How sick is too sick ?

I always offer my highly trained opinion when this question pops up.

Train if you feel like it.  Rest if you don't.  Yes, it's all very technical.

Thank you for your highly technical insight Yeah, guess it is pretty much a no brainer but I am prone to complicating simple things.

my rule of thumb (forget where i heard it) is such: the neck.

the neck? yes

are the symptoms of my sickness below my neck? in the chest/stomache/other area?

if so, can the workout and take the day off

are the symptoms above my neck? headache? runny nose? continue on with the workout at a 50% reduced effort or time 

Ah, I was waiting for the first person to post this.  This is one of the reasons I agreed to help moderate this forum.

It's a rule of thumb that's as arbitrary and meaningless as any I've ever heard.  There's basically not a shred of evidence out there that supports this.  It's been perpetuated because it sounds good and lots of people have heard it before.

Just consider it a old wives' tale.

Like I said in the other post, we make this waaaaay too hard.  Train if you feel up to it.  Rest if you don't.  Use some common sense.

(BTW, this is not a shot at you.  I've just heard the neck comment from any number of people, including some who should know better, and I'd rather people know the truth.)

If you have diarrhea, do you really think you're going to feel like running?

This is where it gets so frustrating to me.  Despite the fact that there is no evidence to support it and the fact that I just pointed that out, you still think that there's something out there to back it up.

Find it.  Find something that's a better indicator of whether you should train or not that's better than your own common sense.  You won't, because it's not out there.

Here it is: http://www.stjohn.org/HealthInfoLib/swArticle.aspx?1,1081

Uh..that's just somebody else's anonymous opinion.  I wasn't really looking for you to find somebody else who's repeating it.  I could link you to a number of posters here who've said the same thing before too.  None of it is credible without actual evidence supporting it.

i'd think that you'd be irate about alot of our training philosophies and basic methods of triathlon training then too eh? Alot of things we abide by as triathletes are hearsay , there isnt alot of evidence to support it.

 that being said, i dont take the neck idea as a means to an end for training, and anyone who is intelligent will know when to take the day off. If i just have a small headache or a runny nose, i feel better at continuining my planned workout at 50% volume/intensity, sort of an active physiological recovery.

I agree with you, training is about common sense. But the neck rule has worked great for me, and an intelligent person will know its a solid way to supplement your use of common sense when training. But if you're on the fence about training that day, which alot of people may be, there is absolutely no way to define "how sick is too sick". It's personal.

.02 

Were we talking about training philosophies and idea, I'd be with you 100%.  The question is a medical one and requires a higher level of evidence when asked on a medical forum.

I don't treat patients based on hearsay or common wisdom.  I treat them based on credible evidence whether that's by way of research, a personal knowledge of the physiology involved, or any other credible means.

Personal anecdotes are ok, but they're just about the weakest form of evidence out there.  Not saying that you're wrong about anything, but reproducibility over a population is the standard.

That's pretty much all I'm saying.

i'm debating medical philosophies with a doctor?! haha nice, i love the internet...what specialization are you?

so we know there is no way of knowing when to call it quits, but is it even possible to do research on the topic? or is it almost impossible considering there is no general guideline, like "which is the best type of therapy for me?" or "is shimano better than campy?"

we know, as i stated, the neck thing works for me and i've had good results but others will not heed the same results...haha. I stand "edited" (not corrected) in my original statement 

I'm an internist who needs to stop typing a go to work.

You're right that there will never be a trial about this, so there's no answer that will satisfy everybody.  I just don't like generalizations when I can pick out exceptions rather easily.  There are plenty of above the neck conditions that you shouldn't be going near a gym with, and likewise the opposite for below the neck. 

As you stated above, it's personal, and there's no hard and fast rule that's going to work for everybody.  Rest if you need it.

Dude... I don't think it's an anonymous quote/article its the American College of Sports Medicine (ACSM). Doesn't that stand for somethin'?

Sure it's anonymous.  Do you see a name attached to that?

Better yet, do you see any reasoning behind it provided?  So that physician (whoever he/she is) has an opinion on the matter.  Big deal.  I have an opinion on the matter too.  The difference is that I can sit here and tell you a huge number of exceptions to that "rule" and make it pretty much useless.  Why you would give them so much credit for a statement like that without any reasoning associated with it is beyond me.

Well whatever works for folks work eh?

By the way Derek - Happy belated! I celebrated mine the same day although I've got a few more candles on my cake

Yep.  That's pretty much all we're saying.  Listen to yourself and your body and don't rely on silly rules.  You're way smarter than they are. 

Thank you! 

Surgeons.

Heh.

Bluejack - 2006-12-07 11:29 AM Here at the Schuffhausen Institute we have begun the quad armed "people who are sick above and below the neck" trial. We randomize people to exercise or no exercise and above or below the neck pathologies. The data should be available in the next few months. And BTW I have cold and I'm running Kiawah 1/2M on Saturday! Doh!

I'm on day 5 of no training.....due to illness.....of course my core is getting a great workout from all the coughing so in a way I am training.

:-)

 Funny, we just debated this in the office last week and I was convinced of the neck rule. Of course maybe the "water cooler" isn't the best place to seek medical advice.

The only problem is derekl....common sense seems to be lacking in most of us tri geeks (or myself anyway). I mean who would try this stuff if they had common sense.  ;-)