can feel mild or severe and suddenly start and then stop.
Persistent AF : Symptoms last more than a week at a time
Longstanding persistent AF : Symptoms last longer than one year
Permanent AF : Symptoms occur all the time and do not entirely go away.
4. Who is at risk for AFib?
Atrial fibrillation can occur at any age, but your chance of developing it increases as you grow older. As a result, AFib is most common in people over 65 years (ref. link). Other risk factors include high blood pressure, previous heart disease or heart surgery, chronic medical conditions like hyperthyroidism, kidney disease or lung disease, moderate to heavy alcohol use, obesity or obstructive sleep apnea.
5. Does Afib occur more in athletes?
There seems to be a unique relationship between exercise and AF. Studies (ref. link) show that people who exercised moderately seem to have a lower risk of developing Atrial fibrillation. On the flip side, those who participated in intense endurance sports had a slightly increased risk of Afib episodes.
Exercise-induced AF is usually seen in middle-aged athletes who have practised very intense endurance sports like marathon running, cycling or cross-country skiing for more than ten years.
A study published in the British Journal of Sports Medicine, involving 70,478 participants, including 63,662 controls and 6,816 athletes, showed that the risk of AFib was 2.46 times higher among athletes than non-athletes.
Another study, from the European Society of Cardiology, observed that athletes were 5 times more likely to experience Afib than others in the study population.
Atrial fibrillation isn’t usually life-threatening or deemed serious in healthy people. Nevertheless, atrial fibrillation symptoms can be risky amongst those having diabetes, high blood pressure, or other heart-related diseases. Either way, the condition should be properly diagnosed and addressed by your doctor with appropriate atrial fibrillation treatment.
What causes athlete’s to be more likely to have Atrial Fibrillation?
Athletes who train vigorously can have dynamic fluid shifts in the body, causing dehydration and changes in pH. Electrolytes like sodium, potassium and magnesium may fall below normal levels, contributing to AFib.
After many years of high-intensity physical exercise, their heart muscles also undergo material changes that make them more susceptible to rhythm disorders. Stretching and remodelling of the heart, with dilation of the atrial chambers, and inflammation and fibrosis of the heart muscle are permanent changes that cause irregular conduction of the signals leading to irregular heartbeats.
How is atrial fibrillation diagnosed?
The most widely used method of diagnosing Afib is an ECG. This may be through a standard 12 lead ECG, though it may not be the most effective as you must be undergoing an episode of Afib at the time of the ECG for it to be picked up. This method works well for patients in persistent or longstanding persistent atrial fibrillation.
However, if your episodes are intermittent, like in paroxysmal atrial fibrillation, they probably won’t be recorded on the standard 12 Lead ECG. Instead, doctors may use a small portable electrocardiogram device, a Holter Monitor, for 24–48 hours to try and capture an Afib episode on the graph. In some cases, these abnormal heart rhythms may be so sporadic that they may be missed on both. In these cases, long term ambulatory ECG recordings can help capture rare instances of irregular rhythm.
If it can’t be caught the conventional way, many people wonder, “How can I check for Afib at home?”
A regular heart monitor that captures only heart rate will not be adequate. Since the frequency of episodes of atrial fibrillation may increase on physical activity or exercise, a resting ECG probably won’t fit the bill either. Continuous monitoring of ECG using ECG wearables may be the perfect solution!
Consider buying Fourth Frontier’s revolutionary ECG fitness tracker that helps in keeping track of your heart rate.
*The information contained in this blog is provided on an as-is basis with no guarantees of completeness, accuracy or usefulness. The content in this blog is not meant to be a substitute for medical advice, diagnosis or treatment. All content is meant for informational purposes only. This blog contains copyright material, the use of which has not been specifically authorised by the copyright owner.
Frequently Asked Questions:
What is the first-line treatment for atrial fibrillation?
The first-line of treatment for rate control in AF are Beta-blockers and calcium channel blockers. They are effective at rest and with exertion. Intravenous diltiazem or metoprolol is the most commonly used for AF along with a rapid ventricular response.
What triggers atrial fibrillation?
Doing things like drinking excessive amounts of alcohol, or being overweight and drinking lots of caffeine can trigger an episode of atrial fibrillation.
How do you feel when you have atrial fibrillation?
The most noticeable sign of atrial fibrillation is heart palpitations. The heart feels like it’s pounding, fluttering, or pulsating irregularly, often for a few seconds or perhaps a few minutes.
Can you live a long life with atrial fibrillation?
Though AF is a long-term condition, if addressed properly you can live a long and active life. Several decisions can help you control the condition, reduce your chance of stroke, and reduce any anxieties you may have.
How can I correct my atrial fibrillation naturally?
Some natural ways that can be helpful in atrial fibrillation are:
Do you feel like you’re in a workout slump post- covid? Your energy levels are not what they were and you’re finding it difficult to motivate yourself to exercise like you used to? Post-Covid Fatigue is REAL! And according to studies, you’re definitely not alone!
Covid-19 disrupted our way of life considerably over the last few years. But one of the most significant long term effects of Covid is the way it has changed our approach to health.
During the first few months of the lockdown, stay-at-home orders, closures of parks, gyms, and fitness centres made it difficult for us to continue with our fitness routines.
Data from studies done in early 2020 revealed that physical activity levels dropped dramatically in many countries. This was determined by analysing more than 19 million smartphone-based (ref. link), step-counting measurements taken over 1 year. Another study in 2021, found that people who used to have steady walking, running, and cycling habits before the pandemic, decreased their activity levels considerably.
As we start off 2022, with a new vaccine, a steadily declining number of Covid cases and easing up of restrictions around the world, people are now ready to go back to the way things were.
This may be more challenging than we realise!
HOW DOES POST COVID FATIGUE AFFECT LONG-TERM HEALTH?
Although Covid19 is a respiratory illness that affects the lungs first, studies have shown that it can cause long-lasting effects on our overall health.
Studies show (ref. link) that more than one-third of people affected by Covid could develop signs of Post-acute sequelae of COVID-19 (PASC). Another study revealed that fatigue and body pain after exercise were the most common symptoms of long covid, even after 7 months of the initial infection, (as shown in the figure below).
Perhaps the most significant complication of the covid19 infection is its ability to directly affect our heart.
Research has shown that the virus does infect and damage cardiomyocytes or heart muscle cells, and interfere with their contraction. The inflammation in heart muscles is called myocarditis and it is known to occur even in patients who only had mild symptoms. 15% of the athletes (ref. link) at a US-based university developed myocarditis after Covid, while another study revealed that 78% of the people evaluated had cardiac involvement when they were infected, and nearly 60% of them still showed ongoing myocardial inflammation.
In addition, other studies showed that the risk of atrial fibrillation, sinus tachycardia, sinus bradycardia, ventricular arrhythmias, and atrial flutters all increased post covid. Data revealed that dysrhythmias were 1.69 times more likely to occur, relative to control groups, even 12 months after an acute Covid-19 infection.
Covid-19 fatigue is common and can persist for a few weeks into your recovery. That being said, if you had COVID-19 and continue to have bothersome symptoms (such as severe fatigue, chest discomfort, or shortness of breath) after the first 2 to 3 weeks, please consult your doctor.
WHAT ARE POST COVID FATIGUE SYMPTOMS?
It is common to feel tired and drained after any illness. However, the long term effects of covid are often quite severe. People suffering from post covid fatigue report feeling extremely tired doing otherwise routine activities, and this affects their quality of life and their ability to function normally. Aside from post covid fatigue, patients also complain of brain fog, muscle aches and pains, and headaches, which are also called post-exertional symptoms, appearing when patients are extremely tired.
HOW LONG DOES LONG TERM EFFECTS OF COVID LAST?
Fatigue is very common after any viral infection, and usually settles after 2 or 3 weeks. However, some people dealing with post covid fatigue can feel the effects for up to multiple months.
A WORD FROM THE HEALTHCARE PROFESSIONALS
“I think the best advice about exercising after having COVID-19 is to be very careful — this is a challenging disease. No matter your age or your fitness level, it’s a good idea to discuss any physical activity plans with your doctor and proceed with caution.” – Dr Michael Fredericson, MD, professor of physical medicine and rehabilitation in the department of orthopaedic surgery at Stanford Medicine in Palo Alto, California.
“COVID rarely kills young people who are fit, but COVID can cause myocarditis. The risk of myocarditis with COVID is around 1 in 300. A diagnosis of myocarditis means compulsory rest from intensive exercise for at least 6 to 12 weeks.” – Prof. Sanjay Sharma, Professor of cardiology, Sports Cardiologist, St George’s, University of London.
HERE ARE A FEW TIPS TO EASE YOUR WAY BACK INTO YOUR WORKOUT AFTER COVID.
Don’t exercise while you still have symptoms of covid-19. Focus on rest, good hydration, proper nutrition and follow the advice of your healthcare provider.
If you had a mild illness or an asymptomatic Covid19 infection, consider returning to activity after a 10 day isolation period. Start slow and gradually up the intensity. Listen to your body — especially if you have any existing heart issues
If you have required hospitalisation for Covid19 you will need to be evaluated by your healthcare provider before you get back to exercise.
If you were diagnosed with Myocarditis you need medical clearance from your healthcare provider before returning to exercise. You could plan a gradual return to physical activity over the course of weeks or months to monitor for signs and symptoms of myocarditis.
Monitoring your hearts response to exercise using a wearable can help build confidence as you return to fitness!
*The information contained in this blog is provided on an as-is basis with no guarantees of completeness, accuracy or usefulness. The content in this blog is not meant to be a substitute for medical advice, diagnosis or treatment. All content is meant for informational purposes only. This blog contains copyright material, the use of which has not been specifically authorised by the copyright owner.
Frequently Asked Questions:
How long can fatigue last after COVID-19 infection?
Recovery from COVID-related fatigue depends on how extreme your illness was. After a mild case of COVID-19 your fatigue may go about in 2-3 weeks. But in severe cases, you are likely to feel sluggish and exhausted for months.
Is fatigue normal after COVID?
Fatigue is a regular part of the body’s reaction to battling a viral infection such as COVID-19. Fatigue is likely to persist for some time after the infection has cleared. While researchers can’t definitively say how long COVID-19 fatigue should last, it is recommended that you see a doctor when you notice symptoms lasting for over a week.
What can I do to help with COVID-19 fatigue?
In order to cope with COVID fatigue you can start exercising, talk with someone about your frustrations, engage in productive thoughts, be empathetic with yourself, and find things that impact you positively.
What is COVID fatigue like?
Signs of Post-COVID fatigue are typically the same as the chronic fatigue syndrome that includes physical, psychological, and behavioural complications, including constant tiredness and feeling sleepy.
Can extreme fatigue be a symptom of COVID?
Given the wide range of symptoms of COVID virus, it is common to feel more than just fatigued after COVID-19. According to WHO, the most common symptoms of COVID are fever, cough, tiredness, and loss of taste or smell.
They say you are strong when you know your weaknesses. If you are dealing with a long-term diagnosis like atrial fibrillation, knowledge is your greatest tool. The key to living and thriving with Afib is to find out more about your heart.
What makes it tick?
What could trigger an episode of fibrillation?
How much can you push yourself; without going overboard?
Dealing with atrial fibrillation can be overwhelming at first, but once you know what you need to, it becomes much simpler.
Read our previous article – 5 Things You Should Know about Atrial Fibrillation (ref. link), so you can learn how to recognise the signs of Afib early on, as well as how to manage symptoms after receiving a diagnosis.
Treatment options in Atrial Fibrillation
Once Afib has been diagnosed, the manner in which it is managed (ref. link) is very clear. Your doctor will try to reset your heart rhythm and control the heart rate to prevent blood clots that can lead to strokes. This may be done with oral medications, like beta-blockers or anti-arrhythmic drugs, along with blood thinners. Doctors may also try to reset the heart back to its normal rhythm with cardioversion, which is done by sending electric shocks to the heart tissue using small paddles or electrodes on the chest.
In certain severe cases, cardiologists may recommend surgical procedures like cardiac ablation, which uses heat from radiofrequency energy, or cryoablation which uses extreme cold to create scars in the heart tissue. This blocks the abnormal electrical impulses and restores a regular heartbeat, sometimes with the help of a pacemaker.
While a diagnosis of heart arrhythmias can shake things up, with the right plan in place, you can live a life BIGGER than Afib!
Here are 6 ways to learn to live safely and live well with Atrial Fibrillation.
First off, Atrial fibrillation (A-fib) is an irregular and often very rapid heart rhythm (arrhythmia) that can lead to blood clots in the heart. Below we list some treatments that can help you handle atrial fibrillation and atrial fibrillation symptoms.
1. Know your medication and stroke risk.
Atrial fibrillationincreases the risk of stroke (ref. link) by 5 times, and AFib-related strokes are 2.5 times more likely to be fatal. Medicines like oral anticoagulants (blood thinners) can reduce the risk of stroke by 64% and the risk of death by 26% in those with Afib. These medicines do have side effects such as an increased tendency to bleed when hurt.
2. Eat Smart for a Healthy Heart! One study revealed (ref. link) that diets rich in saturated fat were associated with a greater risk of persistent or chronic atrial fibrillation. It is advisable to increase your intake of monosaturated fats like nuts, avocados, or olive oil while eating a well-rounded wholesome diet.
3. More Smiles, Less Stress! Studies have shown (ref. link) that anxiety and stress may trigger atrial fibrillation. Strong emotions can cause your heart to race and skip a beat, triggering AFib episodes. Finding coping mechanisms like breathing exercises or meditation to calm your nerves may help in the long run.
4. Say No to Cigarettes and Cocktails Alcohol can also trigger Afib. Some people experience symptoms from just a drink or two, while others don’t feel adverse effects in a cardiac sense unless heavy drinking is involved. This is believed to be due to a possible link between alcohol consumption and the level of activity of the Vagus nerve, which in turn affects the heart. According to the American Heart Association (ref. link), light to moderate alcohol intake within limits should not trigger Afib. They suggest up to 1 drink per day for women and 2 drinks per day for men, without binge drinking.
With regard to smoking, research from theEuropean Society of Cardiology (ref. link) determined that every 10 “pack-years” of smoking saw a 16% increased risk of Afib.
5. Fit does not Quit. Find a Workout that Suits YOU! It’s natural for people with arrhythmias to hesitate when it comes to exercise. A common question they ask is, “Can I exercise with a heart condition?”
How do you know if your heart is working too hard?
Afib can make exercise difficult because it does cause your heart rate to rise and your Blood Pressure to drop. You may experience heart palpitations, dizziness, sweating and breathlessness. In severe cases, it may also cause arm pain, confusion, and disorientation. If you feel unwell or uneasy while exercising with atrial fibrillation, ask your doctor to confirm if you can participate in regular workout sessions at a moderate level.
While initially recovering from Afib you may be told to consider cardiac rehabilitation. You would exercise under supervision at a health facility where your heart is evaluated using an exercise heart rate monitor. In addition, they will look out for abnormalities using ECG monitoring devices. The specialists there can recommend new exercises to safely try using the information gained through this process.
How do I know how my heart is doing during exercise?
A continuous ECG monitor that tracks your heart’s rhythm and electrical activity patterns can be very useful in understanding whether you are pushing your heart too hard. Therefore, using an ECG fitness tracker can help you maintain a healthy heart by showing you which situations and activities help your heart, and which ones hurt it. You can now buy the best ECG fitness tracker on Amazon from Fourth Frontier and get started right away.
Watch more Frontier X Smart Heart Monitor Video Testimonials (ref. link) if you want to hear from many who use wearables to help understand their heart health.
*The information in this blog is provided on an as-is basis with no guarantees of completeness, accuracy, or usefulness. The content in this blog is not meant to substitute for medical advice, diagnosis, or treatment. All content is intended for informational purposes only. This blog contains copyright material that has not been specifically authorized by the copyright owner.
Frequently Asked Questions on Living and Thriving with AFib:
What are the warning signs of AFib?
AFib signs may be similar to other heart-related issues. Some people experience rapid heartbeat or skipped heartbeats, while others may experience dizziness, weakness, and breathlessness. Each of these are the common warning signs of AFib. It is important to spot these signs and discuss them with your doctor if you do.
Is atrial fibrillation a serious problem?
Atrial fibrillation isn’t generally life-threatening or considered to be serious for otherwise healthy people. Nevertheless, atrial fibrillation can be risky if you have diabetes, high blood pressure, or other diseases related to the heart. In either scenario the condition should be properly diagnosed and addressed by a doctor.
What happens during atrial fibrillation?
During AFib, the normal beating in the upper chambers of the heart (the two atria) is periodic, and blood doesn’t flow as it should from the atria to the lower chambers of the heart (the two ventricles).
Can you live a long life with atrial fibrillation?
Though AFib is a long-term condition, if managed correctly, you can live a long and active life. Additionally, you can take several measures to reduce your risk of stroke.
Can stress cause atrial fibrillation?
Some studies indicate that stress and mental health problems may drive atrial fibrillation symptoms to worsen. High levels of stress may also cause other health conditions.
Do you know that feeling you get when you catch a glimpse of the love of your life? It’s like your heart stopped for a minute, like it forgot to beat. And if it happens once in a blue moon, it may sound so romantic!
But what if you started experiencing this unsettling feeling more often, even when you’re resting? What if you felt your heart skip a beat when you’re working out, or if you get palpitations with a racing heart in the middle of a meeting?
The idea that there could be problems with your heart’s timekeeper can be stressful. We’ve answered 5 of the most common questions asked about skipped heartbeats and what to expect when dealing with palpitations.
1. What does it mean when your heart skips a beat?
Usually, electricity moves through the heart in a very regular and controlled manner. Your heart beats at a standard rate, an average of60-100 beats per minute (ref. link) at rest. This is because the cells of your heart muscles conduct the electrical impulses that stimulate the heart to contract and pump blood in a very regular and controlled manner. It’s usually precise and consistent. Each set of contraction and relaxation of the heart muscle is picked up as a heartbeat.
Sometimes, the electrical impulses may misfire, causing your heart to skip a beat or throw in an extra beat. This disturbance in the rhythm is responsible for the odd feeling in your chest – as your heart jumps or flip flops. We commonly associate these feelings with heart palpitations called ectopic heartbeats or premature heartbeats.
2. Reasons for Heart Palpitations : Is it normal for your heart to miss beats?
Despite the skipped or added beat, the heart continues to usually function normally. There are two main types of ectopic heartbeats:
Premature atrial contractions (PAC), which originate in the upper chambers or atria.
Premature ventricular contractions (PVC), which originate in the lower chambers or ventricles.
An example of premature heartbeats
The causes of skipped beats could also be: 1. Lifestyle Factors
Dehydration
Smoking
Eating spicy foods or drinking too much caffeine and alcohol.
Emotional triggers like stress or anxiety
Sleep disturbances
2. Hormonal Factors
Hyperthyroidism or an overactive thyroid
Hypoglycemia or low blood sugar levels
Pregnancy and menopause
3. Medical Conditions
Anaemia
High fever
Side effects of certain medications
Arrhythmias or other heart conditions like enlargement of the heart muscles cause disturbances in electrical impulses’ conductivity.
Do people experience heart palpitations after COVID 19?
The most common effect that the Covid 19 virus had on the heart was inflammation of the cardiac muscle or myocarditis. It usually resolves on its own as the infection dies down. But it can cause serious outcomes in some patients (ref. link), like arrhythmias, heart failure, acute coronary syndrome and venous thromboembolism.
Lingering symptoms are seen inCovid “Long Haulers” (ref. link) after suffering from even a mild Covid infection. These include fatigue, shortness of breath, chest tightness, and heart palpitations.
A recent study showed that patients with Covid 19 often experienced increased heart rates, low energy and sleeping problems by using wearable devices and an app to track their symptoms.
According to data fromJohns Hopkins (ref. link), patients recovering from the coronavirus sometimes show symptoms of a condition known as POTS (postural orthostatic tachycardia syndrome). This nervous system problem affects heart rate and blood flow. People have complained about rapid heartbeats, palpitations, brain fog and lightheadedness when getting up from rest.
This may explain why some people experience heart palpitations after Covid. These symptoms could be due to a problem with the heart but could also be because they have just recovered from a severe illness, may be dehydrated, and have spent time resting and inactive.
3. What does it feel like when your heart skips a beat?
You may experience ectopic heartbeats in a variety of ways. You may feel like your heart missed a beat and then rebounded with a harder one and that it’s beating faster than usual or fluttering rapidly. This feeling can last from a few seconds to a few minutes.
People experience skipped heartbeats even when they are just standing, sitting, or sleeping, not only when moving or exercising.
The frequency ofirregular heartbeats also vary. You may experience only one episode in your life. Or you could have had it for a long time, with short episodes that end on their own.
4. Heart Palpitations : When should you be worried about an irregular heartbeat?
When you notice that your heart misses a beat often, you may wonder, “Are skipped heartbeats dangerous?” In most cases, if felt on their own, they may not be anything to worry about. However, if they are accompanied by: the following symptoms then it may indicate a bigger problem
chest pain or discomfort
severe shortness of breath or difficulty breathing
dizziness and nausea
fainting
If you notice ectopic beats, try to analyse if they followed any triggers or if your heart rate also starts increasing during an episode. You may experience bouts of palpitations that last for long periods and do not improve but get progressively worse over time.
This could indicateheart disease, and you should bring it up with your doctor so that they can get to the root of the issue. They usually recommend an ECG, a 2D echo, a stress test or continuous monitoring with a Holter for 24 to 72 hours to detect heart palpitations that aren’t found during a regular ECG exam.
5. Can you exercise with skipped beats?
Many people experience palpitations before and after exercise due to the fluctuations in adrenaline as you step up or decrease your pace or effort. However, further evaluation is advisable if these skipped beats are accompanied by difficulty breathing, chest discomfort, dizziness, blackouts, or loss of consciousness.
These can be worrying symptoms. How do you know if your heart is safe during exercise? Continuous and real-time monitoring of your heart’s activity may be the answer!
Frequently Asked Questions :
What causes heart palpitations?
Heart palpitations are known to be caused due to anxiety, stress, panic attacks, or any kind of fear. Some heart palpitations are connected to abnormal heart rhythms that might be caused due to various heart diseases.
What are heart arrhythmia symptoms?
Heart rhythm problems (heart arrhythmias) may feel like a racing or a fluttering heart. The signs and symptoms include a slow or a racing heartbeat, chest pain, and shortness of breath. There are a number of other symptoms including anxiety and fatigue.
When should you worry about heart palpitations?
Heart palpitations are serious when they are accompanied by symptoms including severe chest pain, breathlessness, and unusual sweating. If you have pre-existing heart conditions or a family history of heart diseases and sudden death, you need to consult your doctor immediately.
Can you stop heart palpitations?
The best way to treat heart palpitations is to avoid any triggers. Reduce your stress levels, try relaxation techniques and avoid stimulants to treat heart palpitations. You need to keep a tab on your water intake and ensure that you stay hydrated to prevent heart palpitations.
What can make your heart palpitations worse?
Lack of quality sleep, stress, and anxiety are some of the factors that can worsen your heart palpitations. It is recommended that you avoid stimulants (including heavy alcohol use, appetite suppressants among many more) to ensure that heart palpitations do not get any worse.
*The information contained in this blog is provided on an as-is basis with no guarantees of completeness, accuracy or usefulness. The content in this blog is not meant to be a substitute for medical advice, diagnosis or treatment. All content is meant for informational purposes only. This blog contains copyright material, the use of which has not been specifically authorised by the copyright owner.
There’s nothing quite like the exhilaration of running a marathon. Cheering crowds, the blood pumping in your ears, and adrenaline coursing through your veins as you race to the finish line.
Those few hours are a testament to the weeks and months of training and hard work you put in before the BIG DAY!
It’s not surprising that 1.1 million runners complete a marathon each year. However, according to data from the International Institute for Race Medicine (ref. link) (IIRM), only 0.01 per cent of the world’s population routinely takes up this running challenge.
Marathon training workouts are notoriously challenging, but those who compete have several motivators to push them. Whether you are running for charity, to keep up your health goals or simply because you love running, the thrill of the challenge and the personal victory from achieving such a high goal can certainly inspire marathon runners to push through the pain!
As marathon season kicks off this year, here are a few tips to boost your performance.
IT’S ALL IN THE MIND!
As race day gets closer and closer, the miles start piling up. The long runs get longer each day and nervousness sets in. No matter how confident you are in your marathon training, you may ask yourself – Am I ready? Have I done enough?
Runners know that getting ready for a race takes more than just marathon training and strength training. When working towards crushing your goals, it’s equally important to develop a running mindset alongside completing your endurance and marathon strength training! Mental toughness in fitness (ref. link) needs the right mindset and strategy to stay focused and relaxed to get the most out of your marathon workouts.
It is perfectly natural to feel nervous before and during a big race. Runners have been known to lose steam even midway through a race. However, a 2014 study showed that self-talk keeps exhaustion at bay while motivating you to push forward and boosting your endurance.
LISTEN TO YOUR BODY.
Whilst you may feel the drive to push through any pain, don’t forget to listen to your body. Look out for any injuries sustained and make sure that they’re treated immediately to avoid further damage. The RICE method (ref. link) is a popular, go-to approach because of its simplicity.
Rest: First, take the weight off the injury by sitting or lying down.
Ice: Apply the ice for at least 15 minutes (maximum 20 minutes) and then leave it at least 45 minutes before re-applying to avoid any chance of frostbite. Do this about 5 times throughout the day.
Compression: Compress the area using an elastic bandage, wrapped tightly enough to provide support but not limit movement.
Elevation: Raise the injured limb above heart level to reduce the swelling.
SLOW DOWN TO SPEED UP.
In the week leading up to a race, tweak your marathon training schedule to decrease your running volume so that you prep your body before the big day. Studies have shown that when runners taper or reduce their training load in the weeks before race day, it helps them recover from the weeks of high-volume, high-intensity training used to enhance performance during the race itself.
Sleep is an important factor for recovery at any time in your marathon training plan, but it should be prioritised even more during the week before race day. Try and get at least 8 hours of sound sleep every night.
LOAD UP ON THE CARBS.
Studies show that during intense, continuous endurance exercise, the glycogen or energy stored in your muscles is depleted after about 90 minutes. Carb-loading involves eating more carbs at every meal and snacks 5-7 days before your race so that your muscles have plenty of energy stored on race day. Then, on race day, try and eat an easily digestible meal high in carbs and low in fibre.
KEEP AN EYE ON YOUR HEART
Although regular exercise contributes to many well-established long-term health benefits, vigorous exercise is also associated with a transient increase in the risk of heart events. Studies conducted by the American Heart Association (ref. link) evaluated the rate at which cardiac events occurred during high-intensity exercises like marathons. They showed that 50% of these events took place in the last mile of the race, and among participants in triathlons, almost 40% of cardiac events occurred in first-time participants. During training for high-intensity,multi-hour endurance exercises like marathons, individuals may often experience cardiac strain. Their heart enzymes like troponin and B-type natriuretic peptide (BNP) are elevated and they may have patchy myocardial fibrosis. This sustained load may lead to remodelling of the heart, instigating cardiac conditions like arrhythmias. Therefore, it is essential to be mindful of marathon heart damage.
This year, it is especially important to keep an eye on your heart when returning to Marathon training, because covid induced myocarditis, and myocarditis as an adverse reaction to covid vaccines, may have lingering effects on the health and performance of even seasoned marathon runners.
Click here (ref. link) to read our detailed blog about the warning signs of cardiac disease. Our blog on getting back to your marathon exercises after recovering from Covid-19 also gives practical tips for getting back to your fitness routines.
Frequently Asked Questions :
What heart rate should you aim for when training for a marathon?
Running is an exercise that is known to give lasting cardiovascular benefits. However, you will need to determine your target heart rate for running, especially a marathon, based on your age and maximum heart rate. When running a marathon you should train at up to 85% of your maximum heart rate.
Are running marathons good for your heart?
Research shows that running lowers blood pressure and improves metabolism. As per the Journal of the American College of Cardiology, a positive connection between heart health and running was established among the study participants based on data from 55,000 adults over 15 years. Running has proven to be a heart-healthy activity for most people.
*The information contained in this blog is provided on an as-is basis with no guarantees of completeness, accuracy or usefulness. The content in this blog is not meant to be a substitute for medical advice, diagnosis or treatment. All content is meant for informational purposes only. This blog contains copyright material, the use of which has not been specifically authorised by the copyright owner.
