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Dealing with Illness as a Runner

Getting sick sucks, especially when your training is on a roll. It’s important to have some basic guidelines for returning to action after illness.

And, before discussing return to training after illness, consider a few simple suggestions for staying healthy so you can avoid missing any workouts to begin with:

  • Avoid overtraining. Get enough sleep.

  • Reduce life stress. Eat nutritious meals. Ensure adequate caloric intake.

  • Wash your hands regularly. Avoid sharing water bottles. Drink enough fluids.


To decide if you should stop training, think about “above the neck/below the neck.” If your symptoms are above the neck or in your head (and I don’t mean in your imagination!) such as a sore throat, runny nose, sneezing, or headache, then it’s typically fine to train but with reduced intensity. Consider staying out of the water and avoid cold, wet rides. If the symptoms are below the neck, such as lung coughing, muscle aches, and fever, then shut it down. Remember that pushing your body while a cold or fever is incubating can amplify the ill effects.


When considering my athletes’ return to action, I typically like them to be symptom-free for 24-48 hours, depending on the severity of illness. Initial training after that should be easy, aerobic, and short in duration. Think of the first two to three days as opening up the body to get it moving…like warming up an engine.

This testing period not only ensures you are truly over the illness, but it also prevents injury. If you still feel major symptoms, intensity out of the gate can set you right back. And if you’ve missed four to five days of training, your muscles may be rested, so a hard effort on day one can create a lot of soreness, risking injury and setting training back even longer.

After the test days, if you are feeling pretty good and you want to get back into your preplanned training routine, temper the planned interval sessions by taking them down a training zone while making the recovery portion slightly more active.

For example, if you planned to run 3 x 1-mile intervals with walking recovery at 175 heart rate, do 3 x 5 minutes fartlek running at 165 heart rate with jogging recovery. This way you are accomplishing the general theme of the session without falling off your training progression, but not pushing yourself back over the abyss into illness.


If you have missed two to five days of training, don’t panic. Your fitness has not significantly changed. If you are getting close to race season, you may look at rescheduling some of the key sessions that were missed. This is where it’s helpful you sit with your coach and tinker with your upcoming two weeks of training.

If you have missed six to 14 days of training, you may have to look at your overall progression and take a step back within the training progression (mesocycle). Hit rewind for one to two weeks prior to the onset of the illness (the longer you are out, the longer you hit rewind). Replicate the general framework of training you did prior to getting sick before progressing to the next planned step of your training schedule.

If you have a big race coming up, that can be a tougher call. Assuming you don’t have flu, fever, or chronic coughing or bronchitis, you could consider a very short tempo “tester” effort the day before the race, such as 5-10 minutes of tempo running in Zone 3, to see if your body is ready. Race pacing strategy should be more conservative as well. Think of a building effort. And note that your risk of getting sick after the event is quite high. You should always consult your doctor before considering racing.

While getting sick is never fun, you can take pride in being as professional as possible in returning to action without causing further setbacks. Follow these basic guidelines to minimize risk and reduce loss of fitness.



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