Illness and the Open - Don't Get Sick by kyle ruth

During this past weekend Training Think Tank hosted an on-site Open Prep camp for 60+ athletes. It was an incredibly successful camp. We were able to give real-time feedback for the athletes in a simulated competitive environment and provide the athletes with an educational experience that delivered practical strategies for improving their Open performances. At the conclusion of the camp, however, every single Training Think Tank coach had come down with some sort of respiratory infection and my guess is that many of the athletes who attended the camp have or will experience the same thing. It is inevitable that when we exert ourselves beyond our typical day-to-day experience we become susceptible to infections.

Looking back at the past three years during the Open I’ve had more than a dozen athletes who have been ill, with either respiratory or gastrointestinal maladies, at some point within the 5-weeks of the Open. Depending on the severity of the illness this could easily spell the end of someone’s qualifying bid for the CrossFit Regionals. I distinctly remember fighting my way back in 2013 after a particularly nasty bout of norovirus that hit me the night after Open 13.1. Back then the Open was more forgiving than it is now, taking 48 athletes rather than 20 with a smaller talent pool. Due to the unforgiving nature of the Open as a qualifier, preventing getting sick in the first place is probably your best strategy but this isn’t always possible. In this blog we’re going to explore why you’re more vulnerable to getting sick during a 5-week competition like the CrossFit Open and what you can do to prevent or recover from an illness as quickly as possible.

Why do we get sick?

Athletes, coaches, and researchers have been aware that athletes are at an increased risk for upper-respiratory infections for years. It seems that there is link between the hard physical exertion, airway-inflammation (think fran-cough), and immune suppression that leaves athletes in a compromised state. So why exactly are we more likely to get sick during and after competition? The answer lies in the link between stress and the immune system. Our immune system plays a pivotal role in the recovery from athletic performance. The immune system influences tissue inflammation and tissue repair, mediating our bodies response to stressful training. Stress, and more specifically the stress hormone cortisol, suppresses our immune system as a way to turn off non-essential body functions until the stressful situation has passed. The problem is that most people’s physiologies are not adapted to handle the stress of a 5-week series of tests like the Open. Between the constant leaderboarding creating a perpetual sense of worry, workouts designed to tax your muscular / nervous / endocrine systems to their limits, and repeat workouts with incomplete recovery, the Open is a recipe for constant immune suppression and subsequent susceptibility to a host of viral infections.

For the remainder of the blog we’re going to (1) examine the things that you can do to prevent getting sick in the first place and (2) what to do if you do happen to become sick during the Open.

Preventing illness.

There are a variety of strategies for battling the increased susceptibility to illness during the Open. These range from basic hygiene practices like washing your hands frequently, to managing stress, to nutritional and supplementation strategies to keep your immune function at its peak. What follows is a discussion of stress management and nutritional strategies aimed at keeping immune function high during the Open.

As discussed previously, one of the biggest factors impacting your immune function is stress. As stress hormones increase, we see a corresponding decrease in immune function. Thus the most effective strategies for battling respiratory and gastrointestinal infections during the Open is to reduce stress hormone levels. This doesn’t mean that we should try to suppress cortisol completely as this would result in dramatically impaired performance (cortisol is one of the hormones responsible for preparing your body for intense exercise) but rather work to compartmentalize our stress as best as possible.

We have discussed a number of stress management techniques on the Training Think Tank blog including mindfulness meditation and Progressive Muscular Relaxation, both of which have been shown to cause meaningful reductions in cortisol levels in athletes. In addition to guided relaxation and meditation, deep rhythmic breathing has a profound impact on our autonomic nervous system which in turn can blunt cortisol release. These types of techniques are particularly effective for reducing worry and anxiety and can be effectively used as part of a pre-bed ritual that allows you to drift off into a peaceful, relaxing sleep. Sleep itself is a powerful stress-reducing tool and has been shown in research to be one of the most effective tools at our disposal for fighting off the common cold. In fact recent research has shown that people who sleep 8-9 hours per night significantly less likely to contract the virus that causes the common cold than people who sleep 7-8 hours per night.

Up to now we’ve primarily focused on the impact of stress on the immune system but exercise itself (also a form of stress) can result in marked immune suppression. Nutrition can play a big role in preventing this exercise-induced decline in the immune system. Beyond the obvious recommendations of eating a complete and balanced diet there are some recommendations that can help you fend off the respiratory infections that are so common in athletes during periods of competitive stress.

The consumption of carbohydrate both before, during, and after exercise has been consistently shown in research to improve immune function in athletes during hard training or competitive phases. Part of this can be explained by the fact that carbohydrate can indirectly reduce cortisol levels, thereby minimizing the negative impact of intensive exercise on the immune system. The recommendation then is very simple: consume adequate carbohydrates particularly during and after your Open workouts as well as the training sessions on the days leading into and out of your Open attempts. There are a host of other vitamins, amino-acids, and phytonutrients that have been investigated for their ability to improve immune function in athletes. Everything from vitamin-c to BCAA’s to adaptogenic supplements like Echinacea purpurea and Astragalus membranaceus have been shown to have some impact on exercise or post-competition respiratory tract infections. Digging into this information is a very deep rabbit hole however and rather than cover it in-depth in this blog it makes more sense to provide you with good resources to research this information on your own. My best suggestion is to utilize the website: Examine.com which maintains a massive database of nutrients and their supporting human research. For the layperson this is probably the best resource available online if you’re interested in learning more about the world of supplementation. The four supplements suggested above would be particularly good starting points on this topic, but as always I suggest doing your own research.

What to do if you get sick

Even if you take all the steps possible to prevent getting sick the reality is that sometimes our immune system just can’t fight off whatever pathogens we’ve come in contact with. First off let me say that you should absolutely seek medical advice and treatment if you need it. Putting off going to the doctor because you don’t think it is that serious is almost always a mistake and usually just allows your illness to progress. If you get sick during the Open, you want to take all the steps possible to get back to feeling your best quickly and this means seeking medical advice (even if you think it is just a common cold). At a minimum the doctor should have good recommendations for how you can manage your symptoms and tips for what you might be able to do to kick the illness faster.

As far as training is concerned rest is usually your best option. Just like our bodies have a mechanism for turning off our immune system during times of stress, that general malaise that we feel when we are sick is our body telling us that it is diverting resources to fighting off the illness. Despite most athlete's fears, we lose very little in terms of actual fitness or strength in the 1-2 weeks that it takes the typical cold or flu to pass. In fact from a physiological standpoint it takes 2-3 weeks of complete rest to even begin to lose strength adaptations. Endurance adaptations fade more quickly but that is simply a temporary decrease in blood volume that will return rapidly when you begin training again. Regardless of how much you feel you are falling behind, the best option is to rest. If you are sick during the Open, you may even need to rest until the last day to submit the workout and take all the steps possible to bring yourself back to full health. For example, in 2013 when I battled with norovirus during the Open, I rested Sunday through Friday while my body fought off the virus, then tested out the movements for Open 13.2 on Saturday then completed the workout on Sunday. If you find yourself in this situation, don’t panic, your training will be there for you when it matters, give your body time to fight off the infection and you will be far more prepared to perform than if not.

Conclusion

The Open is a stressful time that can leave you extra vulnerable to illness at a time where it is important to stay healthy. There are a number of steps you should take to help to strengthen your immune system during this time of heightened mental and physical stress. However there is always a possibility that even with the best laid plans you get sick during the 5-weeks of the Open. The best option is to quickly seek medical treatment if needed and then let the illness run its course while you do the best you can to rest and refuel for the next Open workout.

~ Kyle

Created By
Kyle Ruth
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