Illness Checklist

Keeping Small Setbacks Small

If you catch a minor illness early then it’s simply an unplanned rejuvenation block.

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The Checklist

I talk someone through this article at least once a month. Sometimes the someone is me. 😉

1. Backoff at the first sign of illness.

2. Minimize the depth of the illness.

3. Focus on health.

4. Add back frequency.

5. Add back volume.

6. Check lactate response.

7. Resume normal training.

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Tame The Compulsion to Train

What you want to avoid is the pattern outlined in Training For The Uphill Athlete. The book is a valuable resource for all types of endurance athlete. I strongly recommend it to you. You can find my review here.

The pattern explained in the figure (above) will follow you everywhere. If you experience it with illness then you’re certain to see it with injury.

If you fall into the pattern in the photo then you’re looking at a wasted month. This article is going to explain a better way.

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A Better Way

Back off at the first sign you might be dealing with illness. This could be a result of metrics tanking, unusually elevated training heart rate, a feverish feeling or a tickle in your throat.

Upper Left Quadrant - when all metrics are normal but training heart rate unexpectedly elevates, assume you’re about to get sick.

This early stage is the most difficult for athletes. Why? Because you have momentum and can easily continue to train for the next 48 hours.

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My seated AM RHR data. January 21st saw a material shift in metrics (RHR up and HRV down). By the evening this was combined with a tickle in the throat. I immediately shut down the training week. App is HRV4Training.Com.

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Minimize The Depth of the Illness

Do not perform “one last solid workout.” This session, if you are about to get sick, increases the likelihood of a multi week setback.

By backing off immediately, and continuing to maintain core nutrition, our bodies will reallocate energy from exercise towards recovery & adaptation.

At this stage, nothing has been lost. We have brought forward the timing of our normal weekly low-stress days.

Our focus shifts to movement for health and we wait and see if an illness arrives. If it does then, hopefully, it will be minor.

It’s OK to keep moving with light activity and walking, avoid structured and/or group training.

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Metrics Will Tell Us What We Want To Hear

In the picture (above), from January 21st through 25th, the detected trend is “coping well.” But I’m not coping well, I know I have been infected with a virus. I don’t need my data to tell me what I can feel for myself.

This is the stage where the compulsion to train will lead you astray.

• You know you’re mildly sick.

• You still have momentum from earlier in the week.

• You are scared to lose fitness, gain weight, disappoint your coach, lose your streak…

At this stage, nothing has been lost. You’ve taken 48-72 hours easy.

Keep moving for health, keep eating your core nutrition, don’t train.

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Test The Waters

Your focus here is avoiding a relapse. Nothing has been lost at this stage.

After 72-96 hours, it will be clear if you are getting sick, or not.

• If you’re getting sick then you’ll be grateful you didn’t compound things by training into illness.

• If you’re not getting sick then you had the equivalent of a short unload block. I do these all the time and they have a positive impact on my long term gains.

Once the illness is gone, or doesn’t arrive, the first thing you do is add back frequency.

Bring back your normal exercise frequency, keep the intensity Easy / Zone 1, and cap session duration at not more than an hour.

• Watch your energy ~4 hour after you exercise, if you feel a big energy dip then you’re still recovering.

• Watch your evening RHR metrics for unusual elevation. Unusual is more than 5 bpm above normal.

• Watch your sleep and overall energy. If sleep duration is up, and energy level is down, then you’re still recovering.

Easiest way to remember what I just said.

• Train alone.

• Cut your normal session duration in half.

• Cap effort at heart rate Zone 1.

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Return To Training

The duration of your illness should be counted from the first symptom being noticed to the end of all symptoms. Yes, your lingering, minor, not-really-a-cough counts.

The testing-the-waters phase (frequency focus, Zone 1) should last for at least half the days you lost to illness.

• This implies 3-4 days for a minor illness, and

• 9-12 days for something that takes you out for a couple weeks.

At this point, I want you to do a Submax Test and compare the results (HR and Lactate) to your most recent healthy baseline test.

• What you are looking for is elevated heart rate and lactate response. Elevated meaning more than 5 bpm/1 mmol above normal for heart rate / lactate.

• You’ll find an example of normal, and significant, elevation from baseline when Bek tested following a multi-week illness.

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Bek’s January 24th test (red line) shows elevated lactate vs power. The green line is the same test, repeated 7 days later. The second test showed results similar to pre-illness performance. The internal “disruption” shows clearly in the elevated lactate.

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If you are materially elevated (Bek was +2 mmol) then you need another week focused on frequency with a Zone 1 cap. Toss in a little strength training if you are feeling good.

Keep watching for the ~4 hour post-workout crash and elevated evening RHR. Both of these are signs you need to be careful with total stress.

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Pre- & Post-Illness Comparison

Testing example following minor illness of the author. This is the same illness tracked in the morning metrics chart (HR/HRV) at the top of this article.

First symptom was January 21st (evening). Test on the left is healthy baseline. Test on the right is confirmation of return to baseline.

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Once the submax test looks normal, return to your basic week.

• If this entire process (first symptom to normal submax test) took <10 days then you’ll be OK to resume normal training, including intensity.

• If the process took more than 14 days then you should repeat your basic week, twice, without challenging main sets. After those two weeks, you’ll be good to resume normal training, including intensity.

Wait until your lungs are completely clear before doing any sustained intensity.

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Additional Resources

Two articles from the archives.

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The first includes a case study with a classic “HRV collapse” response.

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The second touches on the mental side of chronic illness as well as advice for times when training response disappears without a clear medical diagnosis.

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