December 30, 2010

Running When Sick (first published 12/30/05)

As I recover from a cold (and hope it doesn't lead to a sinus infection), it seems appropriate to consider this age-old question: when the body is fighting off illness, should the athlete keep training? Should he or she train differently? If rest is required, how much rest?

I truly wish there were simple answers to these questions, but in my own experience I haven't found anything simple about the experience of training and racing when sick. Let's say that there are two extreme positions: "old school" and "new school." The old school approach is to consider illness to be one more form of weakness that can be overcome by effort. An old school athlete runs when sick, and eventually gets better and is stronger for the experience ("what doesn't kill me makes me stronger"). The new school approach is to consider illness as a warning sign that the body needs healing before it can resume training. The new school athlete takes two days off, gets better, and gradually works up to hard training again. ("What doesn't kill me still leaves me in a weakened, compromised state that inhibits progressive adaptation and improvement.") So which school is better?

I have taken both approaches in my own running career, and have dispensed both "old school" and "new school" advice to athletes I have coached. The results are inconclusive. Worse than that, the results are contradictory. I once ran a brilliant half-marathon while suffering from the early stages of a cold, and recovered surprisingly quickly. I once ran a 10K race with a cold and developed a frightening case of bronchitis that kept me out of action for nearly a month. I have done track workouts while sick that seemed to hasten my cure, and I have done track workouts when sick that seemed to bring on far worse bouts of illness than what would have been expected. I have skipped track workouts when sick in the hope that I would recover faster, and then have failed to recover faster. It has been, as they say, a mixed bag.

One reason to train through illness is that NOT training doesn't always make you feel better. I mean psychologically as well as physically. One reason to AVOID training through an illness is that hard training has been shown to temporarily weaken the immune system, not a good thing when you are harboring nasty germs.

If I had to summarize the moderate approach, I would say that one should fore-go HARD training while sick, but not necessarily take complete reset. I'd also say avoid all racing when sick unless it is a really important race, for example one you have trained for all season. Thus, if you have a cold or a sore throat or a headache, run easy. Easy running means making it completely aerobic - nothing that involves really hard breathing or placing your body in extreme duress. I think there's little risk that such moderate exercise will lengthen the duration of a common cold. On the other hand, don't do that killer 4 x 1M workout that you had planned. Don't go out for a 15 mile long run in sub-freezing temperature. In other words, don't extend yourself. When you're sick, you're more likely to break.

I haven't even mentioned one of the other factors that comes into play: hypochondria. It turns out that many runners are hypochondriacs. When under mental stress, such as when approaching an important workout or race, they experience symptoms of illness without the actual illness. Far from being crazy, these athletes are actually rather typical. One of the important reasons to not automatically shut it down when you are feeling the early signs of a cold, is to counter this natural tendency to "worry yourself sick." Hypochondria, like other forms of self-doubt, needs to be understood and confronted to be overcome.

Finally, there is the rare malady of the athlete who refuses to take time off, even when continuing to train is obviously counter-productive, if not dangerous. If hypochondria is the result of one kind of insecurity, its opposite is the result of another kind of insecurity: the fear that taking any time off at all is an unacceptable form of weakness. This is where a coach can be very helpful in setting limits that an athlete might not want to set for himself or herself.

So, to conclude, should you run when you're sick?

What, do I look like a doctor?

4 comments:

Anonymous said...

I remember hearing that if what ails you is above the shoulders then you can run easy, below ie achiness, fever, shivers - rest

Anonymous said...

how is a fever "below the shoulders"?

Anonymous said...

The decision about whether to run when “sick” seems that it should be part of the larger decision of whether to run when “hurt”, and, really, training in general – balancing effort and rest. I really wish someone could tell me absolutely what to do.

Some of the challenges in trying to find the right answer include the wish to generalize from past experience (ours or other runners’) to the future, when, as you pointed out in your post about navel-gazing, those experiences are more complex than we’d like to believe. If a cold turns into pneumonia after a race, perhaps it was because that particular cold was going to turn into pneumonia anyway. If a runner runs through aches and knots and twinges and he improves, perhaps he would have improved faster with having rested. If a runner runs with pain and turns a shin splint into a stress fracture – well, he probably won’t do that again. Is stretching necessary, is more better? Are shoes necessary, is more engineering worse? There seems to be a lot of reason to “trust the training” and adhere to the plan, but there also appears to be a role in trying to observe and respect the signals of one’s own mind and body, running thoughtfully and being willing to adapt and adjust, even in the middle of the run.

Good question.

doctor love said...

"how is a fever "below the shoulders"?"

didn't invent this but imagine
it means fever = high bodytemp
basically not just a headcold