Working Out When You're Not 100%

Working Out When You’re Not 100%

Exercise is one of the best ways to stay healthy. But what about when we’re not feeling our best?


Here’s our guide to working out with an illness: when are you good to go, when should you give the workout the heave-ho, and where you should ask your own doctor for further advice.

Exercising With Illness: Yes or No?

The simple answer is that there’s no simple answer. Whether you can or should exercise is based largely on the type of illness you have and how severe it is.

Let’s have a look at some of the most common types of illness and find out whether you should persist with the Pilates or kick the kettleball into touch until you’re feeling better.

Have a cold or the flu? Remember the Above-the-Neck Rule

If you have a mild cold, with nothing more than a runny nose and no temperature, it’s perfectly fine to exercise. The rule, says Dr. Marc Leavey M.D., physician at Mercy Medical Center, Baltimore, is that “If you would not have a second thought about going to work or school, participating in your normal exercise routine should not be a problem”.

However, Dr. Leavey warns, even then you should be cautious, “If you develop any symptom of concern, such as any problem with breathing, wheezing, weakness, pain, lightheadedness, and certainly a fever, you should stop”.

Dr. Leavey also warns that any symptoms not confined to the ear nose and throat are more likely to cause problems when you exercise. So, if you have bronchitis, muscle pains or tightness in the chest before you exercise, you should skip the workout until after your symptoms subside.

Watch the decongestants

Even if your symptoms are confined to the neck and above, you should be careful exercising if you are using decongestants, particularly those containing pseudoephedrine (such as Sudafed Congestion, and Sudafed 12 Hour). “Decongestants in general, and pseudoephedrine in particular,” says Dr. Leavey, “can raise the pulse and blood pressure. Exercise can raise the pulse and blood pressure. Together the combination can push the cardiovascular system to the point of danger, of system failure, of serious consequences.”

When you have a fever:

If you have a fever (38C or 100.4F or above), you must abstain from exercise for several days. Both fever and exercise strain the circulatory system. As Dr. Leavey says, when we exercise unwell, “underlying  disease and stressed regulatory systems could result in a dangerously high body temperature”. This dangerously high temperature makes us even more ill.

How about Long-Term Illness?

What should you do about exercising if you have a long-term (or “chronic”) illness? Should you persist with your dreams of getting fitter and stronger, or should you just give up and spend your days sitting on the couch eating bags of marshmallow?

The good news is that you don’t have to resign yourself to not being able to exercise. However, if you do have a long-term illness, there are a few words of caution.

Caution: anyone with any long-term illness of any kind should always speak to their own doctor before undertaking any kind of fitness programme.

Now, let’s look at four of the most common types of long-term illness and find out the potential cautions and benefits of exercise for you:


Before you undertake any exercise regime, you have to make sure your asthma is well-controlled. As Dr. Leavey says, “The last thing you need to do on the treadmill is to start wheezing”.

So, if you’re having frequent attacks, see your doctor and get those sorted out (maybe your doctor will need to change your prescription) before you start that new regime.

Once your asthma is stable, however, exercise is good news for sufferers. The increased breathing rate in exercise may boost lung capacity and effectiveness.

But remember, it is possible to have exercise-induced asthma. If this affects you, Dr. Leavey advises you to take your inhaler before exercise.


Depression is a common mood disorder that affects 350 million people worldwide. While depression itself isn’t a physical barrier to exercise, Dr. Leavey warns that certain antidepressants (such as the commonly-used Citalopram) increase the risk of heart abnormalities while exercising. If you take this, you should speak to your doctor first.

Otherwise, exercising is great for depression. A 2012 review by James Blumenthal and colleagues showed that exercise is an effective treatment for depression. As Dr. Leavey says, “Whether it is the endorphins generated by exercise, or just the fresh air of running through the neighborhood, the number of people who have improved their mood while exercising their bodies is likely beyond counting.”

Back Pain:

For a simple muscular strain exercise may be effective treatment. However, this comes with a warning. Anyone who has a more complex cause for back pain, such as a slipped disc should only exercise under the care of a physiotherapist. Always see a doctor for diagnosis.

However, if you have a muscular strain, exercise can make you into a whole new woman, strengthening the muscles to give you better posture, which will in turn make you less likely to strain the muscles further in future.


Physical activity is great for diabetics. It helps you get control your blood glucose levels, which keeps you healthy. However, you have to be careful. If you’re going out to exercise (especially as a Type 1 Diabetic), Dr Leavey warns that you should make sure you time your meals properly and carry some carbohydrates, or a Glucagon injector, in case your blood glucose levels drop too low causing you to become hypoglycaemic.

However, if planned properly, Dr. Leavey says, “Exercise should be part of every diabetic’s regimen”. Not only will it improve your blood glucose control, it will also prevent complications such as heart disease and amputation (by improving foot health) and help you achieve or maintain a healthy weight.

What kind of exercise should someone with long-term illness do?

The short answer is that you should do whatever exercise you can do. Good light exercises include walking, swimming, or – if you find walking difficult – Dr. Leavey suggests sitting in a chair and using hand-weights.

The best kind of exercise, Dr Leavey says, “is one that will be done, and it can progress into essentially anything that the person will do on a regular basis and derive enjoyment from it”.

Because that’s the point

That’s what we love about exercise. Not only that it gets us fitter, stronger and healthier – although it does – but that it’s fun. When we work out when we’re burning with fever and wheezing and should really be curled up in bed with tissues and Tylenol and our favourite book, we’re doing ourselves a disservice. We make exercise a chore, one of those things we have to do, no matter how awful we feel, like taking out the trash.

And that’s not how it’s supposed to be.

So, if you feel too ill to exercise, don’t be ashamed to have a duvet day. After all, even the best machine creaks sometime. Don’t be afraid to oil that creak with tea and toast and chick-flicks (or The Terminator, if that’s more your style!).



Dr. Marc Leavey, M.D., physician at Mercy Medical Center, Baltimore, MD,

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