When are you too sick to exercise?

Philip J. Goscienski, M.D.

May 2012

Strenuous physical activity isn't a good idea when you have an acute illness such as a sore throat or stomach flu but you don't necessarily have to avoid the gym if you have a chronic illness.

Almost all instances of sore throat, cold, bronchitis and gastroenteritis are caused by viruses and they tend to last only a few days. However, viruses commonly cause muscle aches in addition to the classic mild fever, headache and fatigue. The influenza virus has a reputation for causing severe muscle pain. Even when such myalgia is mild, strenuous physical exertion can make it worse. Your mother probably told you to stay in bed and rest during such an illness and she knew what she was talking about.

When an outbreak of an ordinarily benign viral illness occurred among a group of high school baseball players nearly half the team developed a mild form of meningitis. That unusually high complication rate was felt to be due to the fact that they had been exercising intensively during the incubation period of the disease. Strenuous exercise is known to lower immunity.

Infectious mononucleosis, also known as kissing disease because it's so common during adolescence, often leaves it's victims with extreme fatigue that can last for months. Ordinary exercise is alright for the teenagers that have the energy to do it but they should avoid contact sports until a physician has given them clearance. That's because "mono" as it's often called causes the spleen to become enlarged and it ruptures easily. The result can be catastrophic, sometimes fatal bleeding into the abdominal cavity.

Chronic diseases are an entirely different matter. In spite of the altered lifestyle that may result from heart disease, peripheral artery disease, chronic lung disease, arthritis, multiple sclerosis, fibromyalgia and chronic fatigue syndrome, staying active can reduce symptoms and improve the patient's quality of life. It's extremely important, however, to avoid a do-it-yourself exercise routine. Physical therapists have the training, insight and expertise that allow them to design a program of physical activity that takes into consideration the risk factors that accompany these diseases.

A few decades ago heart attack victims who survived were cautioned to avoid exercise but that was a fatal prescription. Cardiologists now urge them to enroll in fitness programs that are specifically designed for them. The benefits include lower cholesterol and blood sugar, more flexible blood vessels and overall better health.

Philip J. Goscienski, M.D. is the author of Health Secrets of the Stone Age, Better Life Publishers 2005. Contact him at drphil@stoneagedoc.com.