Ensure Your Exercise Routine Doesn’t Make You Sick!

Train hard, good results, Train harder, better results?

So not exactly…

I’ve generally gotten more sedentary in the past few years when I started my solo PT business; previously I took dance classes and performed regularly. As a result, my general cardio and fitness level is not where it used to be. So I find that when I decide to jump into  a workout that I tend to do too much- usually because as I get warm I feel good and want to keep pressing on.

So my cycle would be to get into the gym, do 10-12 mins of cardio, then do a series of core and leg exercises, then spend 10 minutes stretching. About 1.5 – 2 hours worth. And I would leave the gym feeling really accomplished.

Then I would be sick. Like flu sick- the next day. Full blown symptoms. Malaise, fatigue, sore throat, cough, stuffiness. All the good feels that comes along with a good ole flu.

Really weird. It made me back away from exercise for  a while.I knew something wrong, but couldn’t quite figure out what.  But then  after  2 weeks or so I’ll feel better and go back to step one.

This reaction wasn’t consistent, but when it did, it was strong – almost like exercising got me sick.

I got tired of feeling under the weather when I worked out- so I slowed down and eventually stopped.

Very discouraging right? If you feel like you get sick everytime you exercise then you’re probably not going to exercise, right?

So what could it be? Germy weights in the gym? Doing too much? Bad nutrition?

Actually it seems to be a combo of all of the above…and some other things…

I did some digging after a conversation with a patient, and found some interesting research that had been done on this topic. I discovered the phenomenon on postexercise immune function dysfunction.

Postexercise immune function dysfunction is where acute bouts of exercise cause a temporary depression of various aspects of immune function (e.g., neutrophil respiratory burst, lymphocyte proliferation and more good stuff ) that lasts ∼3–24 h after exercise, depending on the intensity and duration of the exercise bout.1

Bing Bing Bing. That described my problem to a T. I was depleting my immune system.

But how exactly?

So it’s all about the details.This doesn’t mean that if you exercise you’re going to get sick . A couple of things need to happen for the perfect storm to happen

  • You exercise for a prolonged period (1.5hrs)
  • You exercise at a moderate to high intensity (55-75%maximum O2 uptake)
  • You exercise without food intake

Also of note that periods of intensified training (overreaching) lasting 1 wk or more can result in longer lasting immune dysfunction.

So think about your exercise habits…do you go for 1.5 hours? Do you go ALL OUT!? Do you actually eat something that your body can burn before you workout?

My self analysis showed that I had checked all three when I did get sick. Intense exercise – thanks to my new sedentary lifestyle, exercise that was once a walk in the park was a significant challenge. So to counter my relative inactivity I exercised longer. And most times without eating adequately.

Here’s what the research shows

  • One study1 demonstrated that carbohydrate intake  of 30- 60 g per hour during streneous cycling helped to decrease the release of IFN-y T positive lymphocytes ( a type of white blood cell) . IFNγ, or type II interferon, is a cytokine that is critical for innate and adaptive immunity against viral, some bacterial and protozoal infections. It works by inhibiting the ability of viruses to reproduce.  There goes your natural germ blockers.
  • In a recent single-blind, placebo-controlled study2, it was reported that 4 wk of oral supplementation, with a combination of vitamin C (500 mg/day) and vitamin E (400 IU/day), markedly change the release of IL-6 from active muscle and the plasma IL-6 and cortisol response to 3 h of dynamic two-legged, knee-extensor exercise at 50% of maximal power output compared with placebo.
  • Elite athletes also may have an additional concerns. It is possible that the combined small changes in immune system paraments can compromise resistance to minor illnesses, such as upper respiratory tract Infections.3 Prolonged immune depression linked with prolonged training can determine susceptibilty to infection – particularly around major competitions.

So things to learn from my near self-induced death? – well not nearly that dramatic but you get the point 🙂

Takeaway Points:

  1. Good nutrition before and after exercise is soooo important. Literally!
  2. Try to eat some healthy carbohyrdates if you are exercising for  more that 1 hour.
  3. Load up on Vitamin C and E when you’re on an extended exercise regimen, or training for competition/performance.
  4. Watch your dosage-  use resistance to your advantage to get a great workout.
  5. Watch your time – longer isn’t always better.
  6. If you are training for a competition or a show/performance, you can be more prone to infection.

So armed with this information, I changed my workout style and nutrition. And the results – night and day! I don’t feel like I need to recover for a week from one workout. So try these things and see how it changes how you feel. I t definitely did with mine!


  1. Gleeson M  Immune function in sport and exercise. J Appl Physiol (1985). 2007 Aug;103(2):693-9. Epub 2007 Feb 15.
  2. Fahlman MM, Engels HJ. Mucosal IgA and URTI in American college football players: a year longitudinal study. Med Sci Sports Exerc 37: 374–380, 2005
  3. Nieman DC, Henson DA, Austin MD and ShaW (2011) Upper respiratory tract infection is reduced in physically fit and active adults. British Journal of Sports Medicine 45:987-992.
  4. Nieman DC Exercise immunology: practical applications. Int J Sports Med. 1997 Mar;18 Suppl 1:S91-100.
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Danelle Dickson PT, DPT, OCS

Danelle Dickson PT, DPT, OCS

Physical Therapist at Performance Plus Physical Therapy
Danelle Dickson received her Bachelor’s Degree in Biology from Morgan State University in 2003, then her Doctorate Degree in Physical Therapy from the University of Delaware in 2007. After graduating, she earned her  Board Certified Orthopedic Clinical Specialist Certification in 2012. She is continually increasing her knowledge base with post graduate continuing education from manual based courses such as Institute of Physical Arts and St. Augustine courses. Additionally, she has also presented research at local (APTA) and international (IADMS) conferences on dancers, and has published her research with Journal of Dance Medicine and Science.

Danelle combines her 10+ year of clinical, research, and administrative experience  to produce a well rounded, patient driven experience at Performance Plus Physical Therapy. She currently works with patients with orthopedic, sports and Performing arts conditions, along with taking care of the local dance population, and mentoring local physical therapy students as a clinical instructor.
Danelle Dickson PT, DPT, OCS

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