Exercise Induced Asthma & Running

Here is the second part of a very interesting inquiry I received from a parent of a high school runner.

My daughter has exercise induced asthma which first appeared following a bout of pneumonia for which she was nearly hospitalized. Her track coaches expect her to run nearly all events at any given time, nothing is consistent from meet to meet or year to year. She is now a junior in high school. If she does a 100m sprint, as told to do by her coach about two events prior to running a 400m dash, she finds it extremely difficult to finish the race. Thus, her times are poor. She does much better if she simply stretches and does a light jog, or a brisk walk. What do you suggest?

OK, before I begin lawyers around the world want to be sure I tell everyone: I’m not a doctor and nothing said here is meant to contradict what your doctor says about your condition or use of medications.

I was diagnosed with Exercised Induced Asthma (EIA) or “Exertional Asthma” more than 25 years ago. I have been on long acting medications/inhlalers as well as the fast acting inhalers for acute asthma attacks. No doubt dealing with this condition poses challenges for athletes needing to breathe freely to perform their best. Shorter distance performances (like sprints -100/200) will suffer far less than longer distances when an athlete deals with bouts of EIA. By the way, EIA effects 12-15% of the general public. The good news is that for most people most of the time it is ranges from minor to sporadic and rarely keeps someone from fully participating in sports. There are EIC sufferers who are Olympic runners. Therefore, only in the rarest of cases should someone avoid sports due to EIA. In fact, it has been shown that exercise has far more positive effects not only on the lungs but the whole body that far outweigh non-participation.

EIA can be precipitated by environmental allergies, cold air, dry air, and dust amongst other things. Also, stress, dehydration illness (colds/flu) and a general run-down condition will increase incidents of EIA. It can be temporary and it can be geographically instigated (i.e. I never have problems on the coast or up north, but I do here in the dry dusty desert). So, practicing prevention is the first step in managing EIA.

Second, be sure to stay on the medications prescribed by your doctor. And keep your inhaler close by at all times when working out. I even have one girl run with it at all times. Either she puts it in a small pocket in her shorts or she keeps it in her sports bra.

One recommendation which I find absurd is nose breathing. True it may help because your nasal passages help filter and humidify the air before it hits your bronchi. However, if you are a competitive athlete in an aerobic activity there is no possible way you will take in sufficient air (oxygen) through your nose – even with a nose the size of mine! If you do a sprint you might get away with it. If you run anything from 400 meters on up forget it.

To the point of your question: Contrary to what your daughter is doing, more extensively warming up is one way to minimize and in some cases even eliminate EIA. Timing is everything however. Athletes should use a patterned warm-up. It is critical to do more not less in warming up. There are chemical changes that take place that help. [I won't even try to give a layman's explanation to what my Dr. described but it is related to histamines/anti-histamines.] The trick is that even if you have some breathing difficulties in warm-up you should work through it because there is a good chance you will be able to still compete well by the time the race starts. Next, use your inhaler as indicated during or just after your warm-up. ideally, you have about 15-30 minutes after administration of your inhaler to get the race underway.

So, I certainly could be wrong not observing your daughter firsthand but experience says to experiment with far MORE warming up not less. I would recommend a pattern like: 30 minute warm-up ending about 15 minutes before race time – inhaler as needed – relaxing – final strides warm up – race. If you run multiple races and time between races is short, stay warmed up and do not cool down.

Variations are great between EIA sufferers. The best thing an athlete can do is learn their unique patterns and response. Once you find something that works – stick to it!

Finally, part of coping with EIA is admitting that there will be good days and bad days and you may not have any control over it – with or without medications. Adopting a philosophical approach to those days and those performances is important to coping. It is still better to be out there doing something – even if not up to usual standards – than doing nothing and making it an excuse not to run/workout.

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About Dean Hebert

I’m a mental game coach, author and speaker. I work with individual athletes, parents, coaches, and teams on sports performance enhancement. Beyond my academic post-graduate work in sports psychology - the psychology behind athlete performance – I am a certified Mental Games Coaching Professional (MGCP) and certified hypnotherapist. I’ve authored several books and hundreds of articles. “Coach, I didn’t run because…” (2008) is a seriously light-hearted look at making excuses not to workout and how to overcome them. “Focus for Fitness” (2009) and “Screw the Goals Give me the Donut” (2010) are two of my eBooks on mental game approaches for the everyday athlete. I wrote these because I believe that everyone can benefit from the powerful mental techniques that the world’s best athletes use. I have been cited in Runners World, Best Health magazine (CN), SWEAT Magazine, and the Washington Examiner amongst many other publications. I have been a featured mental games coach in Runner’s World and for the internationally acclaimed trail running resource - trailrunningclub.com. I also regularly appear on sports and fitness talk shows such as LTKFitness, Runnersroundtable and for more than three years I have co-hosted a weekly video series with Coach Joe English for Running-Advice.com. I specialize in mental toughness training. My clients include tennis, synchronized swimming, golf, race-kart, soccer, motocross, volleyball, MMA, cycling (road, off-road, time-trialist), running, duathlon and triathlon, basketball, football and baseball athletes. I have coached world-class athletes and athletes internationally. I have a passion for working with youth athletes and helping them apply mental game skills and techniques to all areas of life. Most importantly, my aim is to have people enjoy sports and life to their fullest through peak performances.
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46 Responses to Exercise Induced Asthma & Running

  1. Dean Hebert says:

    Tidbit: One out of four Olympians have exercise induced asthma. 25% of US medals are won by exercise induced asthmatics.

  2. taraschiro says:

    From one EIA sufferer to another, it is nice to finally see some good advice on running with asthma. I also find the “nose thing absurd!” Longer warm-ups definately help.

    http://www.TaraSchiro.wordpress.com
    http://www.TaraSchiro.typepad.com

  3. Dean Hebert says:

    Tara,
    Thank you for dropping by. To all others… please drop by Tara’s blog. It’s a very good account of an individual with EIA. Bravo! and keep it up.

  4. Mike Caudill says:

    Hello Dean,

    I have lived in Tucson for over 5 years and have recently been diagnosed with EIA. I’m 56 and have been running for 35 years, so I am determined to overcome the discomfort. For me the symptoms are not wheezing or coughing, but chest tightness and a sort of raw feeling in the lungs that can hurt at times.

    OK, at 56 perhaps I’m more of a jogger but I choose to call it running. I run at least 5 times a week, from 30 minutes to an hour. The EIA is more or less controlled with an inhaler (Albuterol) but some days it really just hurts.

    Warm ups do help, but I have not found a pattern that works all the time. My guess is I will have good days and bad days. Today it was in the mid-70s and it was a good day. The doc says my EIA is heat induced.

    I travel a good amount and recently was in San Francisco – cool and damp. Took about an hour run along the bay toward the Golden Gate Bridge. No inhaler, no symptoms.

    Every day is different and I am determined to enjoy every day. Got any advice for me?

    Thanks,
    Mike.

    • Dean Hebert says:

      Mike,
      As a 30 plus year sufferer I’ll have to say you’re already on the right track. And that is not so much the inhaler as it is the attitude to adopt. You have to understand that there will be good days and bad days and accept them. It takes mental toughness to stick it out on the bad days. It takes full appreciation of good days when you get them. If yours is solely heat related then also running earlier in the mornings will benefit you. I lived in Tucson for 18 years… those early morning runs should be very tolerable. However, if you have allergies that contribute then know that those early morning hours often have very high pollen and mold counts down there.
      No real magic… no specific answers… just keep running though and don’t let it get to you.

  5. Mike Caudill says:

    Thanks for the encouragement, coach.

    A tip I would like to share with others adjusting to EIA. It’s the same advice I give new runners. Pick a distance and run until you need a rest then walk for while and start running again when you have relaxed. Walk / run your distance – but do the distance.

    I have heard this called “periodizing” – periods of running and resting. I did this today, temps in the high 70s this morning in Tucson. It was fantanstic: 10 min fast walk, 30 min run, 10 min fast walk, 20 min incredible run with a sprint or two – lungs filled beautifully.

    Excuse me for being giddy about it. Just got back – it’s a great day.

    –Mike.

  6. Dean Hebert says:

    Mike,
    this approach is actually very well founded… the more you warm up and the more thorough your warm up the less likely you will suffer an actual attack… I have not heard of this as “periodization” (which is a term relating to training plans) but it is a warm up approach that works. The idea is to be more warmed up than usual for the hardest part of the run… by which time you should run/breathe much smoother.

    • Mike Caudill says:

      Hello Dean,

      Last summer we exchanged thoughts about EIA. I was having discomfort when running and was diagnosed with EIA. However, the discomfort increased and upon further testing we discovered I had been mis-diagnosed. Instead of EIA I had two badly clogged arteries and was very close to having a heart attack.

      After a successful angioplasty to remove the blockages, I was back out running one week later. I have been running without discomfort since then and have taken big chunks of time off my runs (e.g. hour runs are now 45 minute runs).

      My cardiologist told me running saved me in two ways: it gave me the warning sign I needed to seek help (I only felt the chest pain when running, never working out at the gym or while at my stressful job); running also gave me a strong heart which was easy to work on and quick to recover.

      This Thanksgiving week I am thankful my life long habit of running gave me the warning I needed to seek help before it was too late.

      Take care and Happy Thanksgiving everyone!

      –Mike.

      • Dean Hebert says:

        That is one thing that we all have to take to “heart”… that sometimes what we THINK is one thing is really another… and far more serious. Thank you for sharing and welcome back!

  7. Anita says:

    Hi,

    I have only had EIA since June this year when I was doing a half-marathon and I had an asthma attack. It had come completely out of the blue. Seeing I was so gutted after doing 10 weeks of team training I did another one 3 weeks later, and this time just saved the asthma attack until the end.
    I am learning to accept that I do have to stop and walk for bits on long runs, to manage it.
    But this past weekend I had my next race. My asthma attack kicked in at about the 6km mark this time and I had to pull out halfway through. It is so gutting!
    How do you manage it in terms of a race like that? Because I was expecting it to happen, but I thought I’d get to finish the race at least! You can’t exactly do a half-hour jog to warm up, because you need all your energy for the race.
    Any advice? Suggestions?

    • Dean Hebert says:

      Anitas,
      You don’t mention paces and amount of training you do. If you were in a Team-in-Training program that is still considered a basic training program. What I mean is that the more in shape you get, the more you advance your conditioning the less common attacks tend to happen (but not always). Did you take your inhalers and meds as prescribed? Were you well hydrated? How windy was the day (that tends to kick up more dust, pollens, molds and pollutants which cause EIA)?
      Any patterns on temperatures… or weather that may cause your attacks?
      As you can see it becomes more complex and is not a simple straightforward answer. But, by noting patterns you can get better at predicting when you are more likely to have an attack.

      So, keep increasing your conditioning and be sure you do quality training along with your slower long run training. Note any patterns at all in when you get EIA. Take meds prophylactically. Stay hydrated.

      Keep running… and be patient.

      • Anita says:

        The training was quite intensive, I would run 5 days a week, with a bit of cross-training as well. I was aiming for 1 hr 40, which I think I’m totally capable of doing.
        The first 2 races were in the winter, in rain and drizzle, so I put them down to the cold wet air a bit. But Saturday was dry (at least while I was running), not humid, cool but comfortable temperatures. We did a warm-up before-hand. I take a preventor (which last week the dosage was doubled), plus another one Serevent, all of which I take religiously. I had my ventolin out there with me on the race and I took it before it started and then at least 6 times leading up to the attack. It was worse than my other 2 had been as well.
        I don’t know how to predict it, it feels like the medication makes no difference at all.
        I think there must be a reason for why I suddenly started getting it in June, and I think that it’s stress, when I look at the circumstances around then, and this year as well. So I’m hoping that when I leave the job I’m in in 4 weeks that it might go away like it came.
        I want to train for a full marathon next year, is this an achievable goal?

  8. Dean Hebert says:

    You are doing the right things. You hit it on the head… there is a very strong correlation between stress and asthma. So, time to also do some stress management… until the job goes bye-bye.

    Yes, a marathon should be very possible. You can run very well if you can run 1:40 for a HM. USUALLY attacks take place in races with very fast, higher and deeper breathing… i.e. the short races. The are usually less often in longer races. So, get the stress under control. Keep training. You can do this. I ran many marathons well under 2:50 with EIA… you can do it too.

    Stay in touch, I would like to hear how managing stress is for you in effectively managing your EIA.

  9. Anita says:

    First of all, it is so encouraging reading what you’ve said about managing EIA and also doing a marathon.
    We do long easy runs on a Sunday, which are never any trouble for me because they’re at a comfortable pace. I don’t even take my inhaler (and that’s saying something). But I shouldn’t have to just slow down to this pace all the time should I?

    If EIA is not something that you’ve had for most of your life there should probably be a reason for it suddenly starting right? That is my theory anyway. Because I’m very active, I’ve done half-marathons before, and even in all of my training leading up to my first attack there were no symptoms whatsoever. So if it has started suddenly do you think it can also go away the way it came? That’s what I’m hoping.

    What about hills? Is there a way that I can train myself to be able to handle them? Just suffer through?
    And in terms for preparing for a race, how do you keep yourself calm and relaxed enough about it to prevent an asthma attack?

    Thanks for your advice.

  10. Dean Hebert says:

    First, you can get EIA later in life you can get it from moving to new environments (i.e. from the northeast to the southwest). It might be seasonal as well as geographical. It can go away. But, with all I’ve read, I would say that someone who has had EIA has some underlying sensitivity to some allergen/cause that remains.

    As for paces, again, usually the harder paces (and heavier breathing) induce EIA. But “harder” pace is relative. Is it :30 seconds per mile faster? 1:30 per mile faster pace? Is it only running all out? There is no single answer other than knowing your own thresholds.

    As for hills, most runners try to run them too hard in the first place. Ease off and do not induce labored breathing. Besides, if you go up easier, you can catch up on the downhills with less effort on faster paces (therefore lighter load on your breathing).

    Finally, the mental aspects of this are so important. There are many centering, meditative, or self-hypnosis approaches even to help you. It is one of the things I work with athletes on. Take pressure off your racing by not thinking about results, or all the bad things that might happen (EIA, side stitch, cramps, bad day). Focus on relaxed controlled running and the things you do control in the moment. But again, there is no single answer. All our brains and emotions are run differently. Trial and error in practice is critical to getting an idea what will work on race day.

    Finally, you need a strategy to handle it if you actually have an attack… both mentally and physically. You must relax your breathing even while it is a struggle to do so. The more stressed you become over it the worse it will be.

    You can do this… but be diligent in using different strategies… log them and their effectiveness. You’ll be coping with this very well. Good luck and stay in touch.

  11. Sonya says:

    Hi Dean,

    I may have EIA, but I don’t know yet for sure. I’ve talked to my Dr. about it and he thinks it a possibility. He’s prescribed an inhaler, but I haven’t used it yet. I usually feel ok during runs and then experience shallow breathing and a tight chest afterwards.

    I just started a group training for a 1/2 marathon. I’ve felt good during the first two long runs except that I developed painful side stitches about halfway through the course.

    After doing some research, I feel that my side stitches are due to shallow breathing. Are side stitches common for people with EIA? Will an inhaler help reduce the chance of them occuring?

    I’m also realizing that I probably need to do some walk/run intervals which are usually very helpful for me.

    Thanks so much- your site has been very helpful.

    Sonya

    • Dean Hebert says:

      Sonya,
      First, congrats on getting out there regardless of the diagnosis. Running has been shown to greatly enhance pulmonary function and that is critical in EIA sufferers.
      Yes, shallow breathing COULD be the cause of your side stitches. It could be simply conditioning.
      Yes, use your inhaler… if that is the difference in being able to run without discomfort… then why would you avoid it? That is what modern medical science is for!
      Walk/run intervals are good for novice runners… if that is where you are at… then most definitely use this approach.
      Finally, I would recommend a breathing exercise to enhance all your ancillary as well as primary breathing muscles. Look into and use something like this:
      PowerBreathe.

      Good luck. Tell me how you progress.

      • Sonya says:

        Hello again,

        Today we had a 7 mile trail run. I’ve done 10Ks before, but nothing longer until today. I managed to keep the side stitches at bay. I am so happy about this.

        These are the things I did differently today:

        -Took 1 puff of inhaler about 20min. before run.
        -Really emphasized the exhale of my breath. This seemed to help the most. I was exhaling loud and with intention. When I forgot to do this, I could feel the side stitch beginning to surface.
        -I implemented regular walk/run intervals.
        -I concentrated on going at a pace that felt right for me. Slow, relaxed and steady.
        -I made sure to hydrate and drink extra water for at least 2 days prior to the longer run. I also drank water with electrolytes during the run.

        Running has brought to my attention how poor my breath and breathing habits have been. I have always had shallow, quiet breathing and I think I sometimes hold my breath without even realizing it. I’m grateful for the opportunity, through running, to have more awareness around this.

        It’s really encouraging to hear that running is good for EIA. My breathing has been pretty shallow all afternoon. I used my inhaler once, which only seemed to help a little.

        Tomorrow is a rest day, which I am happy about!

        Thank you again so much for your support and for your informative site.

        Sonya

  12. Dean Hebert says:

    Sonya – Well done. Thank you for contributing your process. I like that you documented it. That is how we learn what works and what still needs to be tweaked.
    Keep it rolling!

  13. jim pillow says:

    dean,thanks for your info. as a runner I too suffer from asthma , last summer I was running 10-12 miles no problem but winter and cold weather have brought my running down to 1-2 miles, my heart rate runs 156 to 178 it normally runs 127- 143 and I find breathing VERY difficult. finally warmed up to 70* and I finished my first 3 miles in 6months. it felt great, my question is will, or can I regain my longer distances?? I love to run and would love your advice.. thanks jim

    • Dean Hebert says:

      Jim,
      The fact that you were once were @ 10-12 is a good omen that you will return. Often asthma is seasonal and certain weather brings it on – dry air, hot air, cold air, seasonal allergens – and once those go away often you return to former breathing. So, as with any build up, be careful and just go gradually on your way back. By the way, though you had elevated HR that is almost no worry to me whatsoever unless you have heart disease. The heart is a muscle and it is simply responding to the demand from the body for supplying that oxygen. Since less is coming in, it accelerates the pace to attempt to deliver more. Of course, rather futile in that none is being supplied from the laboring lungs.

      So, though the HR indicates you were struggling… do not use that as an indicator of whether to run or push on or not. On the other hand listening to your breathing and managing any possible impending asthma attack (using inhaler) is important.

      Hang in there!

  14. EM says:

    Dean – thank you! I have been watching my patterns and believe I have EIA! I did some experimentation and found that warming up does wonders, also if I use my inhaler at least 20-30 minutes prior to any exercise or running, I can definitely last longer and it’s great – no emergency inhales needed! Since my allergist hasn’t been able to pinpoint what is wrong with me, now I can tell them I think I have the answer! Thank you so much for sharing your information.

  15. Therese says:

    Dean,
    I just found your blog and I am so glad I did. I am 50 and have had diagnosed EIA for 2 years. In Sept. I went to my Dr. and got the script for my Qvar increased from 40 to 80 mg to use morning and night. Also, I am now on a rescue inhaler, that I was told to use before I run. I am not doing so well with my running, but blame it on the cold weather coming and I’m not getting out as much as I used to. Any thoughts? Should I just push myself harder?

    • Dean Hebert says:

      Therese,
      I’m not familiar with Qvar. But, using your inhaler before workouts is a good idea. It will take some trial and error to figure out for YOU how long before you need to take it. Cold weather can indeed exacerbate EIA. The better approach is to run easy for a bit, do a few pace pick ups… then rest a bit. Use it like a good warm up – and then settle into your workout. Oftentimes when you do this, you may labor in that first “warm up” period but after a short rest… you breathe easier. So, I would push PORTIONs of your running for sure. But you have to monitor how you react and what you patterns are. I have found that no two people react the same. So, don’t give up and instead treat workouts as experiments for now. You’ll find patterns. Learn from them and modify workouts, efforts, timing of workouts, timing of inhaler use, etc. Also, hydration is critical… regardless of weather. So stay on top of that. Don’t give up… you’re better off exercising than not!!!!!

  16. Pauline Baggarly says:

    Thank you for your blog.
    I have struggled with Asthma one form or another all my life. I started running in 2008, and more recently have been getting into doing speed for the longer distance. I have found, i can do short distance speed work without much trough (i.e.: 400’s, 800’s, up to about 1600’s), however, tempo runs (maybe keeping a certain pace for an extended period of time) has always troubled me. I have found that allergens are the worst and cause me the most discomfort and still working with the medicines. But my racing days that I can give the best effort, and perhaps PR are between Sept-Dec, the rest is training for those months, and struggle to figure out what works best. Jan-April being my work allergy season. But I still run and just run slower and not be hung up “on my time”. Every year I have improved, but it is a bit discouraged for so many months to see your progress from the previous year, appear to have disappear… and I know it’ll be back, so the message I am sending is really to thank you for acknowledgement to us who like to run and compete, and not to minimalize what we go through. — I am holding up my Inhaler as a toast of appreciation of this and to continued effort to keep healthy, cheers! – Pauline

    • Dean Hebert says:

      Pauline,
      Thank you for dropping by.
      Cheers to you for hanging in there!
      One approach you may try is to substitute any tempo styled run with workouts of even higher number of reps of the faster stuff. That is, increase the quantity of your quality. And you can push the quality faster too! These can compensate – conditioning-wise – to a large degree for those tempo runs. Of course, come race day, you’ll still have to get those “right days” to be able to race well but, you should be able to continue your improvement!
      Keep it rolling!

      • Pauline Baggarly says:

        Hi Dean Sept 30th, I’ll let you know how this worked! Running Wineglass marathon!! Cheers, Pauline

  17. Christine says:

    Hello,

    First of all, thank you for this entry. I know it was posted a while ago, but I just came across it and found it to be very encouraging and helpful. I’ve had EIA since I was a child, and I’ve been a swimmer my whole life. With swimming, my asthma stays relatively controlled, but I have recently picked up running. My biggest problem is I develop anxiety when I feel my asthma giving me trouble. I can push myself through mental fatigue, muscle fatigue, but when my lungs start hurting, I immediately begin feeling anxious and I don’t know how much to push through it or to back off. I feel it’s an issue of trust, and perhaps not knowing how much my lungs are capable of when running; I know I can push myself through muscle fatigue and will be fine, but I don’t trust that I can push myself through chest pain and not have any repercussions.

    Would you have any ideas for this and how to not panic when my breathing becomes painful and really difficult?

    Thank you for the entry, again!

    • Dean Hebert says:

      The anxiety that comes along with asthma is the double-whammy. More anxiety yields a worse attack – more tension in the body, etc. So the answer is relaxation exercises, relaxation response through cues or triggers, visualizations, etc. It’s retraining your brain to REACT differently to the breathing difficulty. Through stress/anxiety reduction your attacks are greatly lessened. So, practice relaxation techniques and apply them at those moments. It does require practice to get good at that response. Keep on!

  18. bob says:

    got a question I’m 34 and 3 years ago i had double lung pneumonia. I have never had to work at being athletic before if i wanted to i could run 3 miles with no problem. now i want to run to get my lungs back in shape and my lungs feel like they are burning in just 2 or 3 hundred yards my lungs feel like there burning i dont have the money to go back to doc. i can still force my self to go a mile but lungs burn the hole time. i know i should see doc but money is tight.

    • Dean Hebert says:

      First, if you have asthma then you are in a riskier situation and have to be careful coming back. If you were given the “clear” to go back to running by your doc then you need to do so very gradually.
      It is expected to be uncomfortable breathing in the process.

      I can’t advise you medically. One symptom such as “burning” doesn’t necessarily mean anything – on the other hand combined with weakness, lightheadedness, fever, coughing and pain in your chest/lungs are not good signs! You may need to get back to the doc. That being said, I think it would be very unusual to have some kind of lingering pneumonia after 3 years!!!!

      After all this time I think it’s a matter of inactivity, loss of conditioning that is more likely the issue. You could try some inspirometers that are good for getting lungs and breathing muscles in shape.
      This device has actually been used with athletes for conditioning purposes even though the original use was medical. http://www.powerbreathe.com
      It’s an inexpensive option for you to try.

  19. Linda says:

    Thank you so much for this post! I was diagnosed with EIA this past summer and have been having a real tough time dealing with it! I ran a HM this past Sunday and it was one of my worst ever! Asthma kicked in around mile 6 and my anxiety and panic caused it compound my asthma until I was reduced to a walk! I am a very competitive person and having my body betray me after several years of competitive running is taking a toll on my mental game (to say the least)! I appreciate the comments regarding “retraining my mind” to handle the attacks differently. If anyone has any suggestions I would really appreciate it. I have an appointment with a pulmonologist next week and hope to get some better medications as the Proventil doesn’t help once the attack comes on.

    • Dean Hebert says:

      Actually it’s unusual that an attack would happen that far into the race and at a long distance race at that. It is far more common to have attacks when going very fast and breathing hard – and far more common to have an attack very early on or AFTER a very hard short race. You need better meds for sure. If you do not do relaxation exercises, you need to learn them and do them regularly. Learn how to do body scans during runs and races so you can keep tabs on how your body and breathing are doing BEFORE an attack hits. Hang in there.

  20. Debbie Sharkey says:

    Hi I have EIA and do triathlons. The problem is I have being doing them for 2 years and I’m not improving. What am I doing wrong ? Also how can I not get depressed when newbie’s join the triathlon club and within 6 months are beating me.

    • Dean Hebert says:

      I understand your frustration! In my opinion – it appears you may have a couple things to address. EIA itself does not mean we cannot improve in sports. Far from it. There are Olympians who are asthmatics.
      So, unless for some reason your case is out of control (with meds and more…) the reason you’re not improving is broader in my opinion. If athletes hit a plateau it is more often a case of training. To progress your training must change, morph, progress. If you do the same things you were doing when you started you cannot improve. Error #1 that I find is lack of properly constructed quality workouts followed closely by #2 – training that isn’t in cohesive phases. The 3rd element for triathletes is that they do not pay attention to decreasing transitions times and think that training alone gets them better… though predominantly true, you have to look at all aspects to improve.
      And finally your last comment indicates that you would really benefit from mental toughness training. You have to learn to focus on YOU and not others. You do not control another athlete in any way shape or form…you only control you… your effort, your training, your attitude, your focus, your actions etc. Allowing what others do adversely affect you means you are giving away your mental power and energy over to them. And that diminishes your physical energy. Want more? It also has been shown that negative emotional responses (i.e. stress etc.) make asthma worse! Mentally tough athletes fight this with all the various techniques at our disposal.
      Bottom line is that I think your EIA is not the main problem. That is not to say it is irrelevant. It is to say that runners/triathletes can improve regardless of having EIA or not.

      If the opportunity presents itself and you wish to pursue either of these aspects… drop me a line.

      • Debbie Sharkey says:

        Thanks very much for your comment. I understand and agree, as to how better others are I know I should focus on myself but feel those without EIA seem to always overtake me and I get so frustrated. I need help from a personal fitness coach or running coach to look at the my exercise routine and tell me where and how I can improve my training, which in turn will improve my race times. Is it too late to do something different in a race, or does it have to be the training ? The reason I ask is for the last 4 years I have done the same 10km race. I had a good time for me in 2010 (56:36:34) 3 years ago and since then my time has crept up, 57:01:00 in 2011 and 58:49:00 in 2012, so should I look at my watch during the race and adjust my speed or can I just concentrate on finishing ?

  21. Dean Hebert says:

    Debbie,
    One of the services I offer is training review, analysis and prescriptions to improve training. As for “is it too late” for a given race – it depends on when the race is. That being said, the sooner you make changes… the sooner you will get better results. If you are interested email me and we can start with the completion of an information form. Your times indicate that you can improve and so do not become discouraged. coach@rxrunning.com

  22. Marleygirl says:

    I know this was posted a long time ago, but I was hoping you might have some advice for me…
    I am almost certain that I have EIA, I have many of the key symptoms like wheezing, coughing and tightening/aching of the chest after strenuous exercise. I have never seen a doctor for it and cannot have it diagnosed. I have been offered a pilot slot in the Air Force and a diagnosis would instantly disqualify me. I have never had an actual asthma attack, and don’t think my EIA is very bad, I just can’t perform nearly as well as I would like to. I have been running regularly for about 4 months now, but can’t get my pace much below a 9 min/mile for anything over 1 mile. I can run consistently at a 10-12 min/mile for 3-5 miles. I have currently been doing the ‘in through the nose-out through the mouth’ method for breathing, which actually really helped me in the beginning. I think it was because it forced me to think about/slow down my breathing. Do you have any tips on how I should be properly breathing while running or know of any breathing exercises I could do without much equipment? I’m also curious as to how I should be training. The Air Force cares about your speed on the 1.5 mile run and not as much about distance, do you have any tips for increasing my speed?
    Thank you so much for the article, I’ve read though all the comments and already have some new training ideas, I was just hoping you might have a minute to give me some advice! Thanks!

    • Dean Hebert says:

      Congrats on getting your pilot slot. Here are a few things. If I’m not mistaken you’ll have to do the 1.5 in about 12:00 which is an 8:00/mile pace. You can do that. EIA or not.
      1. Get a PowerBreathe unit. They are good for all breathing related ailments AND athletes. I have one and still use it. (http://www.swimoutlet.com/productbrand.asp?Brand=1657&gclid=COqlhZu27bUCFZE-Mgod-HMAOQ) Hospitals use them and they are used in many athletic arenas too. PS – get the cheapest one. They all work.
      2. There is no complete substitute for inhalers if you have a bad case of asthma or EIA. That being said – here are some tried and true things to try:
      Stay hydrated – any dehydration will exacerbate the breathing issues.
      Warm up extra well before doing really hard efforts. That means get to point of having some breathing issues then STOP. Recover. Then go on with your real workout.
      A home remedy for the wheezing/coughing is hot sauce in water. 3-6 oz. of water with some shakes of hot sauce (your choice). Drink it down. It may not taste great but it acts as a bronchodilator. I have used this PRIOR to workouts as well.

      I hope this helps…. good luck!

  23. Kate West says:

    After walking my dog in the winter and coming inside 2 different times I experienced difficulty breathing and my right eye swelled shut for 4 days. I have always been allergic to pollen etc. Had tests not allergic to dogs. In the last 2 weeks after running outside in the cold and coming in I again had trouble breathing, wheezing, coughing tightness. Again my right eye has swollen up (huge). I was given a puffer which seems to help with the breathing but what is with the eye swelling? I’ve had patch test but nothing significant showed? Even putting cold clothes and benadryl right away don’t keep it down.

    • Dean Hebert says:

      Kate,
      I wish I had something to offer. Benadryl would have been my first choice because it sounds like an allergic reaction. Time for the Doc I think. Ask if there are specific eye drops that act like Benadryl…

      • Kate says:

        I have seen my family Dr., eye Dr., Allergist/Immuno Dr. I am thinking that it may be due to hormones as I have read that asthma sometimes starts up in your 50’s especially when you are lean ( I am very) . I don’t get how the eye and the asthma are linked though. Maybe if I can prevent the asthma I can prevent the eye …..
        Thank-you for your venue

  24. Shayla says:

    Hey Dean,

    I have suffered with EIA for about 15 years now. I am a very active person. Go to the gym regularly. I do weight training, as well as cardio training on the elliptical, stepper, and the bike, without experiencing much, if any, asthma symptoms (good days and bad days). Running though, is what really gets to me. After just a couple minutes of running, I feel my chest start to tighten up, and I feel that I am not able to breathe well enough to continue. I mean, I probably could push through it for a bit longer, but it makes me nervous. Up until now, I have avoided running at all costs, but I do love running and would love to be able to do a half marathon in the near future. I haven’t been to see the doctor regarding this for years. She had given me a couple puffers, but never any medication. How well does it work? Is it something I should try out? Do you have any other suggestions for me to slowly “build up my tolerance” to running?

    Any help would be much appreciated =)

    • Dean Hebert says:

      It is rare that someone with asthma could not run at some level. And in most cases running helps asthmatics not hurts them. But ultimately this is between the athlete and doc to decide.

      I completely know the nervous feeling of getting to that edge and not wanting to push further in fear of having a full blown asthma attack. The hardest thing for someone with respiratory issues is to go through the experience of “getting in shape”. That means being winded during aerobic activity is normal for EVERYONE trying to get in shape. It does not mean that if you are struggling a bit with breathing that it is because of asthma… it could be just expanding your horizons of conditioning. You’ll have to learn the difference. That is an “experiment of one”. No one can feel what you feel.
      Here are some differences:
      Asthma is associated with a constricted feeling, wheezing, coughing (bronchospasm), shortness of breath.
      Lack of conditioning may have shortness of breath but you recover when you stop.
      If you live in hot dry climates (as I am in AZ) a dry-raspy-raw-burning sensation in your throat from breathing harder on a run by themselves are NOT asthma.

      That being said… you should have an inhaler WITH YOU as you explore running and trying to differentiate your breathing issues. Inhalers ARE medications. It’s not too often that the average asthmatic need pills of some kind. They are generally prescribed inhalers of various kinds (long acting, short acting, different chemical combinations). If one inhaler doesn’t work really well then there are plenty of substitutes. There are very typical inhalers but might take a couple different ones to find what works best for you. Unless the asthma has been found to be initiated by allergies then allergy meds might be also prescribed. Take the inhaler as prescribed.

      And I can’t underscore this enough: an inhaler doesn’t make you breathe better if it’s a conditioning issue. They help only if it is an asthma reaction in your lungs.

      There is not secret to building up. Go slow. Vary paces and efforts and distances. Don’t do the same thing everyday. RELAX! Tension and stress have been associated with asthma. Think “relaxed” running. If you want to be cautious then start by running on a treadmill so you aren’t far from home (gym) and others. It may offer some security and let you relax more as you run.

      I hoep this helps some. Stay in touch. I’d like to know how things go.

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