How to Maintain Fitness through Illness
By Sarah Willis PhD.
We continue to gradually get back into training realizing that we may not have a lot of energy since the sickness usually zaps this out of us. Working to eat restorative foods to supply the body with all necessary nutrients (fresh fruits and vegetables, lean proteins, whole grains, limited processed and refined foods). Managing our energy intake is also valuable, as both higher and lower intakes will increase risk for infections. Further, possibly considering the use of supplements during higher training or stress loads (vitamin C, vitamin D, zinc). We should rest and sleep as much as possible/needed; for me this is the biggest one and has helped me the most with recovery. Staying hydrated and even using a humidifier to help support restoration of our airways, as keeping the mucus lining moist and hydrated will help reduce irritations and improve our body’s ability to keep infections out.
There are times throughout the year when getting sick just happens. We all make plans in our calendars, make plans for training blocks, make travel plans, and have race plans. But we never make plans for getting sick – and it happens. We know that we need to decrease our training intensity and work towards accepting that the planned outcomes are blocked (at least temporarily).
Let’s first acknowledge that listening to our body is of utmost importance, whether we are feeling sick or not. Listening to our body is the number one way to prevent us from getting sick in the first place and listening to our body will also help us reduce the amount of time we are sick.
What does this mean? How do we listen to our body?
For me, this is really taking the time to check-in with myself. Often times, many of us are keeping too busy and just ‘numbing’ ourselves with social media, with staying busy, with everything except listening to what our body is really telling us. It has taken me years to figure out the nuances of my body and understand what I need or what will help my body. It comes down to noticing how our bodies feel including tension, aches, fatigue; understanding and having curiosity in our sensations (physical and emotional); realizing how we speak to ourselves – ideally with kindness and compassion just like how we would want others to treat us. Working to understand what our bodies need and then honoring that and actually giving ourselves more rest, proper exercise, sufficient nutrition, etc. will really help us thrive and keep our health.
Things start to go wrong when we are not listening to our body and just go on ignoring all the signs and symptoms that are leading to fatigue, decreased performance, overtraining, illness, etc. We need more of some types of cytokines when we have infection or inflammation, which also includes stress (as we have talked about in a previous article). Note, cytokines are little proteins that help control the amount of growth and activity of immune system cells and blood cells. For example, not getting enough sleep may lower the production of these cytokines and other antibodies and cells that help us to fight infections. Further exploring the effects of illness on our system, having a fever decreases our muscle strength and endurance while impairing precision and coordination which increases the risk of injury. In fact, viral infections (like the flu) can cause temporary muscle weakness which extends to the muscle cells of our heart and weakens our cardiovascular system, particularly with strenuous exercise.
It is logical then that in order to maintain fitness while we are sick, we should focus on low-intensity activities like walking, gentle yoga, or stretching, which significantly reduces the intensity and decreases the duration of our usual workout. In addition to listening to our body, rest is of greatest importance along with hydrating well by getting plenty of fluids. If symptoms are primarily “above-the-neck”, like a runny nose or sore throat, light exercise might be ok to continue. Furthermore, avoiding strenuous exercise if we have a fever, severe cough, or other significant symptoms “below the neck”. Conversations with your doctor are also important to have as the severity of illness increases.
There is an often untold psychological factor about getting sick. This is that many of us have a difficult time missing out on training and when we lack getting in key sessions for race preparation, this greatly impacts and shatters our confidence.
So, how do we build stamina after illness?
If you listen to your body when it gently whispers that something is wrong and problems are rising, the road back to a "normal" and healthy fitness level will often be significantly shorter than if you ignore signals and wait until your body breaks down in need of rest. When in doubt, just rest! This is not a sign of weakness, and it doesn’t mean you are taking it too easily. Rather, it means that you are listening to your body and making smart decisions! (though not easy to do this)
Some things that may help you pay attention to your body during training include: recording heart rate from training (including intervals and recovery heart rates); recording resting heart rate and possibly heart rate variability in the morning (see previous article here on NTS for support); record a perceived load of training from light to heavy (1-10); record any fatigue experienced as well as feelings later in the day or next day as residual fatigue. Training should feel normal, in that you are not abnormally fatigued during and after training. If this is true, then it simply means that training should be adapted and adjusted specifically to you. It is important not to go too fast here by getting into high intensity sessions and rushing back to competition, that, in the long run may do more harm than good. Working to improve your wise counsel and have a support team to progress with you is very important here.
What about deconditioning? How fast does our fitness level decline?
Deconditioning is when we have decreased muscle mass, decreased cardiovascular capacity, and diminished metabolic efficiency due to disruptions in our activity levels. The severity and speed of decrease depends on factors such as fitness level, age, length of break, and reason of break.
When examining muscle mass declines, this also results in decreased muscle glycogen stores for energy, decreased oxidative capacity (think aerobic metabolism for endurance), and increased muscle fatigue. There can be a 50% reduction in our muscle mass within 3 weeks of inactivity. Muscle declines quickly! Specifically assessing the cardiovascular system is also quite interesting, as within 24 hours of inactivity our system can have some effects on blood flow and availability of oxygen. Over time (maybe about a month), there are noticeable decreases in left ventricle mass and size, increased resting heart rates, decreased stroke volume, and decreased cardiac output. No wonder our fitness decreases, and we feel tired and fatigued more quickly.
Our metabolic efficiency decreases the longer we are inactive with having a lower lactate threshold. Over time we produce higher blood lactates at lower intensities. Further, decreased insulin sensitivity lowers the ability for our body to utilize glucose effectively.
If you are going through a period of less training and are working on gradually returning to sport/racing, it can be helpful to indeed progress gradually. In addition, focusing on specific muscle groups where there has been the most muscle loss is effective. As well as introducing interval training again while maintaining proper nutrition.
My best personal advice is to listen to your body by taking time for yourself, and then if need be – attack it with sleep and fluids! Hoping you will return to competition and be stronger than ever!