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Exercising With a Cold and After: DrSugar Answers

DrSugar Answers: Running and Getting Over a Cold

DrSugar is in the house! She's here to answer your health-related questions, and this week she's discussing training after a cold.

Dear DrSugar,
I'm training for my first half marathon. I'm getting rid of a lingering cold but I'm still trying to keep up with my training so I don't fall behind but it has been difficult. I can't run without my heart racing and having to stop after a minute or so even though before the cold I could run 4 miles without stopping. Should I just not run until I'm well or should I try and run/walk the distances that I'm supposed to be doing?
Wanting to Run

The topic of whether or not one should exercise when sick is an important subject to discuss, as with Fall and Winter fast approaching, some of you may encounter this dilemma and wonder what you should do. To read more about exercising when sick, keep reading!


First, I would also like to provide you with this very interesting fact: people who exercise on a regular basis report fewer colds than their inactive peers! Research has also shown that during moderate exercise, several positive changes occur in the immune system. Once the exercise is over, the immune system returns to pre-exercise levels. But, each exercise session provides a boost that appears to reduce the risk of infection over the long term. This information should be a great motivator for not only our active readers to keep exercising, but also to anyone to get moving!

However, there is some research that shows that more intense exercise and rigorous training can actually have a negative effect on the immune system. According to the American College of Sports Medicine, there is some evidence that elite athletes (marathon runners, Olympians) who participate in heavy, prolonged training have reduced resistance to colds. The researchers have studied the immune systems of marathon runners before and after running for two to three hours. A steep drop in immune function occurs after running that lasts for six to nine hours; that can be a time where the body is more susceptible to infection.

The Mayo Clinic and the ACSM both endorse the "neck up" rule and state that you can proceed with your workout if your signs and symptoms are "above the neck" — such as runny nose, nasal congestion, sneezing or sore throat. It should be noted that if you have the "above the neck" symptoms, you should not engage in exercise if you also have a fever. One should employ some common sense as well and not engage in exercise if one has severe "above the neck" symptoms. Waiting until the symptoms resolve, if severe, is the smart thing to do.

Also, according to a CNN medical expert, people with colds should begin working out at 50 percent intensity. If symptoms improve in the first five to ten minutes, you can gradually increase the length and effort up to about 80 percent of your normal workouts. On the other hand, if your symptoms do not improve, you should only engage in mild exercise such as walking. And remember, over-doing it with heavy and intense exercise may actually reduce your immune system function and prevent you from getting better!

If your symptoms are "below the neck" — such as chest congestion, hacking cough, upset stomach or consist of systemic symptoms such as fever, extreme fatigue, severe muscle aches or swollen lymph nodes, you should rest and not participate in intensive exercise for at least two to four weeks. The American College of Sports Medicine also recommends a gradual progression back to normal training after a systemic (widespread) illness. You should be evaluated by a medical professional if you develop severe above the neck or any below the neck symptoms, in order to determine the cause of the symptoms.

There are a few precautions to keep in mind if you have above the neck symptoms and proceed with exercise. The first is to keep very well hydrated, since the nasal drainage associated with colds can speed up dehydration and some over the counter remedies can dry you out further. Illness can predispose you to dehydration, so no matter what type of symptoms you have it is very important to drink plenty of fluids. Second, if you work out in a public gym, be extra vigilant about cleaning equipment before and after you use it and try to use machines away from other people to avoid spreading your illness (or catching another bug that someone else might have)!

I commend you on your commitment to your fitness goals and I’m certain you’ve put in a lot of time and effort in your training. However, in order for your body to heal and to avoid further detriment to your health, it is possible you may need to alter your training plans until you are well. I am unable to tell you whether you should stop training all together or change your training program, as this type of advice should only be given after a thorough interview and physical examination by a physician. In terms of your heart racing symptoms, this can represent MANY problems such as dehydration, fever, low blood pressure, low blood sugar, or heart rhythm abnormalities to name a few. Again, it’s hard to determine what the fast heart rate represents given that I do not have enough information. I recommend you make an appointment with your primary care physician to discuss the racing heart rate and to determine what course of action is safest for you with regards to your training. Better to be safe, when it comes to your health!

Have a question for DrSugar? You can send it to me via private message here, and I will forward it to the good doctor.

DrSugar's posts are for informational purposes only and should not be considered medical advice, diagnosis, or treatment recommendations. Click here for more details.

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