por breno melo

Training Through Sickness: A Guide for Endurance Athletes

Training Through Sickness: A Guide for Endurance Athletes

When endurance athletes face illness, the decision to continue training or to rest can significantly impact both recovery and performance. This guide explores how athletes can navigate training when unwell, drawing on the latest health research and expert advice.

The "Above the Neck" Rule Revisited

The "above the neck" rule is a commonly followed guideline suggesting that if symptoms are confined to the head — such as nasal congestion, sore throat, or sneezing — it's generally safe to continue training, albeit at a reduced intensity. Moderate exercise under these conditions can help clear nasal passages and provide temporary relief. However, the intensity of workouts should be significantly reduced to avoid exacerbating symptoms or prolonging illness.

According to Dr. Edward R. Laskowski of the Mayo Clinic, light to moderate physical activity may be beneficial if symptoms are mild and above the neck. However, it's vital for athletes to monitor their body's response and scale back the duration and intensity of their exercise accordingly (Mayo Clinic).

"Below the Neck" Symptoms and Endurance Training

Training with symptoms "below the neck," such as chest congestion, bronchial congestion, body aches, fever, or an upset stomach, is generally advised against. Engaging in physical activity with these more severe symptoms can lead to increased health risks and longer recovery times. Training with a systemic infection, especially with a fever, can increase the risk of developing conditions such as myocarditis — an inflammation of the heart muscle that can be dangerous, particularly in high-intensity sports settings.

Research underscores the importance of rest and recovery when symptoms are more systemic or involve the lower respiratory tract, where continued physical exertion can worsen conditions and delay healing processes (American Heart Association).

Special Considerations for COVID-19

For athletes recovering from COVID-19, extra caution is necessary due to the virus's impact on cardiovascular and respiratory systems. The American Heart Association advises avoiding all physical activity during the CDC-recommended isolation period of at least 10 days after the onset of symptoms or a positive test result. Following this period, athletes should only gradually resume training, closely monitoring for symptoms like chest pain, palpitations, undue fatigue, or difficulty breathing.

Strategizing Training During Illness

The balance between exercise and immune function plays a crucial role in decision-making for training during sickness. While moderate exercise can enhance the immune system and may be beneficial during minor illnesses, intense or prolonged exercise can suppress immune functions and make an athlete more susceptible to infections.

Guidance from Precision Nutrition suggests adjusting training based on symptom location and severity. Athletes with mild "above the neck" symptoms may continue low-intensity exercise, while any "below the neck" symptoms, fever, or widespread malaise should prompt complete rest. Following recovery, a gradual return to full training should mirror the duration of the break to prevent relapse or injury (Precision Nutrition).


Endurance athletes should approach training during illness with caution, prioritizing long-term health and performance. By adhering to the "above the neck" and "below the neck" guidelines and adjusting training based on symptom severity, athletes can manage their training schedules effectively without compromising their health. Consulting with a healthcare provider is always recommended to tailor decisions to individual health needs and goals.