Triathletes refuse to miss workouts—no matter how sick we get. But there are times when training during illness can be unwise, not to mention counterproductive. This cold and flu season, follow a few key guidelines to train smart and, if you do fall ill, recover fast.
Written By Kristin Harrison
A few months ago while training for the New York City Marathon, I came down with all the symptoms of a common cold—runny nose, headache, sneezing. I also had a cough that lasted for a week, then two weeks,
then on to three.
I kept working out, increasing my mileage and maintaining my usual frenetic schedule despite the exhaustion I felt. But then, that so-called cold pushed back. On a run that should have been 12 miles, I felt like I was running through concrete by mile three. At mile six, I began wheezing and gasping and had to stop. That finally got my attention.
My doctor diagnosed me with walking pneumonia, a bacterial infection of the lungs. With a stack of prescriptions, an inhaler and a stern order for rest, I headed home.
During the next four weeks of my slow recovery, I had to wonder: Had my training made me sicker? Should I have stopped exercising sooner? To find out, I dove into the research and interviewed numerous doctors and exercise immunology experts.
Here’s their best advice for navigating the cold and flu season so you don’t miss weeks of training like I did.
Stay healthy by training smart.
As triathletes, we like to train and race hard. But sometimes, this can make us more susceptible to getting sick. While moderate exercise can benefit the body, researchers have shown that intense exercise can decrease the body’s ability to fight off viruses.
David Nieman, Ph.D., a leading expert in the field of exercise immunology at the Human Performance Labs at Appalachian State University, proved this with his famous study of runners in the 1987 Los Angeles Marathon.
He and his colleagues followed 2,311 runners for two months before and for one week after the Los Angeles Marathon. They found that during the week after running, the marathon runners became sick at a rate six times greater than those who didn’t run. Numerous studies since have made similar findings, including a 1997 study of 42 triathletes who completed an Olympic-distance race and Nieman’s 2009 study of ultra-marathoners who competed in the 100-mile Western States
Endurance Run. How much exercise can
compromise your immune system and increase your chance of getting sick? For most of us, it seems to come after prolonged, heavy exertion of more than 90 minutes. Additionally, runners who trained more than 60 miles per week doubled their odds of getting sick compared with those training less than 20 miles per week, according to Nieman’s research.
But this doesn’t mean you have to stop competing. Instead, follow a well-designed training plan and avoid overtraining; be sure to eat a healthy, balanced diet; get adequate sleep; and avoid excessive stress, says Jason Glowney, M.D., a sports doctor at the Boulder Centre for Sports Medicine. In addition, be particularly vigilant about washing your hands.
In general, no one knows your body better than you. As University of Houston exercise and immunology researcher Thomas Lowder, Ph.D., puts it: “There is a great quote by Supreme Court Justice Potter Stewart, who said, ‘I can’t define pornography, but I know it when I see it.’ This relates to athletes. You won’t become a stronger athlete in a week, but you can certainly become a weaker athlete by training when you’re sick.”
You can train with a common cold—in moderation.
By exercising regularly, you are already taking a positive step to reduce your chance of getting the common cold. Researchers at the Fred Hutchinson Cancer Research Center in Seattle followed 115 women for a year and found that those who exercised moderately and consistently (45 minutes five days a week) experienced half as many colds as those in a sedentary control group.
But it’s almost inevitable that you’ll get at least one cold this year. According to the National Institute of Allergy and Infectious Diseases, Britons suffer two to four colds per adult per year. And if you’re like me, you push through the sneezing and congestion and keep swimming, biking and running. But should we?
Thomas Weidner, Ph.D., director of the Athletic Training Laboratory at Ball State University in Muncie, Indiana, conducted a study in 2002 to answer this question. He inoculated 50 people with rhinovirus, the common cold, and then divided them into two groups—one group exercised for 40 minutes every day, while the other group rested and remained sedentary. His findings were surprising: Neither group differed in the severity of symptoms or length of their colds.
“Nobody feels good when they have a head cold, but research says people can exercise,” Weidner says. “We found that cold symptoms do not get worse after working out.”
But this doesn’t give you a green light to exercise as hard as you can. It’s vital to pay close attention to your symptoms and your effort level during workouts. “Light to moderate exercise is okay with a minor illness like a cold,” says Glowney. “But intense exercise has the propensity to make a relatively minor illness more severe.”
According to the article “Exercise and the Immune System” published in Clinics in Sports Medicine, most experts define “moderate exercise” as 40 per cent to 60 per cent of your aerobic capacity and “vigorous exercise” as 70 per cent to 80 per cent of your aerobic capacity. But each athlete is different and must judge his effort based on how he feels. For triathletes, this can vary greatly by sport. If you are a weak swimmer, you might work a lot harder aerobically during an easy workout than you would on your bike, so you should adapt your training accordingly.
If you do exercise with a cold, it’s more important than usual to pay attention to your hydration, says Andrew Hunt, M.D., medical director for USA Triathlon. You need “at least one good clear urination per day,” he says. Also, keep in mind that chlorine can be an irritant to your nose and lungs, so swimming in an over-chlorinated pool can cause additional discomfort with a cold.
Take time off with symptoms below the neck. Experts generally tell athletes to use the “neck rule” to help determine whether they are too sick to train. This means, if you experience symptoms above the neck—a runny nose, nasal congestion or sneezing—light to mild exercise might be of some benefit, says Dr. Glowney. But if you experience body-wide symptoms or any in your chest and lungs such as a fever, cough that’s not from post-nasal drip, fatigue or stomach issues, Glowney says, “A break from exercise is the best approach.”
Why? Because below-the-neck symptoms can denote more serious illness – bronchitis, influenza, pneumonia—that, in their most serious forms, can require hospitalisation and many weeks of downtime.
As Dr. Hunt says, “Running while you experience symptoms below the neck won’t cause pneumonia. It might be pneumonia.”
During illnesses like this, “The lining of the respiratory tract breaks down as infected cells slough off,” says Glowney, “leaving you more susceptible to a bacterial super infection on top of the pre-existing viral one.” There have also been reports of sudden death in athletes who were found post-mortem to have been suffering from bacterial pneumonia, another reason to back off.
The bottom line: If you have a fever, shortness of breath, a heavy cough, vomiting or diarrhea, or feel exhausted even when not exercising, stop training until your symptoms improve.