Tick Bites and Running: Protection, Removal, Lyme

The tick bite is the risk endurance athletes misjudge most often — in both directions. Some abandon every trail run the moment a blade of grass touches their ankle; others run through tick habitat for years and never check afterwards. Yet the matter is remarkably well defined: ticks sit in grass, not in the forest, transmission of Lyme bacteria takes many hours, and anyone who checks in the evening and removes the tick correctly has the risk almost fully under control. This article explains how the animals operate, how common Lyme disease really is in Central Europe, what the TBE vaccination does and when a harmless bite becomes a matter for a doctor.

Ticks sit in grass, not in the forest

The widespread image of a tick dropping from a tree in the forest is wrong. Ticks do not jump and do not climb higher than about half a metre. They sit in the vegetation and wait for an opportunity: blades of grass, leaves, undergrowth, unmown strips beside the path. Anchored to a stem, they stretch their front legs forward and grab onto whatever brushes past — the leg of a runner's trousers as much as the coat of a deer. You pick them up when your leg brushes tall grass, not because you stood under a spruce.

That gives the practical hotspots for training runs: the meadow path that stands waist-high in June; the forest edge with its unmown fringe; the narrow path through the leaf litter of damp mixed woodland; the trail section where you squeeze past blackberries at a bottleneck. Wet, warm years with early vegetation raise activity considerably; the season now often starts in March and only really ends in November in mild weather. Anyone still running trails in late autumn belongs to the risk group. The same seasonal logic applies to planning: the base you build in autumn carries your form into the following spring, see Autumn Training in Endurance Sport.

How a tick works: three stages, one time window

Ticks pass through three stages that matter to humans. The larva, barely a millimetre long, sits mainly in grass and leaf litter and is almost always overlooked in a body check. The nymph, two to three millimetres, is the most common cause of Lyme disease because it is small, common and hard to spot. The adult tick is larger and immediately obvious during a check. TBE viruses, by contrast, are transmitted mainly by adults, which is why TBE risk and Lyme risk do not have identical distributions.

The decisive point is how the feed proceeds. The tick looks for a suitable entry point, anchors its mouthparts in the skin and begins to feed. The Lyme bacteria, however, are not in the salivary glands but in the midgut — they first have to multiply and migrate to the salivary glands before they reach the blood with the saliva. That typically takes 12 to 24 hours, occasionally less. This is precisely where the central rule of prophylaxis comes from: it is not the repellent that decides, but whether you find the tick within the first hours. A nymph removed on the evening of the training run carries practically no transmission risk.

Lyme disease: the real risk in Central Europe

Austria is among the countries with the highest Lyme borreliosis incidence in Europe, because the share of infected ticks is high. Depending on region and study, 5 to 30 percent of ticks carry Borrelia burgdorferi sensu lato, and in some natural foci more than that. That sounds like a lot, but it relativises through the sequence: not every bite comes from an infected tick, not every infected tick transmits, and transmission needs the time described above. A high infection rate therefore does not translate into a high disease rate.

What is striking is the frequency compared with public perception. Contrary to a widespread assumption, the number of reported TBE cases in Austria is in many years lower than the number of Lyme disease cases — Lyme borreliosis is not notifiable in the usual sense, the number of unreported cases is high, and the actual number of cases needing treatment is estimated in the thousands per year. For runners the relevant perspective is this: the problem is not the dramatic individual case but a risk that accumulates over many training years and many bites, and which can be controlled almost entirely by mechanical means.

TBE: the second pathogen and the vaccine

TBE is the second disease transmitted by ticks, and the only one against which a vaccine exists. The virus attacks the central nervous system; the course ranges from a febrile illness that heals without consequences to inflammation of the meninges, brain or spinal cord with long-term effects in a proportion of those affected. Austria counts as a classic TBE endemic area, and the number of registered cases fluctuates widely: in high tick years more than 150 to 200 cases have been reported here, in other years markedly fewer — a pattern that repeats in other endemic countries too, because weather, rodent populations and vegetation shift activity from year to year.

For runners the conclusion is clear: the TBE vaccination is the only measure that genuinely works against a pathogen, and it is well tolerated. The standard is basic immunisation with three doses — the first two one to three months apart, the third after five to twelve months — followed by a booster at three-year intervals from the last dose. Anyone who has missed the booster for years does not have to start over: a single dose generally reactivates protection sufficiently; after a long gap a doctor may recommend a titre check. This vaccination belongs to training preparation just as much as a warm-up before a tempo run, especially for trail and forest runners. If you are seeing a doctor in spring for a Pre-Race Health Check and Heart Screening anyway, this topic can be covered in the same appointment.

Protection before the run: clothing, routes, repellent

Three layers, in ascending effectiveness. First, clothing: on trails with tall grass, long running tights or at least calf cover are the simplest measure. Ticks search preferentially above the ankles, in the groin area and at the hip; if you offer no skin there, you remove a large part of the attack surface. What matters is not the colour but the seal: a trouser leg that ends above the shoe and gapes open with each step offers access again. Anyone already running in long clothing in winter has the advantage in early spring without noticing. Together with the clothing question — see Choosing Running Clothing — that is a decision you make once in early summer.

Second, routes: keep runs in early summer on broad paths, mown verges and dry coniferous sections. On unavoidable grass passages, stay in the centre of the path instead of stepping aside, because vegetation at the edge is the actual source. Third, as a supplement, repellent: products with DEET or icaridin reliably keep ticks away for a certain time, a few hours depending on the active ingredient and formulation. Icaridin is usually better tolerated and kinder to plastics, DEET is stronger but attacks gear such as lens coatings and watch straps. No repellent replaces the body check afterwards: it lowers the probability of a bite, it does not guarantee it. Some runners additionally treat clothing with permethrin, which must only be applied to fabric and never to skin.

After the run: a five-minute body check

The body check is the most effective measure in this whole article, and it takes a few minutes. Ticks prefer warm, damp, thin-skinned places. Specifically, check:

• The back of the knee and the back of the thigh. The most common finding site in runners of all.
• Groin, genital area, gluteal fold. Warm, damp, thin-skinned — the nymph's favourite spot.
• Armpits, chest and navel. Often overlooked, because ticks travel there under the shirt.
• Neck and scalp. Mainly relevant in children; in adults more often behind the ear and at the hairline.
• Between the toes and on the top of the foot. Especially if you were out in sandals or low socks.

Take your time and look properly: a nymph is two to three millimetres small and looks to an untrained eye like a speck of dirt or a wart. The best moment is after the shower, in good light, running your fingertips over the skin. If you have a running partner, swap the backs — back, neck, backs of the knees; no phone camera can check those reliably. If you live with animals, the dog belongs to the same checking ritual, because otherwise it brings the ticks indoors.

Removal: what works, what makes it worse

Remove the tick completely and in one motion, without squeezing, without anaesthetic agents. The correct method is fine tweezers or a tick removal card, applied as close to the skin as possible at the head — not at the engorged body — then pulled out with steady, perpendicular traction. Twisting is not necessary. Afterwards, disinfect the site briefly, keep the tick between a piece of tape or in a sealed container so it can be identified later if needed, and note the bite with date and body site.

Wrong, and very widespread: dabbing the tick with oil, glue, grease or alcohol. Such agents put the tick under stress and can accelerate the very mechanism you are trying to prevent — the animal regurgitates gut contents in its defence reaction, and with them potentially Lyme bacteria into the puncture site. It is equally wrong to scratch the head out with your fingernails, because contamination increases. If the head is stuck: do not drill after it. A remnant of the mouthparts in the skin is not automatically a drama, because the pathogens sit in the gut and not in the mouthparts. Leave it alone and show the site to a doctor if it becomes inflamed or does not heal. A quick look at First Aid for Runners helps to have the field behaviour ready.

Rash, erythema migrans and the 12-week rule

The most important diagnostic clue to Lyme disease is erythema migrans, the spreading rash. It usually appears three to thirty days after the bite, typically one to two weeks. The classic form is a red ring expanding from the entry site while the centre becomes paler — a ring or garland shape, not an evenly filled disc. It can reach several centimetres or more than 20 centimetres across. If it is caught with a size reference, the diagnosis is clear to a doctor and treatment follows without laboratory confirmation: that is favourable, because at this stage the illness almost always resolves without consequences under treatment.

Where the rash is missing — in roughly a third of cases it is not pronounced at all — only the non-specific signs remain, and those are the real trap. From the third to the twelfth week after the bite the following may occur: fever, headache, fatigue, migrating joint and muscle pain, cranial nerve symptoms, dizziness or tingling paraesthesia. These symptoms are very often misread as incipient overload or as overtraining warning signs — with the result that a treatable infection is managed as a training problem for weeks. Hence the 12-week rule: after a tick bite in this risk window, a symptom combination of fever, joint or nerve complaints counts first as suspected Lyme disease, not as a recovery deficit. Blood tests only help to a limited extent: antibodies appear late and non-specifically, so clinical picture and history decide.

What a bite means for the training plan

As long as no symptoms appear, a removed tick changes nothing in the plan — even a mild local redness at the entry site is no reason to pause, and you can run the next session as planned. Only when symptoms are added does the rule apply that holds for any febrile illness: with a fever, endurance training has no place in the plan.

Once antibiotic treatment has started, the body is not only dealing with the infection but often also with the effects of the medication; gastrointestinal complaints and skin reactions to sunlight are common side effects. The way back has three stages. During treatment and until symptoms subside: no intensity, at most easy movement in short units of the kind described in Recovery Run Training. In the first week after becoming symptom-free: zone 1 and zone 2 only, no intervals, no long runs. From the second to fourth week, depending on the course and medical feedback, the stepwise return follows. How to guide that return methodically is described in Return to Running After Injury; the logic is the same, only the trigger differs.

Important for perspective: Lyme disease caught and treated early is not a training catastrophe but an episode of two to four weeks. The real risk lies in the late-recognised form with joint or nerve involvement — and that arises not because of the bite but because of symptoms nobody connects to the bite.

Common mistakes

• Checking only after forest runs, not after meadow runs. The meadow and the unmown verge are the main risk, not dry coniferous forest.
• Missing the nymph. Two to three millimetres looks like a mole or a speck of dirt. Without a tactile check it stays attached for 24 hours or longer.
• Checking only the next morning. That removes exactly the window in which prophylaxis works.
• Oil or toothpaste on the tick. That speeds up transmission instead of preventing it.
• Head stuck → digging after it with a needle. More contamination, no benefit; leave remnants alone and observe.
• Not noting the bite. Without a date, a rash three weeks later cannot be placed in context.
• Dismissing a rash as a local reaction. An expanding, paling redness is not a puncture reaction but erythema migrans.
• Reading symptoms as a training shortfall. Fever, joint pain and nerve symptoms after a bite are first a suspected infection and only then a planning question.

How Peakora handles illness phases

Peakora cannot remove a tick, but it can handle the consequence. If you log an illness in your training, the engine works with the break instead of against it: planned sessions move back, the fitness curve across CTL, ATL and TSB shows the resulting gap honestly, and the return starts at reduced intensity rather than at the point where you stopped. After Lyme treatment the way back is a rebuild, not a switch being flicked — the marathon framework under Marathon training from base to goal race applies to illness-related interruptions too. CTL, ATL and TSB are explained in the training glossary.

Frequently asked questions