Sick gains: How to Train when ill

Jan 09, 2026

Gentlemen, if you are a man over 40 battling a cold or flu but itching to hit the gym, worried that skipping sessions will derail your progress, you are not alone in that dilemma.

As an online personal trainer for men over 40, I have guided countless blokes through the murky waters of training while under the weather, helping them avoid setbacks or worse, prolonging illness. In my own 40s, during my transformation from 120kg to a stage-ready 80kg at 10 percent body fat, I pushed through a nasty bug once, ended up sicker for longer, and lost progress from forced rest. One client, a 48 year old dad, ignored his symptoms and trained hard, turning a mild cold into a chest infection that sidelined him for weeks. We got him back on track in my Silhouette PT Transformation Programme with smarter guidelines. Training when ill can be done, but only wisely, "sick gains" are possible if you follow rules like the neck rule. Let us unpack the neck rule for training when ill, why above the neck symptoms might allow a gym go, why below the neck means stop, and why this is a guideline to use smartly, with three action points to navigate illness without losing your edge.

The Neck Rule for Training When ill


Gentlemen, the "neck rule" is a simple, time-tested guideline from sports medicine to decide if you should train when feeling rough: if symptoms are above the neck, like a runny nose or headache, you might proceed with caution, but if below the neck, like chest congestion or fever, hit pause. This rule, popularised by experts like Dr Thomas Weidner in the 1990s, stems from research showing mild upper respiratory issues often do not impair performance or prolong illness with light exercise, while systemic or lower body symptoms signal your body needs resources for fighting infection, not lifts.

For men over 40, this is crucial as our immune systems slow, and pushing through serious illness risks complications like myocarditis or prolonged fatigue. A study in the British Journal of Sports Medicine found moderate exercise with above-neck symptoms can boost immunity slightly, but intense work with below-neck issues delays recovery by 20 to 30 percent.

My client had a stuffy nose (above neck), trained light, felt better. But when chesty (below), he rested, avoided worsening. The rule is not absolute, listen to your body, but it is a solid starting point.

Let us expand, the neck rule considers infection location: above-neck like sinus or throat often viral upper respiratory, mild exercise ok if no fever. Below like lungs or gut means systemic, exercise diverts blood from immune fight. Over 40, add age factors like reduced lung capacity, making below neck riskier.

Why Above the Neck is Ok to Go to the Gym

Gentlemen, if your symptoms are above the neck, a stuffy nose, mild sore throat, or headache without fever, heading to the gym can actually be beneficial, provided you scale back intensity. Why? Mild exercise boosts circulation, elevating immune cells to fight the bug faster. A study from Appalachian State University showed moderate workouts during colds shorten duration by a day and ease symptoms.

For men over 40, this maintains routine, preventing the mental slump from skipping. Light sessions preserve muscle, crucial as sarcopenia looms. My prep had a head cold, I trained reduced volume, no PRs, but kept momentum, recovered quicker.

But caveats: no fever (over 37.8°C), hydrate extra, avoid spreading germs. If congested, cardio might worsen, stick to weights.

Let us detail, above neck often localised, exercise endorphins lift mood, countering illness blues. A review in Medicine & Science in Sports & Exercise found light activity safe and helpful for mild colds. Over 40, it keeps joints moving, preventing stiffness from rest.

Why Below the Neck Isn't


Gentlemen, if symptoms are below the neck, chest cough, body aches, fever, stomach upset, or fatigue, skip the gym full stop. Why? These signal systemic infection, your body is in full battle mode, diverting energy to immune response. Exercise steals blood flow from vital organs to muscles, prolonging illness and risking complications like dehydration or heart strain.

Science from the American College of Sports Medicine warns exercising with fever increases viral myocarditis risk, inflammation of heart muscle, especially over 40 with potential undiagnosed issues. A study showed training with below-neck symptoms extends recovery by 3 to 7 days.

My client pushed through chest congestion, illness lingered two weeks instead of one, lost training time. Below-neck means rest, light walks at most.

Let us expand, fever means infection, exercise raises temp further, stressing system. Gastrointestinal symptoms dehydrate, gym worsens. Over 40, immune response slower, pushing risks secondary infections like pneumonia.

Be Smart: This is a Guideline


Gentlemen, the neck rule is a guideline, not gospel, be smart and tune into your body. If above-neck but feel wrecked, rest. Fever always means no. Hydrate, eat nutrient dense, consider doc if symptoms persist.

For men over 40, err cautious, we recover slower. My programme includes illness protocols, light mobility if mild, full rest if severe.

Let us emphasise, guideline means adapt: post 40 with conditions like asthma, below-neck threshold lower. Track symptoms, if worsening post workout, you pushed too hard.

Smart means preventive, build immunity with consistent training when healthy, making illnesses rarer.

3 Action Points

  • Assess symptoms daily using neck rule, journal to track.
  • If above neck, train light 50 percent intensity, monitor feel.
  • Rest fully if below neck, focus nutrition and sleep for quick recovery.

Gentlemen, train smart when ill, protect gains. Join my Silhouette PT Transformation Programme at www.silhouetteptonline.com, your online personal trainer for men over 40.