Respiratory Infection: How Long to Rest?

author : AMSSM

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Member inquires about rest period and recovery from respiratory infection

Member Question from TMS

Hello, I'm new to BeginnerTriathlete, so forgive me if this is a stupid question. I never get sick but I am sick now with a sinus infection, strep throat, fatigue, joint pain etc. I was put on antibiotics and prednisone yesterday. My illness is six days old now. It is driving me nuts not working and even moreso not training. How long before I can start training again once I feel like I am on the mend?

Answer by Troy M. Smurawa, MD
Member AMSSM

Upper respiratory tract infections are extremely common in both the athletic and nonathletic populations. Most of the time symptoms will be caused by rhino-viruses. Although, moderate exercise offers a potential protection against infections, respiratory infections are the most common type of infection contracted by athletes.

Most upper respiratory tract infections are self-limited and the typical symptoms of rhinorrhea such as sore throat, fatigue, nasal congestion, mildly elevated temperature, and cough resolve over a 7- to 10-day period.

Caution needs to be taken when prescribing medications for athletes such as antibiotics and decongestants due to risk of dehydration and hyperthermia. Athletes with mild viral infections can continue to compete as tolerated since the symptoms and severity of the illness do not seem to be adversely affected by exercise. Although, athletes with fever, with more a more severe bacterial infections such as sinusitis and pharyngitis as well as those with symptoms below the neck should restrict sports participation. The “neck check” guide was first suggested by Dr. Randy Eichner and recommends that athletes may return to sport if their symptoms are all “above the neck” (rhinorrhea, sore throat, congestion). If there are symptoms present “below the neck” (fever, malaise, gastro-intestinal symptoms), then the athlete should be kept from participation until symptoms have resolved.

When an athlete is treated for a bacterial infection such as sinusitis or pharyngitis, the athlete should not have a fever and have been on antibiotics for at least 24 hours before returning to participation. After this then a short trial of activity can be undertaken and if there is no effect on symptoms then participation may be continued. If, however, there is aggravation of significant symptoms, activity should be halted.

Eichner ER. Infection, immunity, and exercise: what to tell your patients. Phys Sportsmed 1993;21:125.

Jaworski, CA, Donohue, B, Kluetz, J. Infectious Disease. Clin Sport Med 2011;30(3):575-90.

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date: September 1, 2017