Antibiotics and Exercise

Nicole Porter

In the continuing saga of illness and exercise - my ENT is putting me on a round of Cipro related to my continued sinus issues. My concern is reading about the possibility of tendonitis and tendon ruptures while on this medication (my boss also just dad-ed me about this via text). What do our gurus know about this and what precautions should I take?

Sawyer Paull-Baird

This is a new topic for me, so certainly not an expert. I did just review a handful of google scholar articles though and found some of the following information:

Here are a few other full texts you could review but most of the information seems consistent with the above:

https://fqresearch.org/pdf_files/Fluoroquinolone-associated-Tendinopathy.pdf

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2921747/

I don't feel comfortable making a recommendation one way or another about the safety of exercise specifically with regards to using these antibiotics. I would err on the side of whatever your doctor recommends. That being said, if you do exercise, below are some precautions you could take if you wanted to be extra cautious:

- Reduce your loads in strength training based exercise by 20%. Stay away from exercise to failure until you stop the medicine.

- Avoid impact such as jumping or running. Opt for lower impact activities such as biking, swimming, etc.

- Do not jump if doing FS class

- Perform proper warm ups prior to exercise. Perhaps get into FS early and warm up on a bike in addition to the pre-class routine. Get a good warm up in prior to SS.

- Be more sensitive and aware of joint pain than you normally would. Err on the side of caution if you experience any pain, and stop the activity that causes it.

Interested if @Mike Stack has any experience with this.

Nicole Porter

Thank you! That's consistent with what I was finding - that it can happen, but the incidences are very low. My doctor said that Cipro was very safe and to continue activity as tolerated when I reached out to him; I'm waiting to hear from a pharmacist friend, too. Just covering my bases, I don't want an injury before race season now that I can breath through my nose again!

Mike Stack

Thanks for tagging me @Sawyer Paull-Baird! @Nicole Porter, your concern is a valid one if you do a quick Google search, the good news is there is likely little concern given the type of activities you engage in. Certainly if you were performing more high-intensity, reactive, sporting activities this might be a bigger concern (but even then, as you mentioned, the incidence is low). I would suggest you continue exercise like normal and listen to your body. As Sawyer said, if you start to notice anything abnormal I would scale back intensity, or maybe even terminate exercise for that session.

In terms of exercising with overall illness, I have a good general rule of thumb, if your symptoms are neck up, exercise is likely very appropriate, if your symptoms are neck down, it's best to take some time to recover until you are symptom-free for 24-36 hours. Maintaining this rule will prevent you from getting sicker. That being said, I think your overall orthopedic risk is very minimal being on Cipro.

Nicole Porter

Thanks everyone! I also checked with my GP and a pharmacist so I have everyone's input rolling around my head while I'm working out!