The ECCC's "Ask A Pro" Forum

Here is a forum where riders can ask questions of experienced pros - no question too basic or too advanced! Email your questions to amyw[at]alum.dartmouth.org.

Dear Dr. Mike,

I've been a little sick lately. Some people tell me it's OK to race when I'm sick and others tell me to wait until I am better. You're the pro here, so what should I do?

Thanks,
Under the Weather

Dr. Michael Ross, race doctor & author, Responds:
Dear Under the Weather,

Exercise is generally regarded as a healthy pursuit. There are some exceptions to this rule that can help you to exercise smarter. I am frequently asked when it is safe or even beneficial to return to exercise.

In general, it is important to determine if returning to training or racing will be detrimental to your overall health. Having minor symptoms may not hinder performance, but they can make you feel worse. If you know when to go easy, you will feel better and not exacerbate your condition.

Most physicians will agree that the “neck check” is a safe guideline. According to this rule of thumb, if symptoms are limited to above the neck, (nasal congestion, sore throat) it is safe to resume intense training once symptoms have resolved. Mild to moderate exercise may even be resumed if above-neck symptoms are present. If you feel worse after twenty minutes of activity, stop and resume activity once you are rested and your symptoms have improved.

If your symptoms are below the neck, or involve the entire body (fever, swollen glands, coughing, fatigue), rest until you feel better.

The adrenaline that the body makes during exercise may even help to alleviate symptoms of a “cold”. Adrenaline acts as a natural decongestant to help reduce nasal congestion. Naturally, many athletes tend to want to return to their usual training and racing program. Nevertheless, excessive training will not be beneficial at this time, as the stress of hard exercise will further hurt immune function. Trying for hard exercise will not be fruitful because you are likely to be tired and may be unable to reach target heart rate and power zones.

Below-neck symptoms are an indication to treat the illness seriously. If you have symptoms such as fever, fatigue, muscle aches, or swollen glands, intense exercise should not be performed until two to four weeks after the symptoms have resolved. Light and moderate exercise can be resumed once the symptoms improve.

The bottom line is this: Intensity followed by recovery is what makes you more fit. If you are sick, you can’t (and shouldn’t) train with intensity. It is better to rest until you feel better so that your immune system can do its job and get you back to training sooner.

Michael Ross, MD
Author of Maximum Performance: Sports Medicine for endurance athletes and Maximum Performance for Cyclists
Team Physician for Jittery Joe’s-Zero Gravity Professional Cycling Team
Race Doctor for multiple major international races