The Time-Crunched Cyclist Podcast by CTS

Training After Illness: A Practical Guide For Returning to Training

• CTS • Season 5 • Episode 255

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OVERVIEW
Getting sick sucks, any time of year. When athletes are in the middle of the season, like they are now, they get anxious about losing fitness and they get impatient about returning to training. In Episode 255 of "The Time-Crunched Cyclist Podcast", Coach Adam Pulford details the practical steps he uses to guide athletes back to training following common illnesses like cold and flu. Note: Adam is not a physician and this is not medical advice. His guidance is based on standard cold/flu treatment recommendations and practical experience working with athletes as they return to training.

TOPICS COVERED

  • Identifying the type of illness
  • Using "The Neck Rule" to determine next steps
  • Training recommendations if symptoms are above the neck
  • Training recommendations if symptoms are below the neck
  • When to reintroduce intensity
  • Will you lose fitness?
  • What does a "sick week training schedule" look like?
  • How to know you're ready to resume normal training

LINKS/RESOURCES

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HOST
Adam Pulford has been a CTS Coach for nearly two decades and holds a B.S. in Exercise Physiology. He's participated in and coached hundreds of athletes for endurance events all around the world.

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Speaker 1:

From the team at CTS. This is the Time Crunch Cyclist podcast, our show dedicated to answering your training questions and providing actionable advice to help you improve your performance even if you're strapped for time. I'm your host, coach Adam Pulford, and I'm one of the over 50 professional coaches who make up the team at CTS. In each episode, I draw on our team's collective knowledge, other coaches and experts in the field to provide you with the practical ways to get the most out of your training and ultimately become the best cyclist that you can be. Now on to our show. Now onto our show. Getting sick sucks and I don't know any athlete who would argue against that. Cold and flu season is behind us as I'm recording this episode just before the 4th of July, but anyone can get sick anytime, and a common thing I deal with is helping my athletes decide when it's time to resume regular training after getting sick. We've got good questions about that coming from you, one of our audience members, today, so let's read the original question and dive into some short, actionable advice, and I'll give you some examples as we go. So here is that original question examples as we go. So here is that original question. Hi coach, I really enjoy your podcast, especially the fact that you get straight to the point for us time crunched media consumers who have too many podcasts queued up with too little time. I have some questions around.

Speaker 1:

Coming back from illness. I recently caught a bug from my kids in the middle of a training block, with flu like symptoms, and I took a few days off to recover. When I got back on the bike I started. I recently caught a bug from my kids in the middle of a training block, with flu-like symptoms, and I took a few days off to recover. When I got back on the bike, I started with several easy zone one to two rides to ease back into training before introducing more moderate intensity. But after that moderate intensity session the symptoms came back and I had to take another few days off. So I'm starting all over again.

Speaker 1:

My questions are number one are there things that we can do to avoid losing fitness while ill, such as walking, stretching, et cetera? Two how do we know when we've recovered enough to get back to training? Number three what's the right approach to ease back into training after recovery? And four how much and what type of fitness is lost during an illness? Thanks, eddie. All right, so there's a lot of questions there.

Speaker 1:

I will do my best to hit on all of them, but a couple disclaimers here before we get going. First of all, I am not a doctor. I'm not a medical doctor, so this is not medical advice. If you are severely sick, go see your doctor. I cannot provide you advice on that. As a coach, I can walk you through some of the typical situations I've seen to work in regard to coming back to training and speak to some of Eddie's specific questions here. Now, I mean always use your best judgment when making decisions regarding your health coming back from illness, and I would say the more conservative approach is better than the more aggressive approach. And really what this means is being slower to hit that high intensity after getting sick, so easy aerobic rides first and then gradually build into it Pretty similar to what Eddie did, but with a few other data points around it, and I'll provide that here as we go.

Speaker 1:

Now I'll speak today to cold and flu-like illnesses some of the more common stuff out there. But if it's more persistent, again you want to seek medical advice and that's beyond my scope as a coach. So let's get into a few answers and some advice. First, identify the type and severity of the illness. If you're sick, admit that you're sick and take a rest day or two or more. This rest period is wise, no matter the type of sickness, and it will not kill your training. It will help you heal potentially faster than if you try to stick to some training plan that you're already in.

Speaker 1:

Now, no matter if it's cold or flu, if it's a virus, you'll usually be the sickest at the front end of this thing. So your body's working its hardest to produce antibodies and fight the illness to get healthy again. So resting and not stressing from exercise is key. A couple of things here. So the common cold incubation period is about two or three days. Then you'll typically will have symptoms for seven to 10 days, starting to feel better after days eight, nine and 10. That's the most predictable kind of time period um available out there. The flu has an incubation period of one to four days, so it can hit harder for some people or sooner for some people. Now symptoms will last seven to 10 days. Again, it's a virus, uh, but it can linger up to 14 days and it can linger even longer. I've seen in my athletes who basically just come back to intensity too soon and they have that like symptom rebound. So if it is a virus like that, you'll have to just admit to yourself that for the next seven to 10 days you're going to go easy or keep it light in training, and maybe a little bit longer if it's the flu. If you know it's the flu, don't start back too soon with intensity, otherwise you'll get that symptom rebound which kind of like what Eddie was experiencing there symptoms came back and then you have to start all over again. So once you've kind of identified if it's common illness or like more severe, okay.

Speaker 1:

If it's more of the common cold and flu stuff, use the neck rule. I've been using this rule for so many years and it was passed down by coaches at cts and I think it applies for all athletes. Okay. And the neck rule is simply this if symptoms are mostly uh like above the neck meaning you have congestion, runny nose, cold, doing light aerobic exercise like zone one and two and some light strength training that's okay. But if the symptoms are in your neck or below meaning into your lungs, you're coughing, you have chest congestion, body aches, fever, gi issues then I suggest more rest and not training until all that clears up Again. Your body is just working so hard when it's below the neck for any training to be positive for any adaptation or gain, so you're better off resting Now.

Speaker 1:

Second, once you've taken a few rest days and you're using the neck rule, you want to start back with short, easy spins. I'll include some examples of this here pretty soon, but we're talking about super light rides, zone one to two. You know this is like below 50% of FTP, so it is really light in intensity and we're only going to do 30 to 60 minutes at most for time crunched athletes. What I find there is this will maintain some of the adaptations that we have in aerobic riding, some of the feel on the bike and keep the legs feeling okay and also just like for your head. I think for a lot of us that are training regularly. You know, four or five, six days a week, coming back to some movement and controlling the intensity is really good for our mental health and so that's how we do the cycling component of that and again, if it's neck and above and there's no muscle or body aches, keep the intensity low on the bike.

Speaker 1:

But you can also incorporate strength training back into the mix. But you'll want to bring the weight down. You want to bring sets and reps down. So bring down the load, bring down the intensity. However, you want to think about quantifying that. Whatever you're doing before, knock about 20% or 30% off the top and that'll be a good thing. Now this can definitely help maintain gains in the gym. So muscle strength and muscle coordination so that when you come back to normal training on both the bike and the gym, you will lose less.

Speaker 1:

Now, when you're sick with airway stuff, even with a head cold, I sometimes find that doing strength training hurts my athletes less because you're not stressing the aerobic in the central system. You're just like not trying to jam all that airway in. That's already like clogged. So if we're doing like two to three sessions in the gym on a regular basis, maybe four or five sessions per week on the bike, I will likely decrease total sessions on the bike due to that congestion and so the body can heal. But I will keep two to three times per week in the gym. I will keep that going and that definitely helps maintain the gains that we've made over time. And so you're maintaining aerobic gains on the bike with some light spins a couple of times a week and you're maintaining aerobic gains on the bike with some light spins a couple times a week and you're maintaining strength in the gym with two to three times of strength training per week Now.

Speaker 1:

Third, my advice is start intensity later than you think you should. So my best advice here is don't go too hard, too soon. And too hard means threshold work and above, and you want to wait at least a week, if not longer, before testing that. This is because the intensity seems to be the key stressor that could cause the symptom rebound. When your body is spending all of its energy healing, that extra stress coming from exercise will be seen as too much and it will dilute the already diluted energy for healing.

Speaker 1:

Keep in mind forming adaptation from stress is a healing process, just in a normative state when you're not sick. So when you stress, then rest, you heal. You're forming an adaptation from your intervals, from your strength training, from heat, whatever it is, kind of. In that normative setting you only have so much bandwidth for this healing process to occur. So keep stress low when you're sick and you will heal sooner.

Speaker 1:

Also, the longer I coach, the longer I stretch this out for my athletes, meaning the longer I wait to hit intensity. That's because I've messed it up in the past. I think as coaches as well as athletes, we just want to come back to regularity soon because we don't want to lose anything, but really is the thing that can set you back more than anything. So in Eddie's case, again, that moderate intensity you know for for you and I would have fallen that followed that path, eddie, that you described. But that moderate intensity was either too intense or too soon, so you had the symptom rebound. It's never fun, but it happens, and sometimes you just have to roll the dice and try to see what works for you. And my best advice here for you, eddie, in particular, is you know, now you have kind of one way of testing to see how your body responded, in a flu like sort of manner. So now use my advice here and go longer before you hit intensity again.

Speaker 1:

And as you go longer, seven or even 10 days of just light work and maybe some strength training, not going too deep, not going too hard, maybe it's 10 days down the road, something like that my best advice is the advice that I give to my athletes, which is wait until you feel good, right or normal and then wait another day and then on day three, if you feel good and normal again without doing hard intensity, now you are ready to go. So it's kind of like and I'll get into an example week coming up, but it's like drop intensity, drop volume, drop training, stress, keep some light strength training in the mix, keep some light spins going and then proceed going forward until you start to feel good and then run that out for two or three days. Then, if everything is good, come back to normal training. And a couple of reminders here the time course of these viruses are generally around seven to 10 days and there's not much you can do to speed that up. But you can delay it, meaning, you know, make that longer by not resting or stressing yourself so that the body can't heal as fast. So you're in for at least 10 days. Why would you make it any longer?

Speaker 1:

Also, let's go back to one of my podcasts I did on detraining. This is when you're not sick but you're transitioning. You just had a training season and you're transitioning to the off season and so you want to bring training down or detrain for two to three weeks to offset a bunch of stress that's built up over the year. So the research and everything that I talked about, as well as my observations and working with my athletes, suggests that you can do basically nothing or low intensity for definitely two weeks with limited performance decrements Okay, and you should bring that like. That should give you confidence that you can take a couple of weeks off and you're not going to lose much. And you can take a couple of weeks off if you are sick and know that your loss will be less because you let your body heal. Okay. Now, after three or four weeks, now the VO2 max starts to come down, you'll lose a little bit on threshold but the aerobic base. If you had good momentum for months and months, you can take a couple of weeks off and it's not going to hurt you that much. Okay. So don't stress about how much can I do during my sickness and illness. That will you know. Maintain this or that or something. The key thing is heal first. Then the second thing is once you know, using that neck rule, if it's just a head cold or a flu, now you can adjust the intensity and start making some decisions on what you're going to maintain and what you let go away. You can maintain some of these systems throughout this sickness time period versus just laying on the couch.

Speaker 1:

Let's discuss what some examples are of having a sick week for a time crunched athlete. I'll give you a typical week with a head cold, starting with the incubation time period and some common comments that I'll see on training peaks or on text message from my athletes. So let's just start with, like Saturday I'll get a text message or comment on training peaks that says am I sick? And they'll do their training anyway. And let's just say it's the weekend and I didn't see it right, or they didn't text me, or something like that Sunday I might be sick, monday I'm sick. And then I'll say, okay, definitely rest day, right.

Speaker 1:

Tuesday. Rest day Wednesday head cold confirmed 30 to 45 minute light spin or walk, optional. Or just take another rest day Thursday 30 to 45 minute light spin or walk again if symptoms are not worsening. But if symptoms are worsening, take a rest day, okay. So you can see that there's an incubation time period of a couple of days where it's like, oh, I have some symptoms but I'm not sick yet. Okay, but now I'm definitely sick. Okay, rest, rest. Start with some light stuff. If light stuff is okay, proceed if you have a head cold and it's not that severe. So now we're on Friday. Start to incorporate strength training, and that Friday is only one, two, three, four, four days.

Speaker 1:

After saying I am sick and I've taken a couple of rest days, you can come back to the gym because it's not stressing that central system as much. You want to use your head again, decrease the weight, decrease the load, but proceed with strength training. Saturday maybe you do an easy spin for 60 minutes. Sunday, strength training. Again Monday 60 minutes endurance, maybe some core work. Tuesday, strength training.

Speaker 1:

At this point we are right around 10 days from admitting I am sick, I've taken rest days, I've gone pretty easy, I've incorporated some light strength training in the mix and we're on day 10. That day 10, maybe two by eight minutes or three by eight minutes of low threshold work, meaning right around 85 to 90% of FTP with four to six minute recovery in between, maybe 60 minute total ride time. That's a good test workout because it's not super stressful in total time and zone. It's not super stressful in terms of intensity and if that feels good, especially during the first interval, proceed. If it feels bad, just stop the workout altogether. Get through that session if everything's feeling fine, and then on the next day so Thursday I would rest or take a recovery spin or something light and you want to monitor and see if symptoms are not worsening. If they don't have a symptom, rebound or something like this, and if that's good to go and you're feeling normal, proceed on with an endurance day and then resume regular training after that. So that's a pretty good example and you can rewind and listen to that again.

Speaker 1:

But essentially what I'm doing is I'm taking what we know to be the time course of these viruses and I'm taking examples from real life of how I see it affect my athletes and we're combining both data and feelings to get to a plan that logically works most of the time. Okay. But I will say this listen to your body and know what the healing rate is for you as an individual, because it can be different for different athletes. It can be different for everybody, okay. So some, some of the athletes, heal faster than others, and this could be because you're younger, but not always. If your recovery habits are dialed and you are in control of your work schedule and can minimize stress during times of being sick or during times of heavy training. Then you will heal and adapt faster, and I have some athletes in their 40s and 50s that heal and adapt very quickly for those reasons.

Speaker 1:

But if you're a typical time crunched athlete with a family, demanding job, not a ton of control over their work schedule, the advice that I gave here today should hit well. You may even need to take a few extra rest days and be more conservative if you don't have that control over your life, but just know that if you take rest earlier and you have a more conservative approach, you will get through the illness quicker and then you can resume training more quickly. When in doubt, rest it out. Know that the time course of adaptation or physiological decay that I've gone over in the podcast of detraining is normally saying that you can do two weeks, if not much, and you will have minimal decay of performance. Okay. So just really know that. Let that sink in and that will give you confidence as you head into your rest plan when you're getting sick.

Speaker 1:

So in summary, let's recap some of the key takeaways from today. If you're sick, admit that you are sick and take a few rest days to start the healing process properly. Use the neck rule to guide your decision-making on if you start in with light aerobic work first or take a few more rest days because the symptoms are below the neck, meaning that it is worse than a head cold. Plan on not doing anything harder than zone one or two for the next seven to 10 days, weaving in a rest day here and there and knowing that you're not training but you're maintaining during this time. You can incorporate strength training if symptoms remain above the neck and not worsening. But be sure to decrease load in the gym by decreasing weight sets and reps and using your common sense. In the end, if you are more conservative and have a plan that you can see the light at the end of the tunnel and resume training sooner with no symptom rebounds, you'll be back to pursuing your season goals with a clean bill of health much sooner. So that's it. That's our show for today.

Speaker 1:

Thank you to Eddie for the question. I was a little nervous, actually in providing advice for this podcast as I'm no doctor, but in talking with other coaches as well as my editor, we thought that it was best to give the in the field sort of advice, because nearly every athlete on the planet deals with this same scenario. So best of luck to you, eddie, and I hope this helps if you get down the road and if you get sick again. So now, if you have it for all the rest of the audience members out there, if you have a good question like this, feel free to write into us at train rightcom backslash podcast and click on ask a training question. Those get set directly to me and I'll do my best to answer it on a future episode.

Speaker 1:

We'll see you back here next week for more short, actionable training advice, and don't forget to tell a friend or training partner about us. Thanks again for listening. I appreciate each and every one of you. Thanks for joining us on the time crunch cyclist podcast. We hope you enjoyed the show. If you want even more actionable training advice, head over to trainrightcom backslash newsletter and subscribe to our free weekly publication. Each week you'll get in-depth training content that goes beyond what we cover here on the podcast. That'll help you take your training to the next level. That's all for now. Until next time, train hard, train smart, train right.

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Adam Pulford

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