60A - Fit and Well Column for Feb 22nd, 2004
TITLE: "Exercise During Illness"
Dear David and Trish,
I, like many others this year, have been sick quite frequently. At the same time, I really enjoy my workouts at the gym. Is it advisable, or necessary, to stop working out during times of illness? I have heard others say it is beneficial to “sweat out” a sickness. I’m confused. Any suggestions?
Sniffling in South River
Dear Sniffling,
Let me begin by saying, “Do what I say, NOT what I do!”. I am guilty of going into the gym during periods of illness, and attempting to “sweat it out”. I think part of my problem is that exercise actually makes me feel better, and I have a deep fear of stopping for any period of time. Also, I am STILL threatened by the prospect of re-gaining the 100 pounds that I lost almost 20 years ago! Some things just don’t change!
That having been said, let’s talk about what you SHOULD do, and when….
Make an Objective Assessment
First, do a "neck check" of your symptoms. If your symptoms are located "above the neck", like a stuffy or runny nose, sneezing, or a sore throat, exercise is probably safe. But start slow and monitor your body’s reaction. If you still feel OK after 10 minutes, you can increase your speed and finish the workout or game. If you feel dizzy, weak, or just miserable, STOP.
Generally, people with above-the-neck symptoms will feel better after doing their workout. Keep liquid handy to stay hydrated, and have a sweat towel handy to clean off any equipment after you use it so you won't threaten others with your germs.
Beware of “Below-the-Neck” Symptoms
If your "neck check" reveals "below-the-neck" symptoms, it is a good rule to avoid intense physical activity. Look for common symptoms such as muscle aches, hacking cough, fever of 100°F or higher, chills, diarrhea, or vomiting. Exercising when you have below-the-neck symptoms may mean, at best, that you'll feel weak and dehydrated. Worse, you may risk such dangerous conditions as heatstroke (dangerously high body temperature) and heart failure.
Effects of Illness on Your System
Viral infections can affect the muscular system. Studies have shown impaired skeletal muscle performance and strength during acute viral infections. One study found that all subjects had decreased muscle strength and function, and another showed that 9 of 10 subjects had statistically significant loss of isometric and dynamic strength and muscle endurance.
Some infectious diseases may alter an active person's fluid status. Acute infectious diseases, especially those with fever, often result in reduced fluid intake and increased fluid losses. A fluid deficit of as little as 2% to 3% of body weight stresses the circulatory system and can impair endurance.
Low levels of body fluid could also affect temperature regulation since less perspiration results in dissipation of less body heat. Although body temperature normally rises during exercise, exercisers who have a fever experience an even greater rise. Impaired fluid status and thermoregulation caused could put you in danger of developing heat exhaustion, heatstroke, and circulatory collapse.
Don’t Spread the Bug!~
An additional concern, and responsibility, is whether you will infect others.
Some infections are readily spread in sports and require periods of isolation from others. Be courteous, and responsible to others, please!
Common Cold, Common Sense
As is often true, deciding to exercise when you are sick largely involves common sense. Taking precautions about spreading infection and listening to your body can go a long way in getting you back into action without serious problems.
Know Thyself
Individuals react differently to illness. Over time, you'll learn when it's appropriate to stick to your exercise schedule and when you should just call it a day. But if you're in doubt, try this: head to the gym and spend about 10 minutes getting into your routine. If after 10 minutes you still feel sluggish, ailing, or not into it, head right out the door. If you start to feel better, you may find that you have a super workout and end up fending off whatever was threatening to make you feel ill.
Back in the Saddle
You can resume exercising when "below-the-neck" symptoms subside. However, when recovering from an illness that prevented you from working out, it's important to ease back into activity gradually. A good rule of thumb is to exercise for two days at a lower-than-normal intensity for each day you were sick.
Pace Yourself!
If you have been ill for a couple of days or a couple of weeks, don't rush back to your normal exercise routine. It's very important to feel that you have thoroughly recovered from your illness. Starting to exercise too early is likely to lead to a re-emergence of your illness. When you do decide to return to the gym, make sure you start your workout slowly and with care. Even a week or so off your usual routine can make a difference. Bearing that in mind, ease yourself back into your exercise program by doing about half of your normal workload and gradually building up.
Post Injury Exercise
If the problem was a physical injury, make sure that it is thoroughly healed before you go back to training. A simple injury can be made much worse by your well-meaning attempt to 'loosen it up'. You could injure yourself again but this time in a much more drastic fashion. And if you have any injury that is still painful after 24 hours, seek professional medical advice right away.
TORI: PLEASE BOX THE FOLLOWING:
DO’s and DON’T’s of Illness and Exercise:
DO a check of your symptoms first.
DON'T exercise with a fever! Fever (a body temperature above 98.6 degrees Fahrenheit, or one degree above YOUR basal temperature) means that you are doing battle with a virus. Exercising under these conditions increases risk of dehydration, heatstroke, and even heart failure.
DO modify your exercise intensity. If you have cold or flu symptoms, you cannot sweat away your sickness through more intense workouts. In fact, you may make your illness worse. A simple sore throat, for example, could indicate an infection, and your immunity to fight it will be reduced if you continue vigorous exercise. Moderate exercise, however, is fine for mild cold symptoms as long your heart rate and body temperature do not increase excessively. Stop exercising if you feel dizzy, nauseous or experience any other exacerbated symptoms.
DON'T over-train or stress out. You’ve read it before in our column… over-training can lead to suppressed immune function. The stress of intense training may influence your immune system.
DO exercise to keep your immunity strong. Researchers have found a link between regular exercise and improved immune function response. It has been shown that during moderate exercise immune cells circulate more quickly through your body and are better at destroying viruses and bacteria.
DON'T infect or become infected. Be alert to air-quality conditions at your gym. During cold and flu seasons, exercise during less-crowded hours to avoid catching or transmitting viruses. Consider outdoor activities if weather conditions permit (please, NOT in the snow, unless it’s sleigh riding!). Clean the equipment before, and AFTER you use it. The gym is a virtual HOTBED of germs and bacteria, and the warmer inside temperature makes it even worse.
DO use common sense. If you’re really sick, stay home, rest, and drink plenty of fluids, and get your friend to bring you Dairy Queen. It's difficult and silly to exercise when you're coughing and sniffling, and pretty disgusting, too!
DON'T let a temporary illness stop you permanently. Focus on flexibility, stress management, and mind-body awareness during down times, Make a specific plan on how to resume your activity program as soon as you can rather than letting yourself drift into sedentary habits.
DO return to exercise when you're ready. Making up for time missed in the gym can drain your immune system all over again. Exercise for two days at a lower intensity for each day you were sick. Give your body time the time it needs to recover.
DON'T hesitate to consult your doctor. Even if an illness is minor, check with your physician if you are seriously concerned. Ask for his or her opinion about exercise, and FOLLOW the advise!