Last week I happened to get a particular nasty cold that turned into an upper respiratory infection. I am huge baby once I get the sniffles and being sick not only puts a damper on my training,  but effects our office and my patients as I avoid getting them sick by taking time off to recover.

For most athletes getting sick raises the question of if they should work out or not. The answer isn't always simple, but the first step is to sit down and evaluate what exactly you are feeling to decide on the right course of action. Feel free to skip to the bottom if you are already feeling sick and just want to know if you should work out or not, but trying to prevent seasonal cold & flu might be your best bet.

An ounce of prevention is worth a pound of cure

Let's start by talking about prevention. Although the average adult gets two to three upper respiratory infections a year it doesn't mean you have to.

Avoid over training.
While studies suggest being active will help reduce the chances of catching and the duration of a cold, the average triathlete flirts with over training which can hinder your immune response. Over training is a major contributing factor for many triathletes and one of the best ways to measure this is with your morning heart rate.  Make a habit of taking your pulse first thing in the morning before getting out of bed, make it a part of your training journal with notes about how you are feeling in a general sense.  After establishing a good baseline on well days, you can assess mornings that you wake up fatigued and or sore. With a heart rate that is 5% higher than your base you will want to scale back your workout that day and lower the intensity. If your heart rate is 10% higher than the base, just take the day or two off completely to rest.  Also know the other symptoms of over training
  • Washed-out feeling, tired, drained, lack of energy
  • Mild leg soreness, general aches and pains
  • Pain in muscles and joints
  • Sudden drop in performance
  • Insomnia
  • Headaches
  • Decreased immunity (increased number of colds, and sore throats)
  • Decrease in training capacity / intensity
  • Moodiness and irritability
  • Depression
  • Loss of enthusiasm for the sport
  • Decreased appetite
  • Increased incidence of injuries.
Eat a well-balanced diet. The immune system depends on many vitamins and minerals for optimal function. It doesn't matter what sort of diet and eating philosophy or plan you are into - overwhelming evidence shows that getting the micro  and macro nutrients you need will help keep you well.

Get enough rest. Even if you are not over training, most adults are not getting enough regular sleep. If you are not getting enough rest at night your immune system will not be firing on all cylinders. While coffee might jump start you in the morning,  your immune system will still be a little sluggish.

Wash your hands. Your mom was right, washing your hands keeps the germs off. You touch a lot of things, and in between all those things you touch your face. By extension, all that nasty stuff you touched is essentially going right into your mouth, nose, & eyes.

Come to my office. There is not any definitive research, but a lot of preliminary studies and reports suggest there might be some improvement in immunoregulatory function with spinal manipulation.  Even still, Chiropractic care can help with getting enough rest, nutrition, and over training symptoms when a skilled Chiropractor takes the time to assist you with those areas of your health.

Get sick.   Sometimes it is unavoidable and you end up with an upper respiratory infection or the flu anyway. Being sick and exposed to virus and bacteria is how we build immunity in the first place. Once we recover from the flu virus you are immune to that virus for life, not a bad deal really.  Since you are already sick, take the time to rest and recover. Embrace the awful symptoms  as they are your bodies method of fighting.  I recommend avoiding over the counter medicine that just treats symptoms - that fever is how your body fights the cold & flu. It may also trick you into feeling better than you are and lead to future over exhaustion and fatigue.

Work out or not? Training while sick. 

Alright, so you aren't feeling well and want to know if you should work out anyway?

Depends... In doing some more research to validate my own opinions on the matter, it was hard to come up with any short and concise advice. You really have to figure out your symptoms and know if you just have a mild cold, allergies, the flu, or possibly something else. This is the standard disclaimer - go to your doctor if you are unsure. Relying on Internet advice, even from a health care professional's  blog, is not a smart move. Make an appointment if you have any questions or concerns.

I am going to take a bit of risk and assume we are only talking about the little gray area of "kind of sick" "un-descriptive not feeling well" and we all know that obvious violent flu, food poison, pneumonia, and other very obvious levels of sick are no goes for working out.

If you are otherwise fine and the workout is your only concern it is safe to say that  if your symptoms are above the neck and you do not have a fever, exercise is probably safe. Intensive exercise should be postponed until a few days after the symptoms have gone away. Use some caution, you might be able to workout through a little head cold but if not taken care of and monitored it can develop into something more serious.

However, if there are symptoms or signs of the flu, such as fever, extreme tiredness, muscle aches, swollen lymph glands, then at least two days for everyday you where sick are needed for recovery before you continue with intense exercise again.

but, but, but.... I was sick for a whole week, you really want me to take two weeks off? Three weeks without training! 

It does sound a bit severe, but hear me out.

1. you where probably over training anyway -  if your immune system was up to par you probably would not have been sick as long. Also, if you jump back into heavy training you will be very likely to have a repeat or two and miss well more than 3 weeks, but with actual sick days.

2. If you happened to just be very sick and weren't simply over trained - that is hard on your body. Your immune system just ran it's own ironman event and it needs time to recover from it's own sort of workout.  Just like an injury, you want to come back stronger than before so let your body heal.

3.  You are not going to lose that much fitness... Really, it will be OK. If you don't follow my advice and start training anyway, you will have a noticeable decrease in performance and fitness. It is expected and normal, but guess what? You'll slowly pick it up and be back to normal in about....... oh right around two week. Probably the same place as if you just took the time off to begin with, but with the disadvantages mentioned above.

Feeding the addiction. If you consider yourself a seasoned triathlete, you more likely than not have an addictive personality and training is your vice. You're fixated on psychological/physical effects of physical exercise and fitness and being sick is driving you crazy, feeling better and taking time off?   Do some light cross training.  Go for a walk. Did out that Beach Cruiser bike. Being physically active is okay, and there is some benefit too. You can go for a bike ride, but you don't have to make it a work out. Try that water aerobics class before lap swim, those old ladies will enjoy the company and if you can trust stereotypes - they probably bake some mean cookies. Show some restraint and you can be back into training healthier and faster and not suffer a mental breakdown from training withdraw.

About the Author:
Dr. Ryan Duke Gebhardt DC  is a Denver Triathlon Brand Ambassador and Denver Chiropractor. Between a busy race schedule and practice most of his time is spend chasing his 3 year old daughter around.
7/12/2012 07:15:43 pm

This blog post is excellent probably because of how well the subject was developed. I like some of the comments too though I would prefer we all stay on the subject in order add value to the subject!

1/13/2016 12:40:33 am

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