Buzz
Running on a chilly fall day is invigorating. The cool air, your energetic pace, and—wait, what’s this? A sudden cough and maybe some wheezing. Don’t worry, you're not out of shape. It turns out that coughing after exercising in the cold is more common than you might think, and you're not the only one dealing with it.
Let’s talk about a few reasons why this coughing happens, with the main one being exercise-induced asthma. Keep reading, though! This is actually a lot more common—and underdiagnosed—than many athletes and casual exercisers realize. Research has shown that 8% or 16.5% of Olympic athletes (depending on the study) suffer from asthma, and it's even more prevalent in the sports that seem to trigger asthma symptoms the most. So if you find out you’re among them, you’re not alone.
(On a side note, scientists have several theories on why asthma is so prevalent in elite athletes. One idea is that the exercise itself might cause them to develop asthma, which seems contradictory to other findings showing that exercise can improve asthma symptoms. Another theory suggests asthma might provide athletes with some advantage. Personally, I think elite athletes have asthma at the same rate as the general population, but they’re just more likely to be diagnosed. Us regular folks tend to assume we're out of shape and figure we might as well stop exercising if we’re going to cough every time we do it.)
You might actually have asthma, even if you’re completely convinced that you don't.
For as long as I can remember, I’d always cough after intense exercise, especially in cold weather, but I was never diagnosed with asthma. I certainly wasn’t one of those kids who had to carry an inhaler. I could exercise just fine in summer, and the cough didn’t hold me back too much in the winter. I figured it was just a sign that I was out of shape.
It wasn't until my thirties that I started thinking maybe I actually did have asthma. It all clicked when a cough, unrelated to exercise, lingered even after I'd recovered from the infection that caused it. My mother suggested I ask my doctor about an inhaler. Not only did it clear up the illness-related cough, but I also realized that I could use the inhaler to ease, or even prevent, the coughing that would occur after running hill repeats. Interesting.
Later, I spoke to a doctor about my symptoms: I cough and wheeze (hearing a whistling sound while breathing) after hard exercise, particularly in the cold, and it’s worse when both factors come together. It’s less likely if I take my time warming up or if I cover my face with a scarf. The coughing also occurs less often when I’m in the habit of running regularly. Bingo—this is a perfect match for exercise-induced asthma.
Doctors might use different names for this condition. You might be told it’s exercise-induced asthma (EIA), exercise-induced bronchoconstriction (EIB), or just plain asthma without extra qualifiers. When asked, I usually describe it as mild asthma triggered by exercise in cold weather.
What Exercise-Induced Asthma (EIA or EIB) Looks Like
The typical symptoms of this condition, according to the American Academy of Allergy, Asthma, and Immunology, include:
Wheezing following exercise
Coughing after physical activity
A sensation of tightness in your chest post-exercise
Shortness of breath after exercising
Chest discomfort (though rare) after exercise
Chest pain and breathlessness can signal other, potentially more serious issues, so it's important to get checked if your symptoms are severe or if you have other health concerns.
The symptoms of exercise-induced asthma usually appear five to 20 minutes after activity (so you may feel fine initially and then start coughing), but they can also occur during the exercise itself, as I've experienced during the later stages of some longer runs.
What Triggers Exercise-Induced Asthma
For many people with exercise-induced asthma, there are no symptoms outside of exercise, and the only time it becomes noticeable is during physical activity. Others, like myself, may experience additional triggers (such as allergies or respiratory infections). Of course, for those with asthma that affects their daily life, exercise may exacerbate the condition. In any case, here are some common triggers that may cause or worsen symptoms, according to the AAAAI:
Cold weather, especially when the air is both chilly and dry
Dry air (I learned the hard way not to do HIIT on an airbike)
High-intensity intervals, particularly without a proper warmup
Being out of shape
Uncontrolled nasal allergies
Vocal cord issues
You might also find that symptoms are more likely to occur when air pollution or pollen levels are high.
How to Prevent Asthma Symptoms from Flaring Up During Exercise
If possible, speak with a doctor. They might run tests to check for asthma and could also talk to you about allergies, as avoiding allergens might ease asthma symptoms. For some, a doctor's visit might be just a quick conversation about symptoms, followed by a prescription for an inhaler to see if it helps. If your asthma is more complex, additional treatments may be considered.
No matter what happens during your doctor's visit (or if you haven't seen one yet), here are some helpful strategies for preventing or managing coughing and wheezing:
When exercising in cold weather, be sure to cover your mouth and nose (a cloth face mask works well, or a scarf or buff is a good alternative).
Try to breathe through your nose as much as possible. (Your nose helps warm the cold air before it enters your lungs.)
Start with a thorough warm-up before diving into intense exercise. A 20-minute session that gradually increases in intensity, with some short sprints near the end, may help reduce wheezing during the workout.
Keep an eye on the air quality index and consider moving your workout indoors if pollution, pollen, or smoke levels are high.
Avoid extremely cold or dry weather.
Use your inhaler as prescribed, and you may be advised to take two puffs of your blue/rescue inhaler about 20 minutes before exercise.
Though not an official tip, I personally avoid anything that blows air directly at my face during exercise. This means no airbikes, especially for intense workouts like Tabata sprints, and I prefer using a handheld fan on my neck rather than placing a box fan in front of me while using a treadmill or spin bike.
Other conditions that could cause coughing during exercise
There are other possible reasons for coughing and wheezing during exercise that are not related to exercise-induced asthma. Here are a few additional factors that could be contributing to your symptoms.
Track hack. A ‘pursuiter’s cough’ or ‘track hack’ refers to coughing that happens after exercise, but without wheezing and typically not severe enough to need treatment. If you experience an occasional phlegmy cough that isn’t bothersome, don’t worry about it. Just keep going.
If you have a cold or if allergies are flaring up, this can impact your breathing and may even trigger exercise-induced asthma if you're prone to it.
Exercise-induced laryngeal obstruction (EILO) happens when your vocal cords block your airway instead of opening to let air flow freely during exercise. EILO is sometimes mistaken for EIB, so if your EIB treatment isn’t effective, it could be EILO, not EIB.
Certain heart conditions can cause symptoms like shortness of breath and chest pressure. If this might be the case for you, it's important to get checked out.
If you think you might have exercise-induced asthma, you probably recognize yourself in the symptoms described above. If not, consider whether your cough could be linked to one of the other causes listed. And if you’re unsure or think you may need medication, it’s important to seek medical advice to get a proper diagnosis and treatment.
