What Life Is Like For Fitness Trainers With Long-Haul COVID

Shelby Hedgecock, 29, is no stranger to challenging her body. She's completed Spartan races, exercised daily, and loved fitness so much that she became a personal trainer in 2019. But in April of 2020, she fell ill with aches, shortness of breath, and fatigue like she had never experienced before. Not long after, she tested positive for COVID. And her symptoms haven't ceased since: Now it's long-haul COVID that's pushing her body to its limits.

"Fitness totally changed my life... and now I'm probably never going back," she tells Bustle.

Hedgecock is just one of the roughly 10% of COVID patients that become long-haul cases, which is when symptoms persist indefinitely, long after the active infection has passed. These cases can be devastating both physically and mentally as prolonged symptoms like fatigue, shortness of breath, and brain fog interfere with the ability to do everyday activities — sometimes even basic functions like walking and breathing, Dr. Brendon Ross, D.O., a sports medicine doctor at the University of Chicago, tells Bustle.

For Hedgecock and fellow trainer Donna Walker, 38, — whose livelihood relies on their ability to stay active — long-term COVID has changed everything. Extreme fatigue and cognitive issues knocked Hedgecock flat, forcing her to abandon her personal training job and soon-to-launch wellness business. Difficulty breathing and chest pain rendered Walker unable to teach group fitness classes, a major part of her training career. Now the women are reckoning with their health, careers, and futures as they struggle with a form of COVID that science knows little about.

What Life Is Like For Long Haulers

It's become increasingly clear that there's no typical COVID case — long-haul or otherwise. While research is racing to solve the many mysteries about the virus, there still isn't a definitive explanation as to why some people deal with symptoms indefinitely when others experience little or no problems at all, Dr. Mahboobeh Mahdavinia, an allergy and immunology doctor at Rush University, tells Bustle. But one thing is for sure: Lingering COVID symptoms can wreak havoc on your body, mind, and lifestyle.

Walker, a Chicago-based group fitness instructor and personal trainer, fell ill in December of 2020 after a family member got sick, despite taking stringent precautions — and she hasn't been the same since. She's run nine marathons and taught high-intensity classes for over a decade, and is now dealing with respiratory trouble that she's never experienced before. Since getting COVID, Donna's struggled to coach an entire class due to chest pain, trouble breathing, and brain fog. This ultimately drove her to give up teaching group fitness in favor of personal training, where she doesn't have to raise her voice for long periods of time and can take a beat to rest or catch her breath. "Now I literally have to pump the brakes," she says. "I don't want to give myself a heart attack."

"I don't know what the recovery for this looks like."

Hedgecock also had to pivot her career to advocacy work supporting long-haulers when it became apparent her debilitating long-term COVID symptoms weren't going anywhere. She had to quit her training job altogether and cancel the impending launch of her wellness business — a 12-week program that would teach the foundations of self-care, fitness, and healthy eating — in order to focus on recovery. Ten months after her initial diagnosis, Hedgecock is only now able to incorporate gentle walks and stretching into her days, but she still copes with extreme fatigue, a spiking heart rate, and POTS, a blood flow condition that causes dizziness and fainting, on a daily basis.

"I had to give up a big part of my life because of COVID-19 and its unpredictable long-term effects, which have impacted my quality of life," she says. "It's been a strain on my mental health and it's ripped me away from something I'm super passionate about." Walker's also coping with the emotional fallout of having her physical abilities completely transformed. "So much of my identity as a person, as a trainer, [and] as an instructor had been taken away from me in the past year," she says. "I don't know what the recovery for this looks like."

Downstream Effects of Long-Haul COVID-19

Besides managing daily symptoms of long-haul COVID, those affected face a host of downstream effects. These include loss of job or income, lasting mental and physical health complications, and permanent lifestyle changes, according to Ross. And fatigue is one of the most common symptoms long-haulers struggle with, says Mahdavinia — which rings true for both Hedgecock and Walker. "All of a sudden it's like you're walking through concrete and your entire body is just done," says Walker. For Hedgecock, it's so bad that it can make simple activities like walking to another room or showering exhausting.

COVID can also create lasting internal damage, according to Ross. Internal scarring can cause your organs to lose partial or total function, he says, which can lead to complications like decreased lung capacity and pain even after COVID symptoms subside. Hedgecock has scar tissue in her chest and on her spleen, which contributes to her cardiac problems like elevated heart rate. Scarring in Walker's lungs makes it harder to breathe, and may take months or years to heal.

"All of a sudden it's like you're walking through concrete and your entire body is just done."

Patients can also experience lasting neurological symptoms post-infection, says Ross, like trouble thinking, memory loss, or even stroke. COVID impacted Hedgecock's brain so severely that she has brain damage, which interferes with her ability to think and speak with as much ease as she used to. This makes it difficult to maintain her coaching.

COVID diagnoses aside, the very fabric of the fitness industry has changed as people increasingly opt for at-home workouts, leaving even the healthiest of trainers struggling to find work and make ends meet. And while Hedgecock and Walker have tackled the difficult decision to adapt or change their career paths, managing long-term illness of any kind can present sometimes-insurmountable obstacles for those without insurance, financial access to care, or a viable back-up plan for income.

The Road Ahead

The long-term impact of the pandemic is yet to unfold. But it's clear that researching, treating, and managing long-haul COVID will be a public health issue well after the pandemic ends, says Hedgecock. Though her lasting symptoms have changed her life and career in ways she could have never predicted, she says her work advocating for herself and other chronic patients is pulling her heart in a different direction. "We've got to continue locking arms with patient allies and the chronic illness community," she says. "This gives us a great opportunity to fix a lot of things that are really wrong in society with the stigma of illness and disability."

Walker misses teaching high-energy classes, but is optimistic about her ability to coach in more intimate settings and credits her background in the fitness industry for her perseverance and positivity for the future. "COVID tried to take me down, but I’m not out," she says. "The scar tissue I have in my lungs is just proof that I’m up from the fight of my life, but it’s not over."

Studies referenced:

Greenhalgh, T. (2020). Management of post-acute covid-19 in primary care. BMJ, https://www.bmj.com/content/370/bmj.m3026

Jain, U. (2020). Effect of COVID-19 on the Organs. Cureus. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7470660/

Lu, Y. (2020). Cerebral Micro-Structural Changes in COVID-19 Patients – An MRI-based 3-month Follow-up Study. The Lancet, https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(20)30228-5/fulltext

Rubin, R. (2020). As Their Numbers Grow, COVID-19 “Long Haulers” Stump Experts. JAMA, https://jamanetwork.com/journals/jama/fullarticle/2771111

Tang, Y. (2020). Cytokine Storm in COVID-19: The Current Evidence and Treatment Strategies. Frontiers in Immunology, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7365923/

Townsend, L. (2020). Persistent fatigue following SARS-CoV-2 infection is common and independent of severity of initial infection. PLoS One, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7652254/

Xiong, J. (2020). Impact of COVID-19 pandemic on mental health in the general population: A systematic review. Journal of Affective Disorders, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7413844/

Experts:

Dr. Mahboobeh Mahdavinia, M.D., P.h.D, an allergy and immunology doctor at Rush University in Chicago

Dr. Brendon Ross, D.O., M.S., a sports medicine doctor at the University of Chicago