Back to the Gym?

How Sick Do You Have to Be to Skip Going to the Gym?

The onset of flu season brings some tricky exercise questions: Is it OK to hit the gym with a stuffy nose? Or take yoga class while nursing a fever?

Whether to exercise while sick depends on your symptoms, say doctors.

In most cases, it's appropriate to exercise if you have simple cold symptoms including a runny nose, sinus headaches or a scratchy throat. It is best to avoid exercise with flulike symptoms including a heavy cough, body aches, chills or diarrhea, says Keith Veselik, medical director of primary care at the Loyola University Health System based in Maywood, Ill. Even with a cold, it may be difficult to exercise with the same intensity. "I tell patients to lower their expectations," he says.

When you're feeling ill, first take your temperature. "If you have a fever, your heart is already pumping harder and your metabolism is revved, so [working out] would make you feel worse and raise your body temperature," he says. If your temperature is above 100.5 degrees, take time away from the gym.

Do a "neck check" for a quick answer on whether to work out: Symptoms originating below the neck means you should take a few days off, but those above the neck mean there is no need to break routine.

And as a general rule, avoid group exercise classes to keep from spreading germs.

The overall approach changes for those who have chronic conditions including heart disease or diabetes, he adds. Talk to a physician before exercising. Even if symptoms feel less serious, it can be more dangerous to continue a fitness routine. "If you are ill and have a heart condition, you may be losing more fluid, so it's easier to get dehydrated," he says.

When getting over the flu, ramp up slowly to your routine, says Dr. Veselik. "Do something a little bit less intense where you are still going to get some benefits from exercise," he says. Go for a walk instead of attending that challenging spin class.

Those with chronic conditions should exercise at about 50% intensity for a few days after being ill, he adds.

Even those following a more serious training regimen, including marathon runners, should be prepared to take time off until flu symptoms ease, says Thomas Trojian, director of injury prevention at the University of Connecticut Health Center in Farmington, Conn. Some illnesses that increase the pulse rate can be tracked with the same kind of heart-rate monitor many runners use. Taking one or two days off to recoup won't throw off most serious exercise regimens, including marathon training, Dr. Trojian said.

Exercising with a virus can be especially dangerous because it can spread from your respiratory system to muscles and cause heart muscle damage in some cases, Dr. Trojian says. "You can do permanent damage for the small tiny gains of exercising an extra day while sick," he says.

He also advises against comparing yourself with top athletes who have physicians available round-the-clock and famously compete while ill.

For otherwise healthy individuals, it's possible to be too cautious when feeling sick. Know when to ease up, but don't stop exercising at the first sign of illness because working out is a natural immunity boost, says Dr. Veselik. "I'd say try it, and see how you feel."

By: Alina Dizik, Wall Street Journal
Posted by: Scott W. Yates, MD, MBA, MS, FACP

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