Posted by: Dean Hebert | November 11, 2008

Youth Running: Dealing with running induced nausea or vomiting

Coach Dean Hebert

Coach Dean Hebert

A reader named Denise writes us with this question:

My daughter is 16 and has be running cross country for four years. She throws up while running and after a race. It is getting to a point where she does not want to run anymore. She does have allergies and has a lot of phlegm; we have gone to a lot of doctors and try many medicals to stop it with no good results. She also gets car sick, and sometimes I think maybe she is getting motion sickness when running. We have tried different things like eating or not eating before a race. Any advice you can give to help her we would appreciated.

This is certainly unusual, but more so it is dispiriting. Allergies and phlegm are indeed possible reasons for the vomiting. It’s not clear from your note if this happens during all runs or only harder efforts. So, I’ll address both as best I can. As with so many maladies with athletes there is sparse information and most doctors are at a loss on how to treat us. We present unique challenges to them. Most have very easy solutions… if it bothers you while running… stop running.

It is interesting to note that seasonally I have several runners who experience these types of issues. During the higher allergy seasons, nasal drainage (post nasal drip) is so bad that it gags them. It is only exacerbated by hard running and breathing. I happen to be one of them.

The cure in one case was as simple as taking an antihistamine 30-45 minutes before running. What is nice is that it is an over the counter remedy. There are many choices out there and many are now “non-drowsy” anti-histamines. For some people this is more of an issue than other people. But, you certainly don’t want to feel like you’re ready to take a nap or sluggish on race day!

One gentleman had this problem every single time we did a time trial or very hard repeats on the track. His goal was to qualify for the FBI physical fitness test. He had passed everything else in the process; this mile and a half race against the clock was the last barrier. After exploring this gagging/vomiting issue with him over time, we came to the same conclusion. His anxiety surrounding performing, being “measured” and having to face his ultimate goal welled up inside him. By the time the third lap of the mile time trial came around he was heaving. We worked on reframing the efforts and disarming the importance. We renamed time trials to a “pace run.” I ran these trials next to him, and verbally reinforced his focus on – maintaining a rhythm, listening to his foot strike, controlled breathing, dropping shoulders to relax, running “tall.” These focal points had him concentrate on everything other than the gagging and heaving or whatever the sensations he was feeling in his throat. We never completely removed the problem but he made huge strides in controlling it. (PS – yes he ended up meeting the FBI standards!)

Your intuition, however, about motion sickness is interesting. I have no research or documentation on this (like your doctors apparently) so I can only make some educated guesses. I am not a doctor so I wouldn’t dispense medical care advice contrary to what your doctors are saying/doing. However, with that caveat, sometimes prescriptions aren’t the answer. I would explore over the counter remedies. Have you tried Dramamine (dimenhydrinate) or Dramamine II (meclizine)? Dimenhydrinate tends to cause some drowsiness that meclizine reportedly does not. Also there are naturopathic remedies that you could explore. But I’m not well versed in that area. (Perhaps one of our readers is a naturopath and could help us on that?)

Continue to experiment with food on your daughter’s stomach. There can be many triggers to something like this. Often someone with environmental allergies will have food allergies as well. Experiment not only with types of foods but also with amounts. The same food in smaller amounts may not create the same results.

Please stay in touch with your progress. There are indeed other runners who suffer from this issue. If nothing else I we all can benefit from your experiences and what you learn along the way.

Coach Dean Hebert, Tempe Arizona, USA
Contributing Editor, Running Advice and News
http://www.running-advice.com

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Responses

  1. My brothers ran cross country in high school and that’s actually one of my vivid memories was there seemed to always be someone who threw up at a meet.
    This was in the 1978-1982 era in Indiana for what that’s worth.

    We have a family of runners that throw up; we all have allergies and we all have asthma. And now that the reader mentions it, we also have a bunch of car sickness people in our family.

    Hmmm…. I wonder if maybe the reader is on to something – have they tried one of the bracelets we keep in the car? I was also going to suggest what you did – Dramamine.

  2. When I ran in High School I ALWAYS dry heaved at the two mile mark if I was on pace or faster. I just took it as “normal” for my physiology since I didn’t know how else to think about it back then in the mid 70′s. I had no allergies or asthma. It’s only been as an adult that I’ve thought of it as aberrational, as friends would look at me askance when I would mention it. It will be interesting to see what people find out. It still happens occasionally on harder races or workouts. My assumption has generally been that it’s somehow breathing related.

  3. I found this article via google searching for potential cures to essentially the same problem, I am a high school runner, 17 years old. Every time I race or do a hard workout I end up feeling nauseous and begin to gag/vomit. There have been times when I have been so violently ill during races that I have actually collapsed, unable to stand up or walk. Recently I am starting to get desperate and am questioning whether or not I should keep running at all. Until this indoor season I was planning on pursuing track and xc in college but several races in the past few weeks have been sobering realizations of how bad this problem is. Coaches, doctors, former runners: no one seems to know anything about this. I am happy that I’m not the only one with this issue out there and hopefully you and your daughter can find a solution. In the mean time if anyone has any suggestions please write them. I have currently tried the following to try and relieve my symptoms to all to no avail. Tums, Zantac, dramamine, various antihistamines, breathing techniques(belly breathing etc.), and experimented with foods/drinks.

  4. Nick,
    As you can see from this post and thread that quite about is known about its occurrence but despite all the potential cures, none work on everyone some in some cases, none work on some people at all.

    I think I would have to suggest first to get very regimented about trying things and then documenting precisely what you did and the effects. The reason I say this is that one of the suggestions MAY in fact be the “cure” but it’s the dosage, the timing, the quantity or some other aspect of the recommendation that needs tweaking. Chart and follow each thing you try and be sure to give it ample time to work – it might not be the first time.

    Next, it might be a combination of the above that might be the trick for you and not an “either -or” situation.

    I wish I had the perfect answer all I can say is that we have SOME answers but nobody has THE answer.

    Please, if you find something that does work or combination that ultimately works, drop us a line. We want others to benefit from each others learnings without having to start from scratch themselves.

  5. i was doing a search on running and motion sickness and stumbled upon this posting. i ran cross country in high school and only dry heaved once, but i believe this was due to low blood sugar after the race. i haven’t had nausea and headaches until now after running, i’m 35. i do have motion sickness in cars sometimes especially if i’m not driving and it’s a very curvy road, the plane does it too, as well as boats. it has gotten worse as i have gotten older. this made me think that perhaps it is motion sickness when i run. seems there isn’t much research on this and i was hoping to find some sort of remedy other than taking dramamine or some other OTC before running. as of now, i haven’t taken anything to determine if it would work, which would confirm weather it is truly motion sickness. guess that is my next step. i’ll let u all know if dramamine works or not, it is what i use if i fly or go on a boat. i guess giving those wrist bands a try wouldn’t hurt either.

  6. Dawn,
    I think exploring motion sickness is right on given your have those issues (non-running). I’m not sure about the wrist bands but sometimes anything is worth trying. Please stay in touch and tell us how it goes!
    Dean

  7. I have very similar experience to what several of you have mentioned. I have noticed two things.

    1) Overexertion almost invariably leads to vomiting for me.

    2) I think a related but still separate issue is the motion sickness. I get motion sickness in other situations pretty easily. I noticed when running that when I get tired I tend to look at the ground, then look to the horizon, back and forth, eventually triggering a pretty awful bout of motion sickness. Especially when I get tired, I end up in the looking up/down cycle even if I try to avoid it. Also, in other situations like riding in a car or on an airplane, I have much less resistance to motion sickness when I am tired for some reason.

    In summary, for some of you, if you happen to be looking at the ground while you run, try to avoid it at all costs. Keep your eyes up and and focused out at a reasonable distance.


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