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How glandular fever cut short a young careerAugust 30, 2017
Daniel Gray was one of the UK’s most promising 400m athletes until he contracted glandular fever. His coach, Michael Baker, outlines the devastation the virus can cause
Earlier this year, an athlete in my group, Daniel Gray, retired from the sport. He had arrived in Loughborough in 2015 to study chemical engineering and had won his second English Schools 400m title that summer (his first was as a junior boy in 2011), running 47.18 in the process.
He was excited about the prospect of kicking on into 46-second territory and better during the time he would be studying his degree course at Loughborough.
Unlike some athletes I’ve met at his age, Daniel was eager to learn, ambitious and with a maturity about what it would take to improve, no doubt born from his love of the sport and also his extensive sports autobiography collection.
However, his first semester was riddled with disappointment.
Daniel’s training and life generally floundered a bit due to a string of illnesses including tonsillitis, high temperatures and a feeling of lethargy which often left him bed-bound.
As the weeks and months went by and his symptoms failed to improve, I accompanied Daniel to one of his many appointments that he had over that period. We pushed for him to have a blood test that ultimately showed he had contracted infectious mononucleosis, commonly caused by the Epstein Barr virus and better known as glandular fever.
What happened from then on was challenging for both Daniel and myself as we struggled to help him return to competition before finally accepting that, with the demands of his degree course, his career was severely compromised by the illness.
Even though Daniel’s athletics career didn’t develop in the way his commitment and talent deserved, it’s testament to him as a person that when I approached him about writing this article he had no qualms about me sharing our story. His hope, like mine, is that we can help future athletes and coaches facing similar challenges.
Many athletes across many sports contract this virus and go on to achieve success on the international stage. I don’t think I have provided all of the solutions, but I hope we have at least provided a platform for debate on dealing with a complex issue.
It’s not the same for everyone
Immediately after the diagnosis our first goal was to educate ourselves as much as we could about the virus. It was important I equipped myself with as many facts about the symptoms and recovery times as possible.
The thing that was immediately clear, though, was how much individual variation there was in recovery times, and how little a blueprint for return to play existed. Consequently, while there may be lessons to pass on here, it is important to keep the individual nature of this virus in mind when helping an athlete through this period.
You need to take time
For Daniel and myself, the next step was to aim to start from a position of strength. The virus and recovery from it is not a fast process, so it isn’t worth rushing and constantly trying to manage major symptoms from the start.
Rest, hydration and good nutrition are the cornerstones of the initial effort to reduce the symptoms to nil – and this period of time will be hugely variable.
Once you have got to this point, you are in a much stronger position to kick-start the return to training. In hindsight, we probably started extremely light activity too early but, given the low intensity of Daniel’s training, any lingering sore throat symptoms continued to improve.
Daily monitoring is essential
Having reduced the symptoms, you have got a firmer foundation from which to begin exercise again. We found massive value in monitoring this process daily. This helped ensure our progression was as focused as it could be, given the limited sports science resources available to us.
Our monitoring worked on a very simple 1-10 scale, and we kept tabs on the following: AM feeling, PM feeling, RPE (Rate of Perceived Exertion) maximum of the session, session RPE, and feeling 30 minutes post session.
We took these metrics alongside a record of the amount of sleep and a written account of illness symptoms of any kind that Daniel had. This monitoring process stayed with us even after his return to full training, and acted as a good reference point for me as a coach to review recovery patterns and workloads in my programming.
Keep it low intensity
We initially began activity with maximum session RPEs of 2-4 and we did this for almost three weeks. The reason we remained with this RPE range for this prolonged period was to ensure that Daniel’s symptoms had completely cleared before increasing the intensity.
In hindsight I wish I had waited until all symptoms had totally cleared before starting any form of training. The other consideration I made before increasing training intensity was to ensure that we increased the frequency of training and volume of work to roughly what would normally be required in a week before increasing intensity.
I feel this bottom-up type approach was a strength of my planning in this period, on a simple level ensuring that I was only really changing the intensity variable from week to week. That meant that, if any symptoms returned, I could more confidently attribute these to the intensity of work being too high. This approximately eight-week step-by-step RPE process continued all the way through to Daniel’s full return to training in early February 2016.
Don’t assume full recovery has been made
One of the mistakes I made that summer was assuming that, because he had trained consistently for three months and was recovering well from high intensity training, Daniel was physically ready to recover from competition. This wasn’t the case.
While he was still able to run 47.80 at BUCS in May despite his disrupted winter, his ability to recover from the spike in adrenaline and speed was still a long way below optimal and he then ran a string of poor individual and relay legs.
I wish I’d been more careful by preparing a schedule that avoided multiple race days and even multi-day championships.
Take lifestyle factors into account
With university exams looming, Daniel’s performances took a real dive, forcing us to cut the season short in June. This very much reminded me of the concept of stress of any kind being cumulative.
I wish I had monitored other life stressors much more carefully during his recovery. Daniel’s reaction to periods of high academic workloads was, and continued to be, extreme. In my opinion, this was as a consequence of the virus.
This was also one of the main drivers behind his recent retirement. He just reached the point where he believed that his body just couldn’t seem to balance the academic and sporting demands at the required level to achieve his aspirations.
Know your support network
Throughout the high-symptom stage of Daniel’s glandular fever, things were difficult and my advice would be to know the support network your athlete has around them.
Be aware that you have a huge and yet potentially rewarding responsibility. Daniel’s family are incredibly supportive, his former coach a big support but, having relocated to Loughborough from Hull, he was living two hours away from all of them. As a result, I took on a lot of the responsibility to support him when things were at their worst.
It was stressful and high-pressured for both of us, and I found I struggled to keep on top of my lecturing job as well as coaching the rest of my group. You, as a coach, need a support network as much as them. You need to stay healthy and ultimately positive for your athlete.
» Michael Baker is based at Loughborough University and coaches a group of seven senior and university-aged sprinters and hurdlers, including current and former internationals. He is a former British Athletics junior funded athlete and age group international in the 400m hurdles, captaining GB at the 2007 World Youth Championships