Feb. 7, 2006

Thomas E. Brickner, MD
University of North Carolina Sports Medicine

Basketball season is a fun and exciting time of the year. The cold and flu season is just the opposite. Unfortunately, the two seasons coincide with each other since they're both primarily wintertime occurrences. Being sick during the season not only interferes with the enjoyment of the activity, but it can also decrease performance, restrict participation and result in complications if not dealt with properly. At the same time, however, wintertime illnesses are so commonplace that they are often just part of the burden that all of us have to assume, and we carry on as usual. How safe and wise is this though? That's the question that needs to be addressed not just by health care professionals, but by everyone involved in the decision making process, which may include parents, coaches and the athletes themselves. No firm standards exist in answer to this question every time it's raised, however there are guidelines and recommendations that are useful to determine how best to deal with illnesses and participation in sports. This article is intended to help with those decisions.

There are numerous reasons why we are seemingly more susceptible to illnesses during the winter months, and indeed many of the viruses that cause colds and flu predominate during these months. The decreased temperatures keep us indoors more often and therefore in closer proximity to others who may be sick. This increases transmission rates. The low humidity tends to dry us out and therefore impedes our body's protective mechanisms, especially in the respiratory tracts where moisture and mucus is so important. Combining this with the demands of practicing and playing basketball, in addition to keeping up with school concerns can wear us down both physically and mentally. This can negatively impact our immune systems and thus make us even more vulnerable to getting sick.

Although there are many different illnesses that can occur at any given time, the primary focus of this article will deal with the common cold, which is an upper respiratory illness, and influenza, better known as the flu. Both of these illnesses are typically caused by viruses, and as far as the cold is concerned, there are many different viruses that can cause similar symptoms.

The common cold typically presents with a variety of symptoms which may or may not include head and chest congestion, runny nose, cough, sore throat, headache and fatigue. Fever, if present, is mostly low grade. The onset is usually gradual and the illness typically lasts one to two weeks. The flu is usually more abrupt in onset, is characterized by higher temperatures (102-103 degrees), muscle aches (especially in the back), headaches, fatigue, cough and runny nose. When in doubt, it is best to get seen by a health care provider.

Treatment for both illnesses is typically supportive in nature, as both are usually self limiting and will clear up with time. There are a variety of over the counter medicines that can be utilized to decrease the severity of the symptoms, but unfortunately no medicine currently exists that "cures the common cold". There are prescription medicines that can decrease the duration of the flu if they are started early enough. Many nonprescription medicines will help alleviate symptoms such as a runny nose, stuffiness, fevers, coughs and aches. Paying attention to the labeling information and correlating this with symptomatology will help you pick out medicines that may be helpful, if you chose to utilize them. In addition to this, adequate rest, nutrition and hydration are very important in battling the illness. A variety of "home remedies" also exist, and as long as they're safe they can be tried as well.

Waiting until symptoms have cleared before resuming full activity is always the best advice. However this is also often times impractical. There are certain circumstances that deserve special attention and should limit, if not curtail, participation. These include, but are not necessarily limited to, fever, significant fatigue, diffuse muscle aches and dehydration, especially with ongoing nausea and decreased appetite. Return to activities under these conditions should be guided by your health care provider. If however, these symptoms are not present, and the illness presents mostly with "above the neck" symptomatology, such as with the common cold, then participation is usually okay as long as you feel well enough to do so. If participation seems to definitely worsen your condition, then avoidance is the best medicine. Also, when in doubt, it's always recommended to talk with your health care provider.

Prevention is obviously the best treatment when it comes to colds and flu. Flu shots can help prevent getting the flu and may be recommended depending upon your situation. Basketball puts us in close contact with others, and deep breathing while exercising puts the germs into the air and down into our lungs. Therefore, good hygiene is of paramount importance in trying to prevent and minimize the spread of illness. Hand washing is probably the easiest and most useful technique there is to help prevent transmission. Avoid doing things such as sharing drinks, utensils, food, towels and washcloths. Finally keeping yourself as healthy as possible with good nutrition and rest habits enables the body to be in its best shape to fight off illnesses altogether.

In summary, basketball season is always going to share the spotlight with cold and flu season. Neither necessarily negates the other, and there are ways to deal with both at the same time. Athletes often continue to compete during illnesses, and this is often times permissible. Knowing when to stop is important for both treatment and prevention of complications. Being truthful to how you really feel and paying attention to warning signs of potentially more serious illness is essential. A common sense approach to treatment, prevention and participation is advisable. Finally, never hesitate to talk to your health care provider to help you make decisions about your care.