Training with Illness

In my article Over-training – Causes, Recognition and Prevention, which was my report on Randy Wilbur's presentation at the OTC, I outlined the serious dilemma athletes often find themselves in. You see, athletes need to spend time in a Training Stress Phase called Over reaching (which is in a Zone of Enhanced Performance) while avoiding pushing too hard which can easily lead to Over Training. What often happens is while pushing hard enough to Over reach athletes immune systems are compromised and it is especially difficult to stay in this state while avoiding illness and injury. So, since Over reaching is the goal that will help them reach optimal fitness and Over reaching can leave immune systems compromised to the point they can get ill, what is an athlete to do when illness strikes? 

This article in about that last recommendation, practical guidelines for training while ill. I am motivate to write this not only because it is a great addition to the resource library but it is that time of year. You see it is spring in the northeast and athletes are at high training volumes finishing base training and/or increasing intensity and getting ready to race. This at the same time as the weather is going back and forth between freezing and thawing and warm temperatures. Put all this together and you have athletes getting colds, sinus infections, upper respiratory infections, immune responses from allergies and the like.

So, if you are an athlete training hard and trying to reach your optimal fitness what are you to do if you get ill? Well the answer to this question is VERY important. You see, Randy mentioned that this issue, training while ill, is one of the more common reasons for athletes reaching that non-desirable condition called over-training. Randy mentioned that systemic illness (fever, muscle aches, swollen lymph nodes or extreme fatigue) are all signs that exercise of any kind is NOT recommended. While if your illness is non-systemic sub-maximal exercise is not out of the question. So, how about a little more detail?

While reading my latest ACSM Journal I came across an article by Dr. Mark Harris on Infectious Disease in Athletes. In his article he helps give more detail to this concept of training or not while ill. In the article, Dr. Harris started by outlining the bodies immune response to exercise. You see, “moderately intense exercise, commonly defined as exercise for 5 to 60 minutes within a range of 40-60% of maximum heart rate improves many aspects of immunity.” but, “intense exercise, defined as 5 to 60 minutes of exercise at 70 to 80% of MHR and prolonged exercise, often defined as greater than 60 mins, have detrimental effects on the immune system.”

It is my experience that 95% or more of my athletes are on training plans that constantly have them exercising in what Dr. Harris defines as the intense range. In fact, I would bet most athletes that are racing or competing in endurance sports such as bicycle racing or triathlons are also involved in regular intense training. So, this immune system fact is very important to recognize and address considering this training puts them at high risk for infectious illness and infectious illness will have them asking,

“Can I train? If I can how?”

Later in the article Dr. Harris reminded me of something I heard years ago. Return to exercise should be guided by the “neck check”, that is if the athletes symptoms are above the neck, like runny, stuffy nose or sore throat they can exercise easily for 10 minutes and if the symptoms worsen exercise is to be stopped. If they do not worsen, the athlete can exercise at 50% of MHR for less than an hour. If the symptoms are below the neck, like fever, upper respiratory congestion, GI distress body aches or the like then exercise is NOT recommended.

I tell my athletes that at the first sign of illness start to hedge your bets and back off. I ask them to see their doctor if there is any questions. Get some rest, hydrate, eat well, take their vitamins with extra anti-oxidants and beat the cold early. It is far better to back off a day or two and beat a cold before it stops you in your tracks. I also remind them about over training and the risk of pushing through an illness. I am not a doctor. I highly recommend that when ill see your doctor and follow their advice. I hope that this article will assist you. Get well, then get fit.