You’ve had a cold or the flu and your symptoms have begun to subside. Your nose has stopped dripping, your cough is clearing and your head and muscles no longer ache.

You’re ready to get off the couch. But is it too early to go for a run? Here’s what to consider when getting back to exercising after illness.

Exercise can boost your immune system – but not always

Exercise reduces the chance of getting respiratory infections by increasing your immune function and the ability to fight off viruses.

However, an acute bout of endurance exercise may temporarily increase your susceptibility to upper respiratory infections, such as colds and the flu, via the short-term suppression of your immune system. This is known as the “open window” theory.

A study from 2010 examined changes in trained cyclists’ immune systems up to eight hours after two-hour high-intensity cycling. It found important immune functions were suppressed, resulting in an increased rate of upper respiratory infections after the intense endurance exercise.

So, we have to be more careful after performing harder exercises than normal.

Can you exercise when you’re sick?

This depends on the severity of your symptoms and the intensity of exercise.

Mild to moderate exercise (reducing the intensity and length of workout) may be OK if your symptoms are a runny nose, nasal congestion, sneezing and minor sore throat, without a fever.

Exercise may help you feel better by opening your nasal passages and temporarily relieving nasal congestion.

However, if you try to exercise at your normal intensity when you are sick, you risk injury or more serious illness. So it’s important to listen to your body.

If your symptoms include chest congestion, a cough, upset stomach, fever, fatigue or widespread muscle aches, avoid exercising. Exercising when you have these symptoms may worsen the symptoms and prolong the recovery time.

If you’ve had the flu or another respiratory illness that caused a high fever, make sure your temperature is back to normal before getting back to exercise. Exercising raises your body temperature, so if you already have a fever, your temperature will become high quicker, which makes you sicker.

If you have COVID or other contagious illnesses, stay at home, rest and isolate yourself from others.

When you’re sick and feel weak, don’t force yourself to exercise. Focus instead on getting plenty of rest. This may actually shorten the time it takes to recover and resume your normal workout routine.

I’ve been sick for a few weeks. What has happened to my strength and fitness?

You may think taking two weeks off from training is disastrous, and worry you’ll lose the gains you’ve made in your previous workouts. But it could be just what the body needs.

It’s true that almost all training benefits are reversible to some degree. This means the physical fitness that you have built up over time can be lost without regular exercise.

To study the effects of de-training on our body functions, researchers have undertaken “bed rest” studies, where healthy volunteers spend up to 70 days in bed. They found that V̇O₂max (the maximum amount of oxygen a person can use during maximal exercise, which is a measure of aerobic fitness) declines 0.3–0.4% a day. And the higher pre-bed-rest V̇O₂max levels, the larger the declines.

In terms of skeletal muscles, upper thigh muscles become smaller by 2% after five days of bed rest, 5% at 14 days, and 12% at 35 days of bed rest.

Muscle strength declines more than muscle mass: knee extensor muscle strength gets weaker by 8% at five days, 12% at 14 days and more than 20% after around 35 days of bed rest.

This is why it feels harder to do the same exercises after resting for even five days.

But in bed rest studies, physical activities are strictly limited, and even standing up from a bed is prohibited during the whole length of a study. When we’re sick in bed, we have some physical activities such as sitting on a bed, standing up and walking to the toilet. These activities could reduce the rate of decreases in our physical functions compared with study participants.

How to ease back into exercise

Start with a lower-intensity workout initially, such as going for a walk instead of a run. Your first workout back should be light so you don’t get out of breath. Go low (intensity) and go slow.

Gradually increase the volume and intensity to the previous level. It may take the same number of days or weeks you rested to get back to where you were. If you were absent from an exercise routine for two weeks, for example, it may require two weeks for your fitness to return to the same level.

If you feel exhausted after exercising, take an extra day off before working out again. A day or two off from exercising shouldn’t affect your performance very much.

Ken Nosaka, Professor of Exercise and Sports Science, Edith Cowan University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Picture two people, both suffering from a serious mental illness requiring hospital admission. One was born in Australia, the other in Asia.

Hopefully, both could be treated on a voluntary basis, taking into account their individual needs, preferences and capacity to consent. If not, you might imagine they should be equally likely to receive treatment against their will (known colloquially as being “sectioned” or “scheduled”).

However, our research published in British Journal of Psychiatry Open suggests this is not the case.

In the largest study globally of its kind, we found Australians are more likely to be treated in hospital for their acute mental illness against their will if they are born overseas, speak a language other than English or are unemployed.

What we did and what we found

We examined more than 166,000 episodes of voluntary and involuntary psychiatric care in New South Wales public hospitals between 2016 and 2021. Most admissions (54%) included at least one day of involuntary care.

Being brought to hospital via legal means, such as by police or via a court order, was strongly linked to involuntary treatment.

While our study does not show why this is the case, it may be due to mental health laws. In NSW, which has similar laws to most jurisdictions in Australia, doctors may treat a person on an involuntary basis if they present with certain symptoms indicating serious mental illness (such as hallucinations and delusions) which cause them to require protection from serious harm, and there is no other less-restrictive care available. Someone who has been brought to hospital by police or the courts may be more likely to meet the legal requirement of requiring protection from serious harm.

The likelihood of involuntary care was also linked to someone’s diagnosis. A person with psychosis or organic brain diseases, such as dementia and delirium, were about four times as likely to be admitted involuntarily compared to someone with anxiety or adjustment disorders (conditions involving a severe reaction to stressors).

However, our data suggest non-clinical factors contribute to the decision to impose involuntary care.

Compared with people born in Australia, we found people born in Asia were 42% more likely to be treated involuntarily.

People born in Africa or the Middle East were 32% more likely to be treated this way.

Overall, people who spoke a language other than English were 11% more likely to receive involuntary treatment compared to those who spoke English as their first language.

Some international researchers have suggested higher rates of involuntary treatment seen in people born overseas might be due to higher rates of psychotic illness. But our research found a link between higher rates of involuntary care in people born overseas or who don’t speak English regardless of their diagnosis.

We don’t know why this is happening. It is likely to reflect a complex interplay of factors about both the people receiving treatment and the way services are provided to them.

People less likely to be treated involuntarily included those who hold private health insurance, and those referred through a community health centre or outpatients unit.

Our findings are in line with international studies. These show higher rates of involuntary treatment among people from Black and ethnic minority groups, and people living in areas of higher socioeconomic disadvantage.

A last resort? Or should we ban it?

Both the NSW and Australian mental health commissions have called involuntary psychiatric care an avoidable harm that should only be used as a last resort.

Despite this, one study found Australia’s rate of involuntary admissions has increased by 3.4% per year and it has one of the highest rates of involuntary admissions in the world.

Involuntary psychiatric treatment is also under increasing scrutiny globally.

When Australia signed up to the UN Convention on the Rights of Persons with Disabilities, it added a declaration noting it would allow for involuntary treatment of people with mental illness where such treatments are “necessary, as a last resort and subject to safeguards”.

However, the UN has rejected this, saying it is a fundamental human right “to be free from involuntary detention in a mental health facility and not to be forced to undergo mental health treatment”.

Others question if involuntary treatment could ever be removed entirely.

Where to from here?

Our research not only highlights concerns regarding how involuntary psychiatric treatment is implemented, it’s a first step towards decreasing its use. Without understanding how and when it is used it will be difficult to create effective interventions to reduce it.

But Australia is still a long way from significantly reducing involuntary treatment.

We need to provide more care options outside hospital, ones accessible to all Australians, including those born overseas, who don’t speak English, or who come from disadvantaged communities. This includes intervening early enough that people are supported to not become so unwell they end up being referred for treatment via police or the criminal justice system.

More broadly, we need to do more to reduce stigma surrounding mental illness and to ensure poverty and discrimination are tackled to help prevent more people becoming unwell in the first place.

Our study also shows we need to do more to respect the autonomy of someone with serious mental illness to choose if they are treated. That’s whether they are in NSW or other jurisdictions.

And legal reform is required to ensure more states and territories more fully reflect the principal that people who have the capacity to make such decisions should have the right to decline mental health treatment in the same way they would any other health care.

If this article has raised issues for you, or if you’re concerned about someone you know, call Lifeline on 13 11 14.

Amy Corderoy, Medical doctor and PhD candidate studying involuntary psychiatric treatment, School of Psychiatry, UNSW Sydney

This article is republished from The Conversation under a Creative Commons license. Read the original article.