Health and wellness

Running with a cold: why you shouldn’t even think about it – trust me, I did and I felt a lot worse afterwards

Pavel Toropov had headaches, fever and night sweats, but didn’t want to waste months of training. He soon regretted his 50km race in Hong Kong. Others have suffered more after mistaking pneumonia for a cold. So what to do?

PUBLISHED : Sunday, 04 March, 2018, 6:49pm
UPDATED : Monday, 05 March, 2018, 6:02pm

For a week, I woke up to find my sheets soaked in sweat. During the day, the headache and fever were unpleasant, but not bad enough, I concluded, to waste months of training at altitude, and an invitation to join the MSIG Sai Kung 50km trail race in Hong Kong. I decided to run and “sweat the cold out”.

On race day, adrenaline and excitement fizzled out quickly – soon followed by strength and energy. I dragged myself listlessly over the hills of Sai Kung, sweating profusely from humidity and fever, feeling sorry for myself, until the finish line.

The following day, the fever grew worse, and muscular cramps and spasms grew so severe that I was unable to lie down or sleep. A doctor said bluntly that to have gone running while aware of the symptoms was foolish.

Remaining highly active would likely only prolong your recovery or make the illness worse
Dr Dominic Teichmánn

Many runners suffer from fitness-loss anxiety – they fear they will gain weight if they do not run for two days, and that an irreversible decline in fitness will surely follow if they take more than a week off. Whether to allow this anxiety to drive you out of your front door despite the bodily discomfort and the nagging suspicions that you may do yourself more harm than good with a run is a million-dollar question. A Google search on “running with a cold” unleashes a mass of entries.

They are all reassuringly standard in their advice, which is also reassuringly common-sense.

The “above the neck rule” crops up a lot, in one form or another. Basically, do not run if your symptoms, such as chest pain, bodily aches, bronchial problems, are below the neck. Those above it – runny nose, stuffiness and sneezing do not warrant skipping a run, but you should take it easy.

Dr Dominic Teichmánn, a UK doctor and a senior member of Exile Medics, a non-profit organisation that provides medical assistance to ultramarathons around the world, says taking it easy is key.

“The common cold is a self-limiting viral illness, which means that, in people with normal immune systems, it will just run its course and you’ll feel better in a few days. Nonetheless, your body is undergoing a viral immune ‘challenge’ as it is trying to fight off this infection. This uses a not insignificant amount of your physical energy, and running during this time would not be helpful,” Teichmánn says.

Exercising when air pollution levels are high can do more harm than good

An avid runner and skier himself, he also dissects the “running a cold off” belief. “If the cold is mild, the endorphin release after a run may make you feel better. However, ultimately it would be much better to recover, rest, and only train very gently until you are back up to speed. Remaining highly active would likely only prolong your recovery or make the illness worse.”

There is some truth to “running off a cold”, however. Dr Amy Biondich, an emergency medicine and expedition doctor based in the US state of Wisconsin, has been working at running events for a number of years, and is an advocate of it. “Getting in a short, low-intensity run will cause increased circulation, and thin mucus. But don’t overdo it, basically,” she says.

If a cold has compromised your immune system, how much time should you take off?

There is no hard-and-fast rule. Three days is a number that crops up consistently online, and for those who are worried about losing fitness, rest assured – apparently even 10 days of not running (provided that you do not make up for bodily discomfort with cakes and pies) will not have much of an effect on your fitness level.

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How should you treat a cold? On its website, Britain’s National Health Service lists three simple guidelines: rest, sleep, and keep yourself hydrated, adding that there is little evidence that supplements like zinc, garlic and vitamin C actually help.

“Being viral, colds do not have any direct medical treatment,” says Teichmánn, “and can only be managed with supportive care, rest, paracetamol to keep the temperatures down, and non-steroidal drugs such as ibuprofen to help with the muscle ache.”

While a common cold and its more sinister cousin flu are viral diseases, which renders them immune to treatment by antibiotics, they must be distinguished from pneumonia, a collective term for bacterial infections of the respiratory tract, which can and must be treated with antibiotics. Pneumonia can also deteriorate into something quite scary. The problem is that a broad symptom overlap can make distinguishing a cold from pneumonia difficult.

The issue of pneumonia is especially relevant to Hongkongers who, by often running in pollution, also run a much higher chance of contracting a respiratory illness than runners blessed with year-round clear skies.

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Ultrarunning great Kami Semick, an American former resident of Hong Kong, contracted pollution-induced pneumonia while racing in Beijing. Suffering from what she thought was nothing more than a “bad cough and sore chest”, she kept training.

Doctors failed to spot the problem and recommended inhalers and rest, and so, a few weeks later, the unsuspecting Semick, as planned, entered the Western States, a 100-mile (160km) race in California. Once the race began she immediately struggled, which made her push herself harder, and this effort set off the collapse of her lungs. Unable to get air in, Semick started to pass out.

It was a close call. A fellow runner happened to have an inhaler, which saved her. She was evacuated, and the paramedics had to reboot her lungs with epinephrine in the ambulance on the way to hospital. Semick’s subsequent recovery took many months.

Getting in a short, low-intensity run will cause increased circulation, and thin mucus. But don’t overdo it
Dr Amy Biondich

Anne Newbold, an American casualty ward doctor from Chicago who also works at marathons and ultrarunning events, brings up the distinction between pneumonia and cold immediately when asked for her opinion on running with a cold. “Sometimes people think they have a serious cold and they actually have bacterial pneumonia. Sometimes you cannot tell between the two. Only a chest X-ray and blood tests can determine this,” she says.

So what to do?

Take it easy if you have a cold, keep the distinction between pneumonia and common cold in mind, and do not fall victim to the “fitness loss anxiety”.

Also, monitor pollution levels and take a day off if it is bad out there. A few days off running, with or without a cold, can only benefit a runner in the long term, allowing the body to rest and give niggling injuries more time to heal.