Are you well enough to work out?

Winter colds and other viruses can cause havoc with carefully planned fitness regimes. Sam
Murphy on when it's safe to resume exercise

If your fitness regime has been thrown off course by a bout of flu, a cold or the dreaded
norovirus, you are certainly not alone. But how, in that sluggish post-viral period, do you gauge
whether it is safe to start exercising again?

Your resting heart rate can be a good indicator of whether exercise is appropriate - providing you
know what it is when you are 100% well. "Elite athletes check their resting heart rate daily," says
Dr Mark Wotherspoon, a sports physician with the English Institute of Sport. "If the resting level
is 10 beats per minute above normal, this would be an indicator not to train."

For the rest of us, the nature - and location - of your symptoms is an important determinant of
whether you should don your slippers or your running shoes. "We differentiate between 'above
the neck' symptoms such as a runny or stuffy nose, watery eyes or a mild sore throat," says
Wotherspoon, "and 'below the neck' ones, such as a cough, a congested or tight chest, an upset
stomach, muscle aches or fever." If your symptoms are above the neck and you feel OK, it is fine
to do a light work-out. Research from Ball State University in Indiana found that infecting
subjects with a mild cold virus did not affect their ability to exercise moderately. Lung capacity
of the infected subjects was the same as that of the healthy ones, and running on a treadmill for
15 minutes felt no harder.

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Is there any truth in the old "sweating out a cold" adage? "Bringing up your body temperature is
a way of fighting a virus," says Dr Alex Nieper, sports physician for Chelsea Football Club. "But
keep the activity light to moderate - and brief." Research from the Common Cold Centre at
Cardiff University shows that symptoms normally last around a week - though in about 25%
cases, they can linger for up to 14 days.

"Hard exercise compromises the immune system, allowing a virus to strengthen its hold," says
Nieper. "The body is already under stress in fighting the infection, so piling on additional stress
through vigorous exercise is counterproductive." Studies have found that a long, hard work-out
can lower immunity for up to nine hours.

And if your symptoms are below the neck, give your work-out a miss regardless of how you feel,
or how much you think you need to do it. Exercising with major cold symptoms, particularly a
fever, will prolong your illness and can be dangerous. "A fever is an indication that your body is
fighting a virus," explains Professor Ron Eccles, director of the Common Cold Centre. "If you
are feverish or feeling really rough, then don't force yourself to exercise as you may faint or, in
very rare cases, cause some damage to your heart." Eccles is referring to a condition called
myocarditis, inflammation of the heart muscle, which can result from over-exerting yourself
when you have a virus. It can cause shortness of breath, heart arrhythmias and, in extreme cases,
sudden cardiac death.

Stopping exercising for up to a fortnight can be tough for fitness fanatics or those training for a
specific event with a looming deadline, but Wotherspoon says it is important not to panic.
"There's a tendency to think that if you miss a couple of days of training, it's a disaster," he says.
"But the quality of your training is at least as important as the quantity. Training when you're not
100% well isn't going to give you that quality."

It is important to return to exercise with caution. Monitor how you feel, make sure you stay well
hydrated (particularly if you have had a stomach bug), avoid getting wet and cold and look out
for telltale signs that you are overdoing it, such as a work-out feeling harder than it should,
shortness of breath, weakness or dizziness. "There is no hard and fast rule for when to return to
exercise after a cold or flu," says Eccles. Nieper agrees. "From a sports medicine point of view,
there are no specific signals that you're ready to return," he says. "Once your symptoms have
gone, try a gentle 10-minute work-out and see how it feels. If that's OK, gradually increase the
challenge the next day, and again the day after. If you're still feeling fine, you can gradually work
your way back to where you were." But, he warns, "don't try to make up for lost time. Push too
hard, too soon, and you might end up back where you started."

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How to stay well when exercising

Stay well hydrated Dehydration dries up the mucous membranes, allowing infections to take
hold.

Eat and drink after training Within half an hour of training, eat a carb-based meal or snack
with a little protein to help maximise the replenishment of fuel stores.

Take probiotics A new Australian study published in the British Journal of Sports Medicine
found that taking probiotics during winter training more than halved the number of days
endurance athletes suffered cold symptoms.

Don't overtrain Balance your training with adequate rest and recovery. One study found that
runners who average more than 96km a week were twice as likely to suffer from colds as those
running less than 32km.

Wash your hands after the gym "The best advice is to not touch your nose or eyes when
exercising and to wash your hands when you finish your workout," says Professor Eccles.

Don't linger in damp clothing after exercise As you cool down after a work-out, the cold,
damp clothes will lower your body temperature further, making you more susceptible to catching
a cold.