Should you run when you’re sick?

It’s winter. The mornings are cold, the early evenings are dark and we get the odd drop of rain or two. Throw into the mix a cough and a runny nose, and you have the perfect storm for an excuse to miss a session….or do you?

Everything in moderation they say, and it’s the same with exercise when you’re feeling a bit run down. If you have an upper respiratory tract infection (URTI), that is, your symptoms are above the neck – sore throat, runny nose, congestion-you should still be able to get a workout in, but at a lighter intensity than normal. (Make sure you tell your trainer if you’re a bit under the weather).

When you shouldn’t work out

It could be a good time to put your feet up if your symptoms are below the neck (chest congestion and coughing, vomiting, diarrhoea), or ir you have a high fever, muscle aches and widsrpread fatigue.  If your symptoms indicate an upper respiratory tract infection (URTI) – congested nose, sneezing, sore throat, then you’re most likely good to go, albeit at a reduced workload.

Note that you should stop exercising if your symptoms get worse as a result of exercising.

If you’re looking for information about exercising with an injury, I’ve written an article on managing and working out with overuse injuries

Guidelines for exercising with a URTI or gastrointestinal upset

Day one: No strenuous exercise or competitions if you have URTI symptoms like sore through, coughing, runny or congested nose. No exercise at all if muscle/joint pain and headache, fever, or general feelings of fatigue, vomiting or diarrhoea.

Keep the fluids up, try not to get wet and cold, and keep your general stress to a minimum.

Day Two: If you have a temperature greater than 37.5 degrees C, or if your coughing has increased, or you have vomiting or diarrhoea, no training.

If you have no fever of feelings of fatigue, just above the neck symptoms, light exercise is fine. 30-45 mins with heart rate under approx. 120 beats per minute

Day Three: If you still have a fever or gastrointestinal symptoms, see a doctor.

If your doctor puts you on antibiotics, you should ask not to be prescribed antibiotics from the quinolone family if possible, as they can increase the risk of tendinopathy. Hopefully, you would not have to take the medication for long enough for that to be an issue, but if it can be avoided, you may as well ask for something else (and make your doctor once again curse the inventor of the internet!)

If you don’t have a fever or general feeling of fatigue and weakness, and your initial symptoms haven’t worsened, you can progress to moderate exercise with your pulse under 150 beats per minute for 45-60 minutes.

If your symptoms have remained the same as they were on day 2, keep the exercise light.

Day Four: See your doctor if your symptoms are not getting better. Don’t try to exercise.

If your symptoms continue to improve, keep the exercise light to moderate for a few more days.

 Some Additional Thoughts

• Monitor your response to training whilst you are sick, and if your symptoms get worse, drop the training load back to very light, or discontinue exercising until the symptoms improve.
• If you have had to stop exercising as a result of illness, take the same number of days to get back to pre-sickness fitness, as you have taken off from exercising. So if you’ve not exercised for 5 days due to illness, allow yourself at least 5 days to gradually get back into it.
• And don’t stress, it doesn’t take long to get your fitness back.

References:
Position Statement Part two: Maintaining immune health Neil P. Walsh1, Michael Gleeson2, David B. Pyne3, David C. Nieman4, Firdaus S. Dhabhar5, Roy J. Shephard6, Samuel J. Oliver1, Stéphane Bermon7, Alma Kajeniene8. http://www.medizin.uni-tuebingen.de/transfusionsmedizin/institut/eir/content/2011/64/article.pdf

Ronsen O. Prevention and management of respiratory tract infections in athletes. New Stud Athlet 20: 49-56, 2005