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How to Tell If You're Too Sick to Work Out

t's officially cold season and sooner or later we're all faced with the question: "Am I too sick to work out?" Learn how to tell — and get tips on how to stay healthy all season long from three doctors...

JACOBS, an expert at NYU Langone Medical Center's primary care sports medicine division

Ok, give it to us straight: how do you know if you’re too sick to work out?
Feeling too ill to work out will be different from person to person. If you have a fever (temperature above 100.4 F), cough, body aches, chills, nausea or nausea vomiting, these are symptoms that would truly indicate you are too sick to work out.

So if you’re just a little under the weather, can you work out?
If you're feeling under the weather and have a runny nose or the sniffles, it's likely okay to try working out. You can try a period of 10-15 minutes and see how you feel. If you feel better at that activity or symptoms are not worse, it's okay to continue working out, but should consider working at a lower level of activity.

Got it. Do you have any tips or guidelines that can help ensure you're working out safely while you're under the weather?
If symptoms are mainly at the neck or above (ex: runny nose, congestion, sore throat, etc), it is typically okay to do a trial of exercise to see if symptoms get worse. If they get worse with 10-15 minutes of activity, you should stop.

What about it symptoms are head to toe?
If symptoms are below the neck or both above AND below the neck (such as cough, body aches, fever, chills, etc.) you should rest from exercise until symptoms improve or resolve. After symptoms resolve, a gradual return to activity is best to ensure that symptoms do not worsen. Also, if you have a fever (temp above 100.4 Fahrenheit) you should not exercise because the fever promotes dehydration. Fever can also decrease concentration and coordination, lead to decreased strength, lead to less endurance, and put you at high risk of injury.

Set the record straight for us — can you really “sweat out” a cold?
You cannot “sweat out” an illness. The body’s natural defense is to make you feel warm or produce a fever that will fight off infection. Forcing the body to heat up will not make you better faster. You may feel better if you take a warm bath or shower or bundle up with blankets or a sweater, but it will not help you fight the infection.

How can you stay healthy during flu season?
Everybody should get a flu vaccine to prevent risk of infection. It is still possible to get the flu despite getting the vaccine, but the vaccine significantly decreases the risk of getting the flu and spreading the flu. Always practice good hygiene – wash hands regularly with soap and water or waterless, alcohol-based hand-sanitizers. Try to cough or sneeze in your elbow crease and not in your hands.

And if you do get the flu, how long can you expect to be down for the count?
Flu illness will typically last up to one week; you're contagious one day before symptoms appear and five to seven days after symptoms kick in. Factors that can decrease the risk of getting sick include getting adequate sleep, controlling stress levels and eating balanced diet.

How do you stop the spread of less serious illnesses such as colds?
Be sure to clean workout equipment after you’re a finished with it. The common cold is the most common illness (and has been the most common illness treated at both the winter and summer Olympics!). It typically lasts from one to two weeks, and you can develop symptoms one to two days after exposure. You can be contagious and spread infection up to a week prior to showing signs of illness and for one to two weeks after infection.

What is the best way to recover from an illness quickly and get back into your routine?
Get plenty of rest and stay well hydrated. Once symptoms have resolved, a gradual return to activity will allow you to return faster and decrease risk of possible injury. And talk to your doctor about controlling your symptoms with acetaminophen (Tylenol) or ibuprofen (Advil), which can help fever and body aches. Use of pseudoephedrine and allergy medications, such as loratidine or cetirizine, can help with congestion. Nasal saline washes also help with congestion. Most over-the-counter supplements are not helpful, but taking Vitamin C (200 milligrams a day) can help prevent illness and decrease duration of symptoms when taken before infection.

What about antibiotics?
Antibiotics will not help the common cold and could potentially have harmful effects. Some antibiotics may put athletes at higher risk for heart-related issues or muscle/tendon injury.

How does working out regularly affect our immune systems?
Research has shown that regular, moderate exercise up to 60 minutes, most days of the week can boost the immune system. Exercise can lead to higher number of infection-fighting cells in the body and improved function of these cells. More intense exercise may potentially increase risk of infection by causing added stress to the body, but regular, moderate exercise will not only boost the immune system, but also improve overall cardiovascular health.

DR. DANIELA WINSTON, MD, founder of Daniela Winston MD MedSpa in Boston

How can you tell if you're too sick to work out?
Symptoms of lightheadedness, dizziness, fever, body aches, shivers, nausea, vomiting, lethargy are all a big NO to working out. Usually if you have a slight headache, stuffy or runny nose a light workout is not contraindicated since the increase in blood flow during exercise could actually make these symptoms improve.

Is it true what they say about if your symptoms occur around your neck and above, it’s OK to do a light workout. If you’re sick below the neck, stay home?
The “neck rule" isn't foolproof, and a common sense is always a good idea, so listen to your body, it doesn't lie! If you have a cough, chest congestion, shortness of breath along with fevers, headache, body aches and fatigue - absolutely stay home, and take care of your self, don't spread the germs at the gym or at a SoulCycle class.

Can working out help you beat a cold — or does it make it worse?
Working out usually doesn't make you beat a cold, unfortunately. Once your sick your body needs rest and recovery time, this is valid for everyone, including pro athletes. At least two to three days of rest is necessary (maybe even more, depending on the severity of your cold).

How long after being sick should you wait to return to working out?
I would say if you feel 75 percent better after a cold, you could start working out. Initially it should be a light work out and slowly advancing it as your body feels back to 100 percent.

When you are sick, what can you do to speed up your recovery?
• Hydrate! Fluids, fluids, fluids!
• Take vitamin C 1000 to 2000 milligrams per day orally, and increase your intake of Vitamin C rich foods like citrus, berries, kiwi and red peppers.
• Add zinc orally - “the most immune essential mineral" along with turmeric, honey and ginger.
• Take a warm bath using Epsom salts or Pure Soma products. You can also see an integrative medicine physician for a high dose vitamin C intravenous infusion and antioxidant injection.
• Wash hands constantly; wipe equipment at the gym and avoid touching your face after handling equipment or during a workout. Stay away from people that are coughing and sneezing!

KATRINA KLAUS, an internal medicine physician at Harvard-Vanguard in the Boston area

Can you work out when you’re feeling under the weather?
If you have mild “above-the-neck” symptoms such as congestion, runny nose, mild sore throat then it’s okay to try 10 to 15 minutes of mild to moderate exercise. If you feel fine, go ahead. If that doesn't go well, rest another 24 hours and retry.

What about below-the-neck symptoms?
If you have a fever or a cough, wait at least 24 hours until you’re fever-free without the use of Tylenol or ibuprofen and make sure to aggressively hydrate before trying the above exercise trial. With SoulCycle workouts, which is rigorous, you probably want to wait until you’ve tried and succeeded with more mild/moderate workouts before returning to class. And if you have asthma or a history of pulmonary disease, always check with a physician.
Can working out prevent colds?
Regular exercise is great for immunity and preventing colds, but when you're sick, going to work out won't help your immune system.
And don’t be afraid of hand sanitizer this time of year — just in case the rider next to you is fighting a cold!

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