Let’s Talk About Running… With Asthma

I’ve been trying to give some general advice for runners looking to get better and faster and train more efficiently, but before I get into any more details, there’s some additional information I want to share specifically for runners with asthma. Running with asthma is its own kind of difficult – because running wasn’t hard enough on its own, right – and I’ve learned a lot as an asthmatic runner in terms of how to keep training plans flexible because of this health disability. (I have a number of health problems, but asthma plays directly into running.)

About This Asthmatic Runner
I suffer from exercise-induced asthma (EIA). This means the very act of high-intensity exercise triggers my lungs into an asthmatic shutdown. What does it feel like to me? I start out by wheezing, and my breath gets very shallow. It feels like, no matter how hard I am hauling air into my lungs, I only get a small trickle that goes through. If I try to “push through it”, I eventually get to the point where it feels like I am gasping and panting as hard as I can and getting little to no air into my system. At that point, it feels like my lungs are full of tiny pins and every breath feels like it’s being poked by itty bitty knives. Once I recover, I’ll cough for probably the next 2-4 hours.

I’ve had plenty of EIA attacks triggered by running – especially sprints, intervals, and high intensity workouts – but I’ve also had it trigger in HIIT weight/aerobic/exercise classes my gym offers, and during BodyRock’s HIIT workouts: it isn’t just running.

My running stats are here, if you’re checking my street cred. I consider myself a decently average, overall middle of the road amateur runner. Even with asthma.

What It Means To Be an Asthmatic Runner
There are a couple things you need to train your brain to understand and be aware of, so that your expectations are reasonable and safe. The general running advice you find online will work for you – with certain modifications.

  1. Running’s going to be hard for you. You’re doing something your body doesn’t want to do – something your body so emphatically doesn’t want to do that it’s shutting down your lungs to try to stop you. This doesn’t mean you can’t run, but it does mean that some days are going to be bad. Some days are going to hurt.
  2. Running’s going to be harder for you than for other people. If you’re a competitive person, this is something you’re going to have tocome to terms with. If you like to train with friends, feelings of “how are they getting so much faster and I’m moving so slowly” or “how can they do that pace for a tempo run?” can show up. Running really should be only about you vs the clock, but with asthma, it’s even more so. People who don’t have asthma are going to find running easier than you do. You need to prepare your mind to let that go.
  3. You’re adding another variable to your performance. Runners who race already are concerned about race day variables: weather, course, sleep the night before, general mood, injuries, mental headspace… you’ve now added “lung condition”, or “asthma triggers”, to your set of stars that have to align perfectly for a race to go well. Sometimes, you’ll be feeling amazing, and then that asthma attack will just come (seemingly) out of nowhere and ruin a perfectly good run – or a perfect race. It’s hard to not be disappointed, but it’s just going to happen.
  4. You need to be flexible, self-aware, and honest. You need to be flexible enough with your training that missing a day, or having to rearrange a weekly schedule around days that are hot/cold/high pollen, won’t mess with your mental state. You need to be self-aware, so that you can learn the line between “pushing through a hard workout” and “this is going to lead to an attack”. You need to be honest with yourself when you’re approaching that line, and always err on the side of safety.
  5. Get a preventative inhaler. I have ProAir, and if I take it 20 min before I run, I can reduce the asthma effects I have on the run maybe 80%? It isn’t a perfect fix, but before the inhaler I was at the point where every run would end in gasping and tears. Even through the inhaler, I can trigger my EIA by going too hard or by weather conditions (cold, heat, pollen, etc), but it definitely helps. I also bring it on the runs with me, so in case it triggers on mile 5, I know I can make it home before the vampires come out.

How To Train As An Asthmatic Runner
The concepts I posted about developing a training plan (part 1 | part 2 | part 3) are all still valid. However, you can make your life a lot easier by making certain choices when designing that plan Рsince there are a lot of options Рto keep your training as pain-free as possible.

  • Prioritize the long slow run, and learn to do it. The LSR is already the keystone of any running plan; when you’re asthmatic, it’s your holy grail. Regularly running longer (slower, more mileage) is the way you’re going to build endurance, muscle, and running capacity without triggering your asthma. And you need to learn to do it right, which means, doing it so slow you feel like you’re slacking. Because here’s the thing: if you have an asthma attack on mile 7 or 8 because you’re tired and your exertion level is rising, you’re running too fast. Learn to run long and slow, learn to prioritize it, and do it. More long slow miles will build the base you need to race.
  • Choose your speedwork carefully. As I’ve said before in these LTA posts, I can’t do short sprinting intervals because they trigger my asthma. So I make sure to design speedwork that I know I can perform – tempo runs, and medium to long intervals. If I do put in any short sprints, I make sure that there aren’t many, and that they’re part of an overall workout plan that’s modifiable if my lungs are having a bad day: a course or setup where I have the option to turn to longer slower intervals if needed.
  • Be careful running outside. It isn’t just speed that triggers asthma: it’s exertion. Hills can set this off, even gradual ones. Sprinting to cross a road at a red light can set this off.¬† And when you’re running in a neighborhood and you’re 4 miles out and you have an asthma attack, you still have 4mi to get back home. Be smart and be prepared. Choose your courses wisely: hill training is still good for you, but be aware of how it’s going to affect your exertion level.
  • Make room in your plan for flexibility. Let’s say you go out on your long run, but your asthma hits 2mi into it. Can you turn that day’s run into an easy recovery 3 mile jog, and do your long run another day? Or, let’s say you got 5mi into a 9mi LSR. Can you do the remaining 4mi the next day? the day after? Maybe your tempo run botched. Can you turn it into a short easy run and do some speedwork in your next run? You get the picture here: just because a run went badly doesn’t mean your training plan is defunct. Stay flexible and just keep trying to get those long slow miles in.
  • Crosstrain. If running is really triggering your asthma – maybe you’re out of practice; maybe it’s allergy season; maybe it’s just too cold – you can add some crosstraining into your plan to help grow your overall fitness level in a way that’s easier on your lungs. I find that elliptical – while it definitely isn’t running – is probably the closest, better than bike or stairmaster. Instead of a 3 mi easy run, for example, do 30-40 minutes of a good effort on the elliptical. (Good effort is key: running is harder than elliptical, so you aren’t going to gain anything by coasting on the machine for 20 min.) You do still have to run to get better at running; use crosstraining as a supplement, not a replacement. But it will still challenge your cardiovascular system and help you build fitness.

The most important thing to remember when running with asthma is to listen to your body. Sometimes you don’t really know what the message is; it takes time to learn the language. Put in careful practice, and you’ll learn to work with your lungs, rather than against them.