Run Well by Juliet McGrattan (reading books for 5 year olds .TXT) 📕

often used interchangeably, but there is debate as to whether they are the same thing, what causes each one and ultimately what is the best way to treat them.

A runner with EIA gets symptoms because they have underlying asthma and exercise is the trigger. A runner with EIB gets symptoms despite not necessarily having asthma. The American College of Allergy, Asthma and Immunology states that as many as 90 per cent of people with asthma also have EIB, but not everyone with EIB has asthma. EIB is more common in cold weather sports, such as skiing and ice skating, and in endurance running. The exact cause of EIB is unknown, but it is thought that heavy breathing during exercise causes the airways to dry out. This dehydration then triggers a range of chemical substances to be released in the lungs, which leads to inflammation and airway narrowing. Reliever (usually blue) inhalers such as salbutamol stop airway spasm by relaxing the smooth muscle in the lining of the airways, allowing them to open up. This is an ideal first treatment for EIB and salbutamol can be used 15 minutes before a run to help prevent it. However, if the underlying cause is more complicated and involves any inflammation, which may be the case in EIB and is certainly a component of EIA, then treatment with preventer meds such as inhaled corticosteroids need to be considered.

It’s tricky for the GP that sees you with your exercise-induced cough or wheeze! Advanced lung testing to determine the exact cause of your symptoms isn’t readily available for recreational athletes, and usually it’s a case of exploring your history and symptoms to determine whether you may have an underlying asthma, and monitoring your response to treatment. This is clearly not ideal, so don’t be afraid to make a further appointment with your GP if your symptoms aren’t improving, but read on as there may be another cause too.

Q Sometimes when I run I can feel my throat closing up and I can’t get enough air in. My breathing is very noisy and wheezy. It happens mostly when I race and I’ve had to pull out as I just can’t breathe.

A It’s often assumed that all wheezing and breathing symptoms when you exercise come from the lungs, but this isn’t always the case. There is a condition called Exercise Induced Laryngeal Obstruction (EILO) that is increasingly being diagnosed, but is still often overlooked. The larynx is your voice box and during intense exercise it can sometimes become narrowed. We don’t really understand why this happens, but the delicate folds of tissue in the larynx close in, partially blocking the airway and leading to a noisy, wheezy inward breath as air tries to squeeze past. It is more common in young, adolescent athletes. Currently, the only definite way to diagnose it is to look at the larynx with a fibre optic laryngoscope (a small camera on a tube that goes up the nose and down the throat) while the patient is exercising at full speed on a treadmill or rowing machine. You may also hear the term Vocal Cord Dysfunction (VCD) to describe this phenomenon, but the narrowing really occurs above the vocal cords. EILO doesn’t respond to the (blue) reliever inhalers such as salbutamol used in EIB. Instead, treatment centres on behavioural management with a speech and language specialist. Techniques involve relaxing the neck and throat muscles, learning breathing techniques for when the symptoms start, and identifying and managing triggers such as stress, which might account for increased symptoms during races. If you think you may have EILO then discuss your suspicions with your GP who will be able to refer you to a specialist for investigation.

Real-life runners

During races and training I was finding it really hard to breathe, as if I couldn’t get any air in at all. I discovered that this happened when I was stressed. Since I learnt how to calm my breathing down it has been fine.

Steven, junior athlete and cross-country runner

TRY THIS

AT HOME

Diaphragmatic breathing

The diaphragm is a sheet of muscle beneath our lungs, dividing our chest cavity from our abdominal cavity. Its contraction and relaxation creates and releases a vacuum, which pulls air in and out of the lungs. Many of us, however, tend to use our upper chest muscles to drive our breathing. By focusing on and maximising our diaphragmatic breathing we can ensure that we’re getting the most out of each breath, which can potentially help our performance. If you observe a young baby, you’ll see their belly blowing in and out as they breathe. This is what we need to try to relearn.

• Lie on your back and place the flat palm of your hand on your abdomen, just below your rib cage.

• Take a breath in. As you do so, try to keep your shoulders and chest still, and use that breath to blow out your belly. You should see your hand moving upwards.

• As you exhale, watch your hand sinking back down again.

• Repeat this for 20 breaths or until you want to stop.

When you’ve mastered this technique lying down, you can try it sitting, standing and eventually running. When you do it, always make sure you have good posture and are standing tall with your shoulders back. Complete a session of diaphragmatic breathing every day and gradually it will become natural. Spending some time quietly focusing on breathing in this way is also a great relaxation technique.

Q Is it OK to run with a cold? I get one every winter and don’t want to miss training.

A It can be really hard to maintain training right throughout the main cold and cough season. When a respiratory infection strikes, it’s usually a virus and your airways respond by producing more mucous – which makes you feel very stuffed up, affects your breathing and can make you cough. The mucous may all come from your upper airways, drip down the back