Jaqueline Godbe
USA National team eracer and physician Jaqueline Godbe shares her personal philosophy on training and illness. A Yes, No, and Maybe cyclists checklist.
Okay, let me start this article with a BIG disclaimer. While I have an MD, the personal experience I intend to share shouldn’t take the place of advice from your primary care physician or physical therapist. It is primarily a reflection of how I approach my training as a professional athlete when I feel under the weather.
Now on to the real stuff you’re here to read. We’ve all had that day. We wake up, and BAM, we’re sick. After going through our medicine cabinet to see what we have on hand we try to figure out whether we need to see a doctor.
The next thought in many athletes’ minds is, “Should I train through this?”
The second thought is then, “How much fitness am I going to lose if I don’t?”
Followed shortly thereafter with, “I’m going to get fat from sitting on the couch today, aren’t I?”
As a professional athlete and human being with a uterus, I’ve had the same dilemma multiple times. As you may already suspect, the answer isn’t always the same. Otherwise, why write an article with a flowsheet about it? Why include the part about the uterus?
Well, because feeling under the weather isn’t a binary. There are many different types of “sick,” and I try to let my symptoms guide whether or not it’s appropriate to add training stress to the stress my body is already experiencing.
Let’s start with the easy ones: THE HARD NO!
- Difficulty breathing
- Altered mental status
- Chest (heart) pain that GETS WORSE with exercise
- Anything where I feel compelled to call 911
- Vomiting
- Diarrhea
- Fever
The first three seem pretty intuitive. If you can’t breathe, you can’t work out. You should also call 911.
Similarly, if you’re confused (or taking painkillers that make you “funny”), you shouldn’t work out either. It would be best to have a serious conversation with your doctor, not playing on Zwift.
Chest pain can be a serious sign of heart trouble. You should seek medical attention and ABSOLUTELY NOT make it worse by trying to tough it out on the bike.
These are severe and possibly dangerous signs that you have already stressed your body to the maximum. Don’t make it worse with exercise.
Vomiting and diarrhea also make this list because of how close they put you to dehydration. Exercising will make dehydration worse. Dehydration will make you feel even worse.
It can put a strain on your heart and, if bad enough, land you in the hospital. So if I’m having either of those symptoms, I still drink my Nuun and focus on hydration. However, I do it on the couch instead of the bike.
Next up are the “Maybe” exercise:
- Cold/Sinus symptoms
- Body aches
- Rash
- Injury
In the era of COVID, I consider a cold or any contagious respiratory disease to be in the “maybe” category IF you have a private fitness area. If you work out in a gym or communal setting, it’s a hard NO.
If working out makes your breathing/coughing worse, it’s a hard NO. However, I find that my cold symptoms often feel better after a low-intensity workout.
Increasing blood flow to the lungs, nose, and throat often helps clear up my congestion. For me, body aches (due to delayed-onset muscle soreness or a cold) fall into a similar category.
Moderate-intensity exercise can help me feel better. The important thing for me is not to endanger anyone else’s health!
Rashes are also a maybe, depending on where and why they’re there. I’m not going to stop training for athlete’s foot, but I stopped training when I broke out in a full-body allergic rash to amoxicillin! Sweat (and chlorine) made me itch so badly that it wasn’t worth the adrenaline rush.
Exercising after an injury is a whole topic in and of itself, so I’ll be brief here. My general philosophy is to avoid anything that makes it worse. And follow the advice of my PCP/physical therapist. So no running on sprained ankles!
Editor's Note: I'll take care of it!
A few of my helpful hints on an active approach to cycling injuries, check out the Virtual Case Studies page of The ZOM!
The “Usually Yes” list:
- Menstrual cramps
- (Non-migraine) Headaches
- Post-vaccine blahs
- Allergies
- Swimmer’s ear
- Chalazion/Stye
The most important thing about these is that they do not pose a risk to fellow athletes when I work out. The second most important thing is that while these are all generally awful to have, they do not represent a significant threat to my health. My body can usually tolerate a little bit of extra stress on top of the work it’s already doing.
Menstrual cramps and headaches are demotivating and are common reasons athletes want to skip workouts. When I got the COVID-19 series, I noticed a similar set of fatigue-like symptoms.
It’s tough for me to summon the courage to heap on MORE pain vis-a-vis a VO2 sufferfest when I’m already hurting. However, I also know that moderate exercise generally reduces my pain.
So, I plan to keep my exercise length the same for these situations but dial down the intensity to a Zone 2-3 ride. I also double my usual hydration because the last thing I want to do is make myself feel even WORSE by adding dehydration to the problem.
My allergies (itchy eyes, congestion) also typically improve when I work out. Funny story, this is actually how my Mom got into long-distance running.
Their family had cats growing up, and she developed a cat allergy as a teenager. Running was the only thing that made it better!
Conclusion—Ask Yourself and Answer Honestly
To summarize my approach to illness in general, I ask the following questions:
- Do I pose a health risk (i.e., dehydration) to myself by working out?
- Do I pose a health risk to others by working out?
- Will working out make me feel better?
I will try to train if I answer “no” to the first two questions and “yes” to the third. After all, I work out because I genuinely enjoy how it makes me feel.
It’s not punishment for what I’ve eaten or how my body looks. It’s part of my personal journey to get stronger, healthier, and happier. Ultimately, I realize that it’s okay to take rest days when I need them. I also recognize that exercise is an integral part of my medicine cabinet.
Stay healthy out there!
Your Thoughts?
What is your personal illness training prescription? Comment below! Your fellow virtual cyclists want some of your medicine.
For other articles with Dr. Godbe’s professional and personal insight, check out the Training & Performance page of The ZOM!
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Jacqueline Godbe is a virtual cycling specialist who competes for The Saris NoPinz Team. She placed 5th in the 2020 UCI World Esports Championships. She also holds her PhD in chemistry and graduated with her MD in May 2021. She is newly married to John Cooper, who ALSO bikes and has a PhD.
I had heard once that cold symptoms above the torso – exercise away. Below the torso (chest congestion specifically) – take a break.
Asking because I’ve got a cold now (tested negative twice via PCR). Only symptom is mild chest congestion and a periodic cough trying to expectorate. I’ve been riding and it’s been absolutely fine. Plenty of energy and no breathing or heart concerns.
What would you suggest?
Interesting that you mention the old cycling adage “Above the neck ride, below the neck rest.” I’m writing about that in my next article to he out in a few days. The MD I asked wasn’t a believer. His short answer is that it is more complex than that, Charlie. But his advice to me was “listen to your body.” Yours seems to be saying good things.
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