Adult Athletes and Mono
Contracting mono is difficult for anyone, but it's particularly difficult for adult athletes and those who enjoy a great deal of physical activity. Athletes, by nature, want to be on the move.
One question that mono poses for athletes is when to return. When are they healthy enough to be able to start to exercise again and to be athletic?
The Main Issue with Athletes
According to sports medicine specialists, the decision about when an athlete with mono can return to his sport is a clinical one. The greatest concern for athletes isn't the fatigue or the potential weight loss that mono may cause, but the enlargement and increased fragility of the spleen.
Most splenic ruptures take place within 4-21 days of when the mono symptoms appear. However, as Dr. Chris G. Koutures notes, not all splenic ruptures occur within this time frame.
Furthermore, he said that ruptures can occur from even the most minor activity and in the absence of any obvious trauma.
Feeling Better Subjectively
Most doctors can't tell athletes exactly when it will be alright to join the athletic world again. They recommend to patients that they not return to physical activity until they are feeling better. Certainly, this is a very subjective barometer.
Feeling better means that your energy level is back within a normal range and that you have the stamina to participate in some moderate exercise.
What About Testing for Readiness?
Unfortunately, none of the objective tests that doctors can do will create a definitive answer about returning to sports after mono. While lab tests may help to show if there are still abnormal characteristics of the disease in the body, they are not a reliable way to make a decision about returning to sports.
Imaging tests such as a single abdominal ultrasound are also not a good indicator. They are often unreliable and are only useful in a complicated or prolonged case where you are worried about the splenic size.
What the Literature Says
Most of the literature on athletes and mono recommends refraining from physical activity for anywhere from 2 to 24 weeks from the onset of symptoms!
This is an enormous range, and should be discussed with your physician. The most common recommendation is usually to have a three week period during mono with absolutely no physical activity.
This won't usually be difficult for athletes because mono makes you feel so incredibly tired. However, should athletes start to get antsy and try to resume their activity before the three week period is up, they are putting themselves at risk.
According to Dr. Koutures, this three-week time period is within the window when most of the splenic ruptures occur. After the three week period, athletes whose medical records indicate that they are recovering nicely, and who feel better, may try some light activities. They should not, however, play contact sports and they should take it easy and pay attention to their fatigue.
If the initial week back to light exercise goes well, then athletes can slowly begin to integrate more physical activity into their routine. It is vital for athletes to be in tune with their bodies and to give themselves time to recover.
Mono is quite debilitating on the body, and the system needs time to recover and to build up the stamina that was lost while sleeping and resting in bed.
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