Why You Really Cough After a Tough Workout

February 29, 2016

No, you're not crazy for thinking you have a cough after every long run or tough HIIT session. There's actual science behind it.

As a runner, I try to get my workouts in outdoors as much as possible to mimic race-day conditions—and this is despite the fact that I'm a) a city dweller and b) a New York City dweller, which means for half the year (most of the year?) it's pretty freaking cold and the air's kinda dirty. But whenever I do a really tough run—say, ten-plus miles—or a speedy interval session, I come home hacking up a lung. Despite the fact that the cough doesn't usually persist, it does occur fairly regularly. So I did exactly what any curious info seeker would do: I asked Google. Surprisingly, there weren't many science-based answers out there.
What I did find, though, was a little-known condition dubbed "track hack" or "track cough" to runners, "pursuiter's cough" to cyclists, and even "hike hack" to outdoorsy types. To learn more about this phenomenon, I checked in with Dr. Raymond Casciari, a pulmonologist (that's a lung doctor) at St. Joseph Hospital in Orange, CA. He's worked with a slew of Olympic athletes since 1978, and unlike the majority of the Internet, has seen this type of cough before.

"There are only three parts of your body that interact with the outside world: your skin, your GI tract, and your lungs. And your lungs have the worst protection of the three," explains Dr. Casiciari. "Your lungs are very delicate by nature—they have to exchange oxygen through a thin membrane." That makes them even more prone to be affected by various conditions, including both your workout and the outside environment. Worried that you might be suffering from track hack? We've got everything you need to know right here.

Start with a Self-Assessment

Before you assume anything about an exercise-induced cough, Dr. Casiciari recommends doing an overall self-assessment of your current health. Take a look at how you're doing overall, he suggests. For example, if you have a fever, you could very likely be suffering from a respiratory tract infection.

But there are also a slew of other conditions that can cause this kind of cough, so Dr. Casiciari recommends checking in with your doctor first to eliminate any serious medical concerns. "Ask yourself, 'Could it be heart disease?' Could you be having an arrhythmia?" Dr. Casiciari says, and make sure to carefully eliminate any of these health concerns.

Something else he's seen on the rise? "Gastroesophageal reflux (GERD)-induced coughs. Frequent acid reflux"—AKA heartburn, which one can get for a variety of reasons, poor diet included—"that rises up the esophagus causes a cough," Dr. Casiciari says. "The way you'd differentiate this from a runner's cough, though, is to notice when the cough occurs. Runner's cough will always occur after an exposure to running, whereas a cough from GERD could be anytime: in the middle of the night, watching a movie, but also during and after running too."

Wait, Is Track Cough Just Exercise-Induced Asthma?

Another important condition to rule out is exercise-induced asthma, which is different and more serious than the typical runner's cough. Exercise-induced asthma, unlike track hack, is a prolonged condition that lasts far beyond the five or ten minutes that follow a hard sweat session. Not only will the cough continue, but you'll also wheeze—something that will not happen with track hack—and experience overall decreased performance. Unlike a simple cough, asthma causes the lungs to repeatedly spasm, constricting and inflamming the airways and ultimately causing decreased airflow.

A doctor can test for asthma with use of a tool known as a spirometer. And just because you didn't have asthma as a kid doesn't mean you can't develop it later in life. "Some people are subclinical asthmatics," explains Dr. Casciari. "They never knew they had asthma, because the only thing that brings on the asthma is exposure to extreme conditions, including hard exercise."

Start with your general practitioner for these types of tests, he suggests, and see a pulmonary specialist or exercise physiologist if your symptoms don't cease.

How to Know It's Really Track Hack

Back to my own cough: Like I said, it comes after long runs, especially when it's cold out or the air's particularly dry. Turns out, both of those situations are what Dr. Casiciari refers to as bronchial irritants; therefore, "track hack" is no more than an irritant-based cough. And if you live in an urban area, there are more pollutants in the air—also irritants. Dr. Casiciari believes that I'm inhaling "benzenes, unburned hydrocarbons, and ozone," all of which contribute to a cough. Other irritants can include pollen, dust, bacteria, and allergens.

Likewise, track hack is a phlegmy affair. "Your lungs produce mucous to protect themselves," says Dr. Casiciari, and it coats your bronchial surfaces, protecting them from factors like cold, dry air. "It's kind of like if you put Vaseline all over your body if you're a swimmer," he says. "It's a layer of protection." Which means that while your track hack will likely be productive, it's nothing to be alarmed about.

What also makes track hack unique is that it's often caused because we stop breathing through our noses (due to the extreme amount of effort we're exerting) and use our mouths instead. Unfortunately, your nose is a far better air filter than your mouth.

"When the air hits your lungs, ideally, it's 100 percent humidified and warmed to body temperature since the mucosa of your bronchus are very sensitive to cold, dry air," says Dr. Casiciari. "Your nose is a fantastic humidifier and warmer of the air, but when exercising at maximum capacity, I realize it is difficult to [breathe through your nose]," he notes.

What's more, breathing through your mouth alone can actually cause the cough too. "When you're moving large quantities of air through the bronchial mucosa, you're actually cooling them," he says, the exact opposite of the desired effect.

How to Avoid It

Most importantly, do not grab a bottle of Robitussin. "That will just mask the symptoms of runner's cough," says Dr. Casiciari. Instead, try to avoid the irritants. So, for example, if you're running at night, the air is likely more polluted; try running in the morning to see if that changes things. Similarly, if it's the cold temperatures that seem to get you, run indoors instead (and if you're on the treadmill, step the incline up to 1.0—that will help mimic outdoor conditions, which go up and down, unlike the flat belt).

Another suggestion is to create a cocoon of heat around your mouth to mimic a moist, warm environment and help warm your breath, says Dr. Casiciari. Hack it yourself with a scarf or buy a cold-weather-specific balaclava or neck gaiter to create the cocoon, he suggests, if you still need to exercise outdoors.

Dr. Casiciari also points to new research, which suggests that drinking or ingesting caffeine prior to a workout can help reduce your risk of experiencing post-workout track hack, and could help with exercise-induced asthma too. "Caffeine is a mild bronchodilator," he explains, meaning it helps increase the surface area of the lung's bronchi and bronchioles, making it easier to breath.

Your best bet, though, is to start from the beginning: Dr. Casciari recommends starting with a symptom journal that you can then bring to your own doctor. "Get a notebook and write down certain things," he says. "Number one: When do the problems occur? Number two: How long does it last? Number three: What makes it worse? What makes it better? That way, you can go to the doctor armed with information."

Turns out, I don't have exercise-induced asthma, but I do tend to get track hack. But after following Dr. Casciari's advice and wearing my neck gaiter over my mouth during this weekend's 10-miler, I can tell you I coughed far less (and for far less time) upon returning home. That's a little victory I'll definitely celebrate.

By: Rachel Jacoby Zoldan, SHAPE Magazine

Article Link: http://www.shape.com/fitness/cardio/why-you-really-cough-after-tough-workout

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