With the winter months upon us, we all know it is almost inevitable that we will get sick and have times during our training when we feel pretty lousy. Sometimes when we are sick, exercise actually helps us feel better and it is worth trying to log a few miles. Maybe you are training for a big event and think you can't bear to miss a workout, but you feel so badly, you wonder if you could make things worse by training. What should you do and more importantly, how can you avoid infection in the first place?

Often confused but important to know, is the difference between a cold and the flu. The flu is a very contagious infection, caused by the influenza virus, which affects your nose, throat and lungs. It often begins abruptly, is accompanied by a high fever, significant body aches and lack of energy. As the whole body type symptoms start to decrease, the respiratory symptoms increase. These can include cough, sore throat, nasal discharge, headache, etc., and usually last 4-7 days. The cough and tiredness can continue for weeks, even after the other symptoms have run their course and disappeared. The flu can have serious complications, however most people get the flu only once every several years and recover in 1-2 weeks. A cold, on the other hand, is much less serious, and often occurs several times a year. It typically has a slower onset, and symptoms include runny nose, congestion, sneezing, sore throat, cough, some tiredness and low grade fever (less then 100& F). The symptoms gradually resolve in 7 - 10 days.

The burning question is always should you run or not? A good rule of thumb always is the "neck check". This states that if your symptoms are below the neck (fever, muscle and joint pains, severe cough, GI distress - i.e., flu-like), it is a good idea to slow or suspend training. Why is this so important? First, training with any below-neck symptoms hampers any real training effect, so it is not doing your running any good. Second and more serious is the possible worsening of symptoms. A bad infection could turn into pneumonia and a viral infection could potentially lead to a viral infection of the heart muscle - neither something anyone wants to have! Return to running can occur when all symptoms have resolved. Start back at a moderate pace, and gradually increase to preinjury levels over 1-2 days for every training day missed. However, if your symptoms are all above the neck - so more consistent with a cold, it is ok to resume training as long as you feel up to it. Start slowly and if your symptoms do not increase, continue at a comfortable pace. Running through these symptoms won't likely lead to any serious side- effects, but you might feel pretty lousy during and after your run. It is better to take a day off, rest, hydrate and return to running when you feel up to it. Always remember it is not the end of the world if you take some time off to rest, especially at this time of year.

Some of the good news regarding exercise is that studies have shown it can be helpful in avoiding wintertime colds and flus. A pre-existing exercise regimen can actually cut in half the number of days a person suffers from a cold or flu. Exercise stimulates the disease-fighting white blood cells in your body to come to the rescue and help fight colds and flus. You can also booster your immune system with proper nutrition, adequate rest, and reducing stress in your life. All of these in addition to exercise will decrease your chances of getting a cold or flu. So, couldn't get that flu vaccine this year? No worries, exercise may be just what the doctor ordered anyway.

On the other hand, too much exercise is known to be an immune suppressant. Sustained exercise with significant exertion (more than 90 minutes), may create a period of immune suppression, thus an "open window" of opportunity in which the runner is more susceptible to infection. This does not mean that you must cancel your long distance training during the winter months. You just must be careful and take precautions to bolster your immune system and stay healthy. As above, eat well, rest, avoid extreme fatigue and overtraining, cut back on total mileage - try to keep it below 60 miles/week, above all use common sense and take an extra day of rest if you feel any symptoms coming on. Finally, the best advice to practice: Wash your hands frequently!! Even if you succumb to the cold or flu this winter, if you listen to your body, use common sense, and take the above precautions, you should be able to get back into action without any