In my article ‘Overtraining or Over-reaching’, I discussed the delicate balance athletes must strike between pushing hard enough to achieve optimal fitness and avoiding overtraining. A critical challenge during this process is that while athletes aim to reach a state of overreaching, which is necessary for enhanced performance, their immune systems can become compromised, making them more susceptible to illness. So, what should an athlete do when illness strikes?
Training While Ill: Practical Guidelines
This article provides practical guidelines for training while ill, especially during high training volumes in the spring when fluctuating weather can lead to colds, sinus infections, and other illnesses. The key question athletes face is whether to continue training when they feel unwell.
While I was visiting the Olympic Training Center in Colorado Springs, Randy Wilbur, Senior Sport Physiologist provided valuable insights into training and illness. Read more about my visit to the OTC and Randy’s presenation in my article about Over-training. He recommended trying to avoid getting sick by following scientifically periodized training plans, maintaining detailed training logs, adhering to a strict nutrition plan, using therapeutic dose multi-vitamins, obtaining baseline data on biomarkers, improving recovery techniques, and following practical guidelines for training while ill. This article delves into that last recommendation.
The Impact of Illness on Training
When athletes become ill, it’s crucial to assess whether it’s safe to continue training. Systemic illness symptoms—such as fever, muscle aches, swollen lymph nodes, or extreme fatigue—indicate that exercise should be avoided. Conversely, if the illness is non-systemic, sub-maximal exercise might still be possible.
Dr. Mark Harris’s article on Infectious Disease in Athletes, published in the ACSM Journal, provides further guidance. He explains that “moderately intense exercise,” defined as 5 to 60 minutes at 40-60% of maximum heart rate (MHR), can enhance immunity. However, “intense exercise,” which is 5 to 60 minutes at 70-80% of MHR, and prolonged exercise (over 60 minutes) can weaken the immune system.
Given that most of my athletes regularly engage in intense training, this immune system response is vital to consider. The risk of illness is higher during periods of intense training, which often leads athletes to wonder, “If I am ill, can I train? If so, how?”
The “Neck Check” and Returning to Exercise
A helpful guideline for deciding whether to train while ill is the “neck check.” If symptoms are above the neck—like a runny nose or sore throat—athletes can try light exercise for 10 minutes. If symptoms worsen, stop exercising. If symptoms don’t worsen, continue at 50% of MHR for less than an hour. However, if symptoms are below the neck—such as fever, respiratory congestion, or body aches—exercise is not recommended.
To assess where you are in the healing process, if you feel confident that it is time to consider getting back to exercise or want to test if exercise is a good idea, try a short, less than 30-minute ‘easy’ intensity ride. This will provide insight into your recovery. If afterward the exercise does not make symptoms worse, or you possibly feel better than before (be honest), it might be time to begin scaling up the duration and intensity of training.
However, starting back too soon can make matters much worse. Not providing your body the opportunity to fully heal can turn a few days off into a week or more, or worse, contribute to overtraining syndrome if you push too far.
Final Thoughts Disclaimer: This article is not intended as medical advice. If you are ill or experiencing symptoms, please consult your healthcare provider before continuing any training or exercise.
While I am a coach and metabolic health practitioner, I’m not a doctor, so I always recommend that my athletes consult their physician when they’re ill and follow their advice. This article is intended to provide guidance, but your health should always come first. Get well, then get fit.
