The chances are that there’s been some point in your exercise routine when you’ve gotten sick and asked the question, “Should I skip the gym today?”.

The question itself begs to be answered, “YES!” since you’re not neck deep in the toilet bowl professing your hatred for our cold and flu season. Being sick obviously sucks but we have to be smart and listen to our bodies when it comes to training while you’re body is trying to fight off an infection. Here’s a few things to consider the next time you find yourself asking that question.

The Art Of Being Sick

Being sick will either bring out the grit in us or it will finally give us the excuse to act out a scene from Saving Private Ryan to gain sympathy from a spouse or loved one. And I hope your reading this article for a reason to get back to training and not work on your Oscar performance. That being said, there is some criteria you should be checking off before you lace up those cross-trainers. Let your symptoms (and me) be your guide!

Ask Yourself 2 Questions

1. Is my sickness above the neck? We are looking for symptoms such as:

• colds,
• coughs,
• influenza,
• sinusitis,
• tonsillitis,
• throat infections, and
• middle ear infections

If so, and you don’t have a fever above 99.5F AND you’re absent of chronic diarrhea and vomiting (dehydration) then you should be fine. But always consult with your doctor before undertaking any advice from a blog!

Training with a fever will only contribute to raising your internal body temperature which may also lead to dehydration, especially if your vomiting or have chronic diarrhea. Periodic episodes of vomiting or diarrhea would be considered o.k as long as your intake of fluids is adequate and you’re consuming enough food to nourish the body AND the workout. And be sure the obvious doesn’t happen while on your third set of back squats!

2. Is my sickness below the neck? We are looking for symptoms such as:

• chest congestion
• Upper Respiratory Chest Infection
• hacking cough
• chronic vomiting/diarrhea
• lethargy, and
• widespread muscle aches

This list on only a guide and not all encompassing. You should be self-aware and use your best judgement. But if you said yes to any of the above then it’s best to sit this one out until you can un-check that box to move into the “above the neck” category.

Now, let’s talk briefly about what happens in your body when you’re sick to set the stage.

To Train Or Not To Train?

A Rhinovirus (common cold) walks into a bar (your nose, mouth, throat) and begins to replicate. Your bodies immune system (the bartender) asks the Rhinovirus to kindly leave by rounding up his bouncers (white blood cells). And, unless your bouncers have had a run-in with that exact strain of the virus before, the initial attack fails and your body sends in reinforcements. Your nose and throat get inflamed and make a lot of mucus ie. cold symptoms. With so much of your energy now directed at tossing the Rhinovirus from the bar, you’re left feeling tired and miserable.

So you’ve only checked the boxes in the “above the neck” category and have decided based on how you feel to be gritty and go get some at the gym. Let’s come up with a plan. Otherwise, if gaming for sympathy and room service is your thing then read no further!

Put Me In Coach!

First, let’s define “working out” and “being active” since they will both have different roles in our recovery as we try to stay moving while being sick.

 

Working out is generally seen as elevating the heart rate, sweating, breathing hard, using external weights or gymnastics (body weight) movements to stimulate a stress response in the body for growth or adaptation. Normally, this type of stress is easily handled by the body in the absence of illness. And it’s this response that eventually makes us stronger and fitter!

But…

If we choose to remain active (which I hope you can do) based on the criteria above, then we just have to be smarter in our approach – which we will get to.

 

Being active I would define as:

• walking (preferably outdoors)
• low intensity bicycle, air-bike, row
• gardening, yard work…
• practicing T’ai Chi, yoga…
• mobility/ROM work
• active recovery

And I would conclude that the research recommends (based on severity) to “being active” if it’s decided that your illness is below the neck and under the advice of an MD. Most of these items have been found to boost immunity and not be stressful enough to further burden your body with its recovery.

One final word on the justification for avoiding an intense exercise routine while sick with “below the neck” symptoms such as a chest infection, it has been found that significant abnormalities of respiratory muscle function can occur during upper respiratory tract infections in otherwise healthy young adults. Stressing the lungs to work hard in these conditions can lead to more inflammation and possibly furthering the advancement of the infection to a later stage such as pneumonia.

The Strategy

Alright, we’ve decided that ‘Netflix & chill’ can wait until after we’ve put some work in at the gym. Here’s what to do:

Step 1:

Commit to being active but accept that you may need longer to recover. In the moment you will want to keep the routine the same or even do 3 days in a row because thats what you would normally do. Don’t forget that by working out you are trying to help the immune system in expelling the kinky Rhinos from the bar, not assist them…nevermind.

Step 2:

Adjust your anaerobic (weight trainging) intensity and volume. Chasing 1 rep maxes aren’t your jam this week.

Stick to sets of 2×5 reps or 3×3 reps instead of 3×5 reps or higher. And try to work in the ranges of 65-70% of 1RM. Be sure to take adequate rest between sets in the 2-3 minute range to keep the heart rate down and recover properly. Adjust the rest and load to give you the result of accomplishment and efficiency and not one of struggle and fatigue. More about this later.

Step 3:

Adjust the cardio (aerobic)/WOD intensity. You don’t want to jack your heart rate to 90% levels in recovery doing HIIT movements such as skipping, air bike, row and sprinting coupled with weight training such as a CrossFit workout. The goal for intensity in your training window should also be around 70% of maximal effort. Remember, we are trying to recover and stimulate the immune system and not burden it!

Step 4:

Take into account these aditional factors to optimize recovery, such as:

• sleep quality
• mental stress
• emotional stress
• nutrition

Avoiding or neglecting any one of these will inevitably sabotage your efforts to recover even when you’re not sick. So paying attention to them while training with a cold is of utmost importance! None of the above should be sacrificed for the sake of training!

An Ounce Of Prevention

So why am I sick anyway? I go to the gym often, I eat pretty healthy, I think I’m getting enough sleep…I just don’t get it!

There is far too much information on these topics to cover here but I will cover them in future blogs and touch on one of them now.

Training Intensity

Now some athletes have heard me give anecdotes to my training intensity in class before and my actions have always been based on this research.

Consider the following:

Photo courtesy of Precision Nutrition Infographic

Looking above, one can see that being sedentary (average) or exercising too much (high) can lower immunity, while being somewhere in the middle can improve immunity (low).

Interesting research looking into exercise habits and influenza found that people who didn’t exercise were sick pretty often and those who did so at least once per month and three days a week did the best at fighting off the flu. Alternatively, those who exercised more than 4 times per week got sick most often. Signifying that repeated bouts of intense exercise can, not will, result in immune dysfunction and inflammation.

 “…(resistance exercise)—induced changes in immunity may become clinically relevant after repeated exercise bouts with insufficient recovery…Care should be taken to ensure that resistance training is planned, with adequate variation in intensity and volume over time, to ensure recovery between sessions and to avoid chronic systemic inflammation.

Like I said before, you have to listen to your body and adjust your intensity accordingly. Going into 100% competition mode every workout will land you on the couch or active recovery doing the intensity level you should’ve followed in the first place.

The “Window Of Opportunity”

For infectious bacteria and viruses there is a sneaky window of “opportunity” for them to seige our castle walls and get by our main line of defence.

   After prolonged, intense exercise the number of lymphocytes (white blood cells) in the blood is reduced, and the function of natural killer cells is suppressed;

During this time of immunodepression, often referred to as ‘the open window‘, the host may be more susceptible to micro-organisms bypassing the first line of defence. This is of interest to top athletes who perform frequent severe exercise. (1)

Think about the J-Curve here. You do 3-5 days a week of exercise and each time from the moment you put down that barbell for the next 3-24 hours you’re immunity is more compromised than before you picked up the barbell. Couple this with the overuse of too much intensity and/or duration of the workout and it’s just a matter of time before you shake hands with a nose picker for the win.

 

Fight Back

Of course there are ways to minimize getting sick in the first place like basic hygiene and eating enough quality food to sustain a healthy mind and body, but what are the other factors?

Training Duration

Try and keep your workout session (especially when sick) under 1.5 hours. Studies have shown that working out between 1.5 and 2hrs depresses the adaptive immune system. The adaptive immune system helps us fight infections by preventing pathogens from colonizing and by destroying microorganisms like viruses and bacteria.

Aim for more moderate intensity exercise sessions in the range of about 45 minutes to 1 hour can actually boost your immunity once again (J-Curve). There’s nothing wrong with high intensity but it has its place less frequently than most want to believe. We still gain training adaptations in this mindset without the risk to our immune system. A win/win!

Lastly, brief vigorous exercise such as HIIT doesn’t cause a negative effect on the immune system but conversely doesn’t illicit a positive effect either from the research I’ve seen. Keep in mind that there’s many health benefits to HIIT on the body for fitness and strength so as to not confuse that with the immune response!

Recovery

Perhaps one of the most overlooked reasons one becomes sick or hits a plateau at the gym is the athletes recovery. Most people don’t have a problem putting the work in. But the early mornings for work and late nights relaxing or coming down from the day eat not only into sleep duration but sleep quality.

Recovery will be a separate blog because of the quantity of information but I will touch on stimulants like coffee. I think its safe to say the majority of this blogs readers use it for kick-starting their mornings. But until recently, when I did my genetic testing, it made clear sense. My lack of sleep quality was being thwarted by my first cup of coffee at 5:30 am! That’s right, being a slow metabolizer of caffeine I would fall asleep at night but the quality was affected because I wouldn’t enter a deep state of rest. Something most people wouldn’t think of!

The message here is to use every tool possible to improve your sleep time and quality. Either through the use of blue light filters, meditation, supplements (if necessary), and of course maximizing your circadian rhythm.

Conclusion

Whether your sickness is “above the neck” or “below the neck” it’s important to remain mobile and move around. Keep yourself motivated by improving your mobility routine at home if you can’t leave the house or head out to your local gym and get your workout in while dialing down the volume, intensity, and duration – while practicing good hygiene! Whatever the scenario, we want to be active because it feels good both mentally and physically. It’s important to have a good mental game when staying active with an illness so you don’t get de-motivated in the process but you also don’t push too hard as to sabotage your efforts.

Be patient, recovery well, and exercise smart!

 

 

References:

1. https://www.ncbi.nlm.nih.gov/pubmed/7676100
2. https://www.ncbi.nlm.nih.gov/pubmed/17303714
3. http://journals.sagepub.com/doi/abs/10.1177/1559827609360190
4. https://www.ncbi.nlm.nih.gov/pubmed/17826186
5. https://www.researchgate.net/publication/12426241_Training_Strategies_to_Maintain_Immunocompetence_in_Athletes
6. https://www.atsjournals.org/doi/abs/10.1164/ajrccm/138.1.5?journalCode=arrd
7. https://link.springer.com/chapter/10.1007/978-1-4614-8884-2_24
8. https://www.ncbi.nlm.nih.gov/pubmed/16558471?dopt=Abstract