Should You Race If You’re Sick Two To Three Weeks Before A Hard Endurance Event?


Hi folks! Thanks for stopping by!

Here is a tricky question: After being sick with the flu a few weeks before your race, should you go ahead or pull out?

Rat-adapted Influenza virus infection in the nose of rat, showing infection and thus destruction of the normally protective lining.

Rat-adapted Influenza virus A infection in the nose of a rat, showing the location of the virus factories (virus antigen is shown as dense black staining – easier to see in color, but color is too expensive for scientific journals, usually) and thus destruction of the normally protective lining. Fom an old publication of which FitOldDog was a co-author. Click on figure for link to original article.

You train for many months, have a great workout, and feel on top of your form, and your race is three weeks away. Set to go, and thinking about tapering, for which you reduce your training load to rest your body for the race, whilst maintaining your level of conditioning. This was how I felt at the end of a great workout on a Saturday, ten days ago, comprising a 3-mile swim, 45-minute bike trainer ride, and a 3-mile run, essentially a mini-triathlon. Sunday morning awakens cold and crisp and I’m ready for my scheduled long run, but I have a sore throat. I hesitate on the run, and then by the afternoon I have all the early signs of the flu, even though I had the flu shot. Damn! But I’ve been here before, and so have several of my athlete friends, and it seems to occur about two to three weeks before the event as you reach your maximum training level.

By the Monday I was feeling really sorry for myself, but it only got worse, with rhinitis, laryngitis and tracheitis, and mild fever. My whole upper respiratory tract was infected, as the flu or some similar virus, progresses down my respiratory tract, making millions of copies of itself and killing the airway lining in the process. I could see it in my mind, virus factories and all – as a research pathologist I studied this process in rat experiments designed to improve our understanding of the flu, which kills millions of people annually. A big epidemic could wipe out half the world’s human population (no exaggeration), so it’s worth studying in rats, even though I like rats – hard choices! The flu destroys the protective airway mucociliary apparatus (see my movie, below, still not bad 30 years after we made it) that normally protects most mammals from bacterial infection by killing or inhibiting noxious microorganisms, and washing them away. Be patient, the video takes a minute or so to load (sorry about that!)

My condition goes from bad to worse, and today, 10 days later, I’m still coughing a bit, but feeling a lot better, having missed some critical training in the meantime.

So, should I race or not?

Los Cabos minus 11Absolutely! I might consider a checkup by my doctor, but the chances are she would have told me not to race in the first place, by saying, “140.6 miles in the 70-74 age group, Kevin, starting in a cold Pacific Bay, riding a hilly bike course for 112 miles, then running a full marathon!

Are you crazy?

Carboload 4 am before LPIM 2010

Here I am, at 4 am carbo-loading for the 2010 Lake Placid Ironman with an abdominal aortic aneurysm ready to burst. At least I know I had the flu this time. Photo by Randy Mews.

My answer is always the same when people say these things:

“The 2010 Lake Placid Ironman race saved my life by drawing my attention to my ready to burst, 6.9 cm abdominal aortic aneurysm, thus this blog. I had aortic surgery 10 days later, which is why I’m here to talk about it, so I don’t plan to stop Ironman anytime soon, without a good reason.”

NOW! I’m not saying you should do this, flu or no flu, but we each sculpt our own lives, so decide for yourself. Carry out your own risk assessment, with the help of medical professionals, and remember that a life without risk is no life at all, which doesn’t mean you have to be stupid about it. If I feel on race day like I do today, I would drop out, but in 10 days I should be almost completely recovered, and able to assess my level of race-readiness. It’s not like it’s my first Ironman, for heaven’s sake, or influenza infection for that matter. However, the older you get the greater your risk of dying from most strains of flu virus, I understand.

Time to start sorting out my gear, only 11 days and 9 hours ’till the gun goes off.

Exciting, cough, cough!

-k @FitOldDog



  1. I am glad to see that there are other people my age who are maximizing their physical potential. I myself am a buff grandma who has been involved in muscle-strengthening, yoga, zumba, and–most recently–flamenco classes. I also do 5k on the treadmill once a week. I don’t have many health issues to speak of, but I do have bone loss. I have managed to increase bone density after starting a rigorous workout routine. I think part of the reason that people our age stay away from vigorous exercise is fear instilled by the health-care industry. I recently was startled to find that some of the dire warnings are actually not based on good scientific investigation. For example, there have been almost no scientific studies done on exercise using osteoporosis patients. The only one cited at many sites was done way back in 1984 by Sinaki and Mikkelsen using 59 OP patients with a history of fracture. The study showed that the majority had additional fractures after doing forward flexion exercises. Here it is–2013–and there is a universal watning against bending forward for people with bone loss (which includes many holding AARP cards).

    Check out this thread on Inspire, the National Osteoporosis Foudation’s blog, to see the fearmongers at work: You do have to register to view this, however. At one point a physical therapist tied to NOF starts off her post with the fear message, using the Sinaki study, and then moves on to 2 other studies, one of them done on dead people! These exercise recommendations affect millions of people. I wish we could put more science behind them.

    • Hi Anita, great blogging material, thanks, so I’ll follow up on the article. They have some good points, but progress has to be made, and people need to learn to take responsibility for their own bodies, not bow to so-called experts all the time. I think that one Feldenkrais session is worth more than 20 visits to a doctor or PT when it comes to getting your body back in shape at any age. Science follows the latest fads, like anything else, which is very human. My best piece of research, on transcriptome dynamics, during a successful 40-year career was rejected repeatedly by the most appropriate journals and ignored by the scientific community because it just didn’t fit the current way of non-dynamic thinking in Biology (not enough math being used there, I’m afraid). I didn’t mind, I just loved the research, so I took it as a compliment. When that Greek mathematician in about 300 BCE worked out the equations for the ellipse (conic transections, you know x^2/a+y^2/b=z^2/c or something like that – a piece of string and two pins explains it better to my simple mind), it was ignored and it sat unused for 2000 years before being picked up by Brahe and another guy whose name I forget (oh yes, Keppler, one p or two?) to explain the movement of the planets around the sun (the powers that be at the time loved that work, NOT). So, just push along, enjoy the day, and make changes as one can, especially locally, because as the Tao te Ching, or should I say Lao-tzu, says, the world is too big to change, but it doesn’t mean don’t try, it just is saying enjoy the process, go with the flow, dip your oar in the stream of life, and guide the boat as best you can. You have the most effect if you live lightheartedly, whilst following your heart. You certainly can’t force people to listen – have trouble with that myself. Kind Regards, and thanks again for your comments, kevin aka FitOldDog (well, fit some days).

  2. Hi Anita, thanks for the comment and encouragement. When it comes to osteoporosis the best approach, in my opinion, is skilled weight training combined with posture perfection (in the reverse order). Did you see the bones in the 3 MRI paper – they are dramatically reduced in mass in the sedentary person and thus strength Of course, they’ll break more easily under load, what does one expect. Use it or lose it, I agree with. No pain no gain, I don’t agree with. There are many ways to become extremely fit without pain. Lots of aerobic work, especially walking, for starters – Mark Sisson is correct on that front too. When it comes to nutrition and exercise we are only just starting to work things out. The Common Wisdom is not wisdom at all as far as I can tell. Much appreciated. Kind Regards, kevin

  3. I appreciate your remarks. I think that more and more aging is looked at as pathology and physical therapists are being brought in for “rehabilitation.”

    • Hi Anita, I wrote that blog post in response to your comment, as promised. I had a bad case of verbal diarrhea so it goes on a bit, but I found the subject so interesting. Thanks again! Here’s the link Cheers, kevin

      • Kevin–

        Thanks so much for the great blog post. The information applies to the millions of people who have been determined to have osteopenia or osteoporosis, now that standard deviations are used to diagnose the conditions. I hope some have a chance to read the blog and find some space to make some level-headed decisions. The first information they often get after diagnosis focuses on statistics on fracture rates and warnings about the dire consequences of exercises-to-avoid. So many people tell stories about medical professionals waving fingers at them, telling them they’ll wind up in a wheel chair or worse if they’re not careful. Unfortunately, there are way too many people afraid to move around their house, much less participate in a marathon. Hopefully, some will do their own risk-benefit calculation, maybe become their own guinea pig, and–as June Allyson (who, incidentally, fractured her skull and broke her back at age eight) used to say–get back into life. I’ve taken the road less traveled, and it has made all the difference.

        • Hi Anita, the question is, how do you reach them? I often wonder about this as I advertise on Google, blog, Facebook, Twitter, Digg, Stumbleupon, and all the rest. I guess time and patience are the key. Glad you liked it, which is more encouraging than you know! Thanks so much for showing an interest. OK! Time to focus on cycling, after a good nights sleep, of course. Kind Regards, kevin

  4. Hi Anita, I’ll follow up on your link, and will write another post on osteoporosis when I get time. Many of the negative mental, spiritual, and physical aspects of aging, it would appear, are the inevitable consequences of patterns of behavior set in place in one’s childhood, middle age, or even in previous generations, often due to conditioning of which we are unaware. I still find that MRI set remarkable, knowing that some of my friends are in the middle set. One fall and they break, whereas I tend to bounce, even when I fall off of my bike, which is remarkable (plus a little luck of course). Gravity becomes their biggest enemy instead of their friend. When it comes to the PT industry, people will make money out of anything, but most are well intended. I hope to build a business around one of my ideas, but my real goal is to improve people’s lives. If you would like to see our video set on body awareness just let me know and I’ll send you the link (no charge), as any input in our target of helping improve lives would be much appreciated. Cheers, Kevin

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Disclaimer: As a veterinarian, I do not provide medical advice for human animals. If you undertake or modify an exercise program, consult your medical advisors before doing so. Undertaking activities pursued by the author does not mean that he endorses your undertaking such activities, which is clearly your decision and responsibility. Be careful and sensible, please.