Why Can’t I Breathe When I Exercise?

I’m healthy, but I can’t inhale enough through my nose when I exercise. What’s up?

Take a tour through the online forums on fitness and exercise, and you’re likely to see questions and complaints from many people who wonder why it feels like they can’t get enough air through their noses during exercise. Runners, bicyclists, body builders, soccer players and aerobics enthusiasts – it’s a problem that lots of athletes have.

Non-disease related breathing discomfort

Now, this is NOT to be confused with severe ailments like COPD, or even with more temporary problems like the condition known as exercise induced asthma (and referred to by medical professionals as Exercise-Induced Bronchoconstriction, or EIB). EIB can trigger symptoms like wheezing or shortness of breath, sharply diminished performance and endurance, tightness in the chest, cough and even stomach upset. It can appear when you hyperventilate while exercising in cold, dry air, or are exposed to some airborne allergens. For EIB, the cause is related to the dryness of the air more the temperature. The solution in mild cases is to warm up before workouts, breathe through the nose as much as possible to warm inhaled air, and cover your mouth and nose with a scarf or muffler, for the same reason. If those ideas don’t help, see an allergist to learn if conventional asthma treatment might improve the situation.

What if it’s not EIB?

No, for lots of otherwise fit and healthy people, the problem is not in the lungs but in the nose. Even though many coaches and exercise how-to books specify that we should inhale through the nose and exhale through the mouth when working out, this is next to impossible for many of us. You might even have experienced a pinched-shut feeling in your nose – it feels like the nostrils are tightening just when need the most air.

Nasal Valve Collapse

For many of this group, it may well be that the tightening nostril feeling results from nasal valve collapse. The nasal valve, located inside your nose, runs from about the flare of the nostril to just before the bridge of the nose. It’s the narrowest spot in your nasal passages, and if it’s swollen or narrowed, you can really feel the difference in how much breath seems to get through. The result is you sniff harder to beat the restriction, which builds pressure inside the airway. In extreme cases that pinched-shut effect is visible in a mirror – you can see the sides of your nose pulling inward.

You can see that even professional athletes are affected by this nasal collapse – many football and soccer players wear nasal strips during games, and many swimmers and cyclists use plastic nasal inserts to help keep the nostrils and outer nasal passages wide when they’re exerting themselves all-out.

You can even check yourself for nasal valve collapse, using a simple do-it-yourself diagnostic routine called Cottle’s Maneuver. Using the tips of one or two fingers, positioned on each side of your nose, press lightly and pull outward gently to slightly open the nasal valve. If this helps you inhale more easily through your nose, the obstruction is likely to be in the nasal valve. If you can breathe easier using Cottle’s maneuver, see your doctor for a more thorough evaluation and diagnosis. The remedies for collapsed nasal valve include the strips and clips mentioned above. There’s also a quick, nearly painless in-office procedure called nasal airway remodeling that reshapes the tissue of your nasal valve to help prevent collapse.

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