You did it; you got out there for a freezing run in the middle of winter. And what are you rewarded with? An uncomfortable cough. Did you somehow pick up a cold in the last hour, or is it from the run? Below, we unpack why coughing after running in cold weather happens and provide some doctor-approved ways to prevent it from happening next time.
Why Do I Start Coughing After Running?
You might not cough after running in the warmer seasons, so why does it happen in the winter time? Cold air—especially cold dry air that accompanies the arctic blasts pushing down from northern latitudes—can trigger coughing due to either bronchospasm, which is when the tubes that bring air in and out of your lungs constrict, or asthma.
Many people pushed to high respiratory rates in these conditions will develop contractions or spasms in the smooth muscle that surrounds the airways and also produce extra mucous in the lining of the lung tubes that result in wheezing and/or cough. This is commonly known as exercise asthma or exercise-associated bronchospasm. This can be a form of intermittent asthma or simply bronchospasm from changes in the airway.
I see it frequently in competitive Nordic skiers who are training and competing at high exertion levels that require high respiratory rates to supply oxygen to the active leg and arm muscles, especially when they are training at higher altitudes where the air is usually very dry.
The cough can begin during exercise or shortly after the exercise session ends and can last for several hours. The bronchospasm is thought to be caused by drying of the airways and/or cooling of the airways resulting in changes in the concentration of intracellular contents and/or release of pro-inflammatory mediators that promote the changes in the airway.
There are several ways to test for this condition that involve some form of inhaling dry air. I often go outside with runners or skiers to test them on site with a spirometer, an instrument for measuring the air capacity of the lungs, before and after exercise. This is often easier said than done, as it is sometimes difficult to replicate the conditions that trigger the cough. This is especially true for those who only cough during or following competitions.
There are other causes of “wheezing” during or following exercise that can be difficult to distinguish from exercise bronchospasm like vocal cord dysfunction. Vocal cord dysfunction occurs when the vocal cords come together during inspiration and causes “stridor,” a harsh grating sound, on inspiration as opposed to the expiratory wheeze of asthma.
How Do I Treat Coughing After a Cold Run?
The above two conditions are often put in the same basket, but the treatments are very different. A cold-induced cough may be helped by wearing a scarf over your mouth and nose to prewarm and prehumidify the cold air a bit before it enters the respiratory tree. Some runners do not tolerate this well as it gives a sense of air restriction. Otherwise, it is as simple as slowing the pace a bit to reduce the air exchange demands and waiting for spring before you push the pace again.
If you already have the cough and suspect it is cold-induced, just take a few rest days, and it should resolve itself on its own.
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On the other hand, an exercise-induced cough may be a marker for asthma, since both dry air and cold air (along with pollens, animal dander, upper respiratory infections, irritants such as perfume, tobacco, and other smoke, and air pollution) are triggers for asthma attacks.
While it is possible to have a bronchospasm only during exercise, it is important to remember that nearly everyone with asthma will have exercise-induced asthma if pushed hard enough, even fit runners. If you often cough after cold runs, it’s important to meet with your physician to determine if you have underlying asthma, and see if you are a candidate for intervention with medication.