Few things are more frustrating than when your body feels strong and energized enough to run for miles, but breathing issues prevent you from going the distance. For some runners, a nagging cold or an asthma flare-up is to blame. For others, it’s due to a structural issue in the nose itself—most commonly, a deviated septum.
Mastering how to breathe while running is tricky enough as it is, and running when you have a deviated septum can add extra complications. Fortunately, there are a few things you can do to help improve your breathing and keep running strong.
What is a deviated septum?
The thin partition that separates the nasal passages inside of your nose is called the “septum,” and, ideally, it should stand in a straight line from top to bottom. In actuality, the septum is slightly off-center in nearly 80 percent of us according to Harvard Health—with no noticeable effect on breathing function. But when this cartilaginous structure is significantly bent out of shape either at birth or from some type of trauma to the nose, one or both nasal passages could become blocked as a result, severely restricting airflow through the nostrils.
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Having a deviated septum can make it more difficult to breathe when running, but it can also affect other areas of your life. According to the Mayo Clinic, not being able to breathe comfortably through your nose could disturb your sleep—which, in turn, might negatively affect your performance.
How do you breathe when running with a deviated septum?
The feeling of not being able to breathe well through your nose on a run is an annoyance at best and a workout-disruptor at worst.
Douglas Nadel, M.D., an Otolaryngology Specialist at Pinnacle ENT Associates in Doylestown, Pennsylvania, sees a number of patients who are athletes; those who have deviated septums often tell him that they feel the issue hinders their performance.
“Your nose naturally warms and humidifies the air that you pull in,” Nadel says. “When you’re exerting yourself, you’re likely going to be doing some breathing through your mouth, much more so if you have a nasal obstruction that impedes breathing through the nose.”
Pulling cool, dry air in through the mouth can trigger narrowing or inflammation of the bronchial tubes, which in turn makes breathing on a run difficult—particularly for those who suffer from allergies or asthma. Inefficient breathing that results from a severely deviated septum could have an impact on your running.
Mike Watts is the Director of Athlete Performance at Under Armour and a master instructor of “The Oxygen Advantage,” a program that focuses on breathing technique to scientifically enhance performance. He commonly works with elite athletes who have deviated septums, and part of his training strategy includes easing them into nasal breathing (what he refers to as functional breathing) during exercise.
“Functional breathing is diaphragmatic and rhythmical; it helps with an individual’s performance, recovery, and even sleep,” Watts explains. “Because nasal breathing is slower, it gets down deep into the lower airways, increasing the buildup of CO2—which is necessary for diffusing oxygen—and it releases nitric oxide, which is basically a vasodilator.”
What can you do about it?
If you have a deviated septum that doesn’t completely block the nasal airways, the best way to improve how you breathe through your nose during runs is to train while you’re not running.
“Take baby steps,” advises Watts. “If you go straight to nasal breathing on your long run, you’re probably going to fail miserably and just give up.”
Expert tips for easing into functional breathing practices with a deviated septum:
Try it first while at rest: Set aside two or three minutes a few times per day to sit down and breathe in and out through your nose. “If you focus on making it quiet, slow, and controlled, you will start to develop a sense of ‘Okay, I can do this.’”
Then, take it a step further. Whenever you’re walking, keep your mouth closed and try to use nasal breathing only. Just remember to keep your pace slow. “As soon as the exercise becomes more intense, there is a natural increase of CO2 that builds up in the body. If you are not yet comfortable breathing in and out through your nose, you’ll quickly switch to mouth-breathing.”
Go on a short run with the intention of limiting the amount of mouth-breathing you do. “It helps to take swigs of water and leave them in your mouth, which forces you to breathe in and out through your nose.”
Besides incorporating controlled, rhythmic breathing techniques into your running, there are also a variety of over-the-counter products, such as nasal strips or essential oils, that can help improve respiratory function. Nadel often recommends nasal steroid sprays, such as Flonase or Nasacort—with the reminder that they won’t “fix” a deviated septum.
“If you have crooked cartilage and bone in your nose, that’s not going to just go away,” he says. “But if you have some swelling or inflammation on top of that, steroid sprays can help a lot with getting air through your nose.”
Be sure to give these products time to take effect. Some people find that it takes just a couple of days for them to start showing results, but your best bet is to use them for at least a month to see if they work for you.
The bottom line: While a deviated septum can interfere with your ability to breathe fully through the nose during a run, there are ways to work around it. If nothing seems to be helping after trying different over-the-counter products recommended by your doctor, the next step should be to make an appointment with an ear, nose, and throat (ENT) specialist. They may find that there is a totally different cause of the breathing issue—such as inflammation from allergies, swelling of the turbinates (structures on the sides of the nasal cavities), nasal polyps, or enlarged adenoids.
If it turns out to be a severe septal deviation, however, they’re likely to recommend surgery.
“I usually tell people, the more crooked your septum is, the more fixing it helps,” says Nadel. “If all else fails, you should seriously consider having septoplasty.”
Many athletes prefer to make surgical intervention a last resort; but if it means improved breathing in your running and everyday life, it’s worth consulting your doctor.
Paige Triola is a freelance writer based in Boulder, Colorado, who covers a range of topics in the athletic and outdoor recreation sphere. She spends much of her time cruising the trails on foot or by bike, testing out the newest gear designed for playing outside. Paige has written articles and product roundups for a variety of publications including Runner’s World, Bicycling Magazine, Gear Junkie, and Trail Runner Magazine.