Illness Adaptation Guidelines - Training Modification Protocols

The "Neck Rule" - Core Decision Framework

Rule Overview

The "neck rule" is a medically-sound guideline for training during illness:

Above the Neck (Mild): Light training may be acceptable Above the Neck (Moderate/Severe): Complete rest Below the Neck (Any Severity): Complete rest - no exceptions

Symptom Classification

Above the Neck

• Runny nose
• Sinus congestion
• Mild sore throat
• Sneezing
• Watery eyes
• Slight headache

Below the Neck

• Chest congestion
• Productive cough
• Fever (>38°C / 100.4°F)
• Body aches / muscle soreness unrelated to training
• Stomach upset / nausea
• Diarrhea
• Extreme fatigue
• Shortness of breath

Both

When symptoms appear both above AND below the neck, treat as "below the neck" (complete rest).

Adaptation Protocols by Severity

Protocol A: Above Neck - Mild

When to Apply:

• Mild cold symptoms (runny nose, slight congestion)
• No fever
• User feels capable of light activity
• Symptoms are not worsening

Running Adaptations:

• Volume: 50% of prescribed distance
• Intensity: Conversational pace ONLY (Zone 1-2)
• Feel Test: If symptoms worsen during run, stop immediately
• Cancel: All workouts (tempo, intervals, hills, fartlek)
• Convert: Long run → easy run at 50% distance OR cancel
• Optional: If feeling good, can complete; if feeling poor, skip

Strength Training:

• Cancel: All prescribed strength sessions
• Optional: Light bodyweight exercises (no heavy lifting)
• Volume: Maximum 50% of normal

Supplemental Work:

• Maintain: Mobility work (5-10 minutes daily)
• Cancel: Drills and plyometrics
• Optional: Light walking (20-30 min) if feeling up to it

Key Principle: Recovery first. Training second.

Protocol B: Above Neck - Moderate

When to Apply:

• Strong cold symptoms
• Significant congestion or sore throat
• Noticeable fatigue
• Reduced capacity for daily activities

All Training:

• Cancel: All running workouts
• Cancel: All strength sessions
• Cancel: Drills and plyometrics

Optional Activities:

• Light walking (20-30 min) if user feels capable
• Gentle mobility work (5-10 min)

Message to User: "Your body needs energy to fight off this cold. Rest is the best training right now."

Protocol C: Above Neck - Severe

When to Apply:

• Extreme cold/flu symptoms
• Significant fatigue
• Barely able to function normally
• Need for bed rest

All Training:

• Complete rest - Cancel everything
• Optional very gentle mobility (5 min max) if feeling up to it

Message to User: "Focus completely on rest and recovery. Your training will be here when you're healthy."

Protocol D: Below Neck (Any Severity)

When to Apply:

• ANY fever
• Chest symptoms or productive cough
• Body-wide illness (muscle aches, GI issues)
• Shortness of breath
• Extreme fatigue

All Training:

• Complete rest - No exceptions
• No running, no strength, no drills
• Optional very gentle mobility ONLY

Critical Message: "Fever, chest symptoms, or body-wide illness require complete rest. Training now risks serious complications."

Medical Safety: Training with fever or below-neck symptoms can lead to:

• Myocarditis (heart inflammation)
• Prolonged illness duration
• More severe complications
• Extended recovery time

Adaptation Implementation Rules

For Current Week (Mid-Week Illness)

When illness is reported mid-week:

1. Completed Workouts: Keep as-is (already done)
2. Today's Workout:
   • If not completed: Apply adaptation protocol
   • User decides based on how they feel right now
3. Remaining Days: Apply protocol to all future workouts in the week

Day-by-Day Adaptation

Example: User reports illness on Wednesday (Week 5, Day 3)

Original Week Plan:

• Monday: Easy run 5km ✅ (completed)
• Tuesday: Tempo 8km ✅ (completed)
• Wednesday: Easy run 6km ← TODAY
• Thursday: Strength + Core
• Friday: Easy run 5km
• Saturday: Rest
• Sunday: Long run 12km

Illness: Above Neck - Mild

Adapted Plan:

• Monday: Easy run 5km ✅ (keep - already done)
• Tuesday: Tempo 8km ✅ (keep - already done)
• Wednesday: Easy run 3km (50% volume, conversational pace) - OPTIONAL
• Thursday: Rest (cancel strength)
• Friday: Easy run 2.5km (50% volume) - OPTIONAL
• Saturday: Rest (keep as rest)
• Sunday: Easy run 6km (50% of long run, conversational pace) - OPTIONAL

Key Changes:

• All future runs: 50% volume, conversational pace, OPTIONAL
• All future workouts: CANCELLED
• Strength: CANCELLED
• Long run: Converted to easy run at 50%

Return-to-Training Protocols

After Illness Resolution

When user marks "fully recovered," apply graduated return:

Duration-Based Volume Reduction:

Week 1 Return Protocol:

• All runs at conversational pace (Zone 1-2)
• No workouts (no tempo, intervals, hills)
• Light strength only (bodyweight, 50% volume)
• Full mobility maintained
• Long run reduced to easy run at return volume

Week 2 Return Protocol:

• Gradually increase volume toward normal
• Can add ONE quality workout if feeling strong
• Can resume normal strength at 75% volume

Week 3 Return Protocol:

• Resume normal progression
• Monitor for fatigue or relapse symptoms

Messaging Guidelines

Tone and Framing

DO:

• Frame rest as "smart training"
• Emphasize long-term performance
• Remove guilt about "missed" workouts
• Provide clear rationale (medical safety)
• Celebrate recovery milestones

DON'T:

• Create anxiety about "falling behind"
• Show "missed workout" or "training debt" language
• Pressure user to train through illness
• Make user feel weak for resting

Example Messages

On Reporting Illness (Above Neck - Mild):

"Your training has been adapted for cold symptoms. We've reduced volume to 50% and made runs optional. Listen to your body - if symptoms worsen during activity, stop immediately. Recovery is smart training."

On Reporting Illness (Below Neck):

"Chest symptoms, fever, or body-wide illness require complete rest. Training now risks serious complications and longer recovery. Your plan will be here when you're healthy - focus on rest."

On Daily Check-In (Better):

"Good to hear you're improving! Keep taking it easy. We'll have you back to full training soon."

On Fully Recovered:

"Welcome back! You were sick for [X] days, so we're rebuilding gradually with [Y]% volume this week. All easy running to start. Back to normal progression in 2-3 weeks. Recovery first, then performance."

Special Considerations

During Taper

If illness occurs during taper (pre-race):

• Extra conservative approach
• Consult user about race readiness
• May need to adjust race goals or consider withdrawal
• Health > single race performance

Multiple Illnesses

If user has multiple illness events in short succession (e.g., 3+ in 8 weeks):

• Flag pattern to user
• Suggest evaluating recovery, sleep, nutrition, stress
• May indicate overtraining or compromised immune system

Chronic Conditions

This guidance is for acute illness only. Users with chronic conditions should follow their healthcare provider's guidance.

Implementation Checklist

When adapting a plan:

• Identify symptom location (above/below/both)
• Identify severity (mild/moderate/severe)
• Select appropriate protocol (A/B/C/D)
• Keep completed workouts unchanged
• Apply adaptations to remaining days only
• Mark all workouts as OPTIONAL (user decides based on feel)
• Include clear messaging about rationale
• Track illness_event_id for plan linkage

Medical Disclaimer

This guidance is for general training adaptation and does not constitute medical advice. Users should:

• Consult healthcare providers for medical concerns
• Seek medical attention for severe or worsening symptoms
• Not use this as a substitute for professional medical advice
• Prioritize health over training always