Training guide
Breathe however feels natural. At an easy pace you can breathe through your nose if you like; as you speed up, most people open their mouth, and that's the right call: breathing only through the nose cut peak exercise capacity in lab tests. Most runners fall into a rhythm with their strides without trying, and no breathing pattern has been shown to make running easier or prevent stitches.
Feeling out of breath is mostly about pace: slow down until you can talk in full sentences, and it gets easier within weeks. This guide covers nose and mouth breathing, rhythm, how to breathe on your next run, side stitches, cold air, asthma and throat closure during exercise, breathing muscle trainers, and the signs that breathlessness needs a check.
Most people switch from nose breathing to breathing through the nose and mouth together as the effort rises, without thinking about it. At an easy pace, nose breathing is fine if you like it. When you work harder, open your mouth: breathing only through the nose cut peak exercise capacity in lab tests.
Runners lock their breathing to their strides on their own, most often one breath every 2 strides (4 footsteps), and some don't lock at all. No trial has shown that counting a set rhythm, such as 2:2 or 3:2, makes running easier or prevents stitches.
Run at a pace where you can still talk in full sentences, and walk for a minute when you need to. The point where talking first gets hard matches a breathing threshold measured in the lab, and fitness rises within a few weeks of regular running.
About 70% of runners get a stitch in a year. Avoid large meals and drinks in the 2 hours before you run, especially fruit juice, and slow down or walk until it passes. What helps once it starts hasn't been tested.
Coughing, wheezing or a tight chest after exercise can be exercise-induced asthma, and a noisy breath in with a tight throat can be the voice box narrowing. Both are common in young athletes, both need a GP, and our asthma guide covers what helps. Chest pain or severe breathlessness is different: see the warning signs.
The NHS counts running as vigorous activity. At rest you breathe calmly and slowly, about 12 to 15 breaths a minute, through your nose. As the pace rises you breathe faster and deeper, and by moderate effort, at about 35 to 45 litres of air a minute, most adults start breathing through the mouth as well as the nose.
The nose warms, moistens and filters the air, which is why it suits easy efforts and cold days. At high flows it can't pass enough air, so breathing only through the nose caps how hard you can go.
A stride is two footsteps, one with each foot. The most common pattern, one breath every 2 strides, is 4 footsteps to a breath, which many coaching sites call "2:2" (2 steps in, 2 steps out). Some sources count steps and some strides, which is why their numbers disagree.
Above your first breathing threshold, your breathing deepens and talking gets harder. In 15 adults, the last pace where talking was still comfortable was at about 64% of their maximum oxygen use.
Fitness changes breathlessness most: the same pace feels easier within weeks of regular training. Younger runners get more stitches. Asthma, a narrowing voice box, a breathing pattern problem, heat, cold air, pollution and pollen all change how breathing feels.
In 30 healthy adults cycling in a lab, 20 switched from nose to nose-and-mouth breathing at about 105 watts, when they were breathing about 35 litres of air a minute; 5 kept breathing through the nose and 4 always used both. A later review puts the usual switch at 35 to 45 litres a minute. The studies are small and old, but they agree.
In a maximal bike test in 12 healthy adults, breathing only through the nose cut peak oxygen use from 33.4 to 28.0 millilitres per kilogram per minute and peak power from 207 to 184 watts, with more breathlessness at every stage. On a treadmill, 10 women breathed much the same through nose, mouth or both at 5 to 7 km/h, but nose-only breathing fell short at 10 to 11 km/h, and most of them couldn't keep it up at 12 km/h. In an older study of 20 active adults, everyone could still reach a training intensity breathing only through the nose.
Ten recreational runners who had trained nose-only for at least 6 months reached a similar maximum either way, and in 12 well-trained men, mouth and nose-and-mouth breathing gave similar results. Sprint power didn't differ by breathing route in 9 adults. In 16 recreational runners, 4 weeks of breathing drills with nose-only easy runs made breath holds longer but didn't raise fitness. A review found "little-to-no data" showing that nose breathing improves exercise capacity in healthy people.
We found no trial of this popular advice. It's fine at an easy pace if it feels comfortable, but there's no need to force it.
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People lock their breathing to their strides in several ratios, with 2 strides to a breath the most common. In 14 adults running on a treadmill, 11 had periods of fixed coupling, most often 2 strides per breath, and some didn't couple at all. These are studies of how people breathe, not trials of teaching a rhythm.
We found no trial showing that a counted pattern such as 2:2, 3:2 or another odd-even count lowers the effort of running, prevents stitches or prevents injury. The idea that odd counts prevent stitches comes from expert opinion. In 16 novice women, sound cues taught them to couple breathing to their steps, but the study didn't measure any benefit. NHS Couch to 5K suggests trying 3 steps in and 2 steps out to steady your breathing: fine if it helps you relax, but it hasn't been tested against breathing freely.
In 16 adults on a treadmill and a bike, the point where talking first got hard closely matched a breathing threshold measured in the lab, and the test kept tracking that threshold after training moved it. A review found it worked across walking, jogging, cycling and other machines. The studies are small, which is why our start running guide grades this emerging too.
In a small trial, fitness rose within 3 weeks of cycling 3 times a week. Endurance-trained men felt less breathless than inactive men when breathing the same amount of air, in a study of 62 men at one point in time.
Training the breathing muscles with a hand-held device improved time trials and endurance modestly in pooled trials of athletes (21 trials) and healthy people (46 studies), more in less fit people. Inspiratory training had a moderate effect on sports performance across 25 studies. A common trial dose was 30 breaths twice a day, 5 days a week, at about half your maximum breathing-in pressure. In 25 active men, 5 weeks eased breathlessness at a hard workload, but no more than a sham device did. It's optional: regular running does far more.
Breathing low from the diaphragm, so your tummy rises gently as you breathe in, is the relaxed resting pattern NHS physiotherapists describe, so it's fine to practise off your feet. We found no study showing it makes running easier (our reading).
Across 139 studies, music made exercise feel a little easier and more pleasant and improved performance slightly. Keep the volume low enough to hear traffic.
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Our editorial sequence, built on the talk test studies (Persinger 2004; Foster 2008), the studies of how runners couple breathing to stride (Bramble 1983; Daley 2013), the nose and mouth breathing studies above, the stitch review (Morton 2015) and NHS Couch to 5K.
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The movement on the figure: Treadmill jogging
In a survey of 965 people who did sport regularly, 69% of the 439 runners had had a stitch in the past year, and about 1 in 5 people get one during a single event. Most describe a sharp pain in one spot, most often at the side of the tummy along the lower ribs, sometimes with an ache at the tip of the shoulder. Stitches get less common with age and weren't linked with sex, body size or training status, and they were about 10 times more common in running than in cycling.
Food and drink in the hours before running make a stitch more likely. In 40 people prone to stitches, fruit juice before a treadmill run brought on more stitches and bloating than no drink, flavoured water or a sports drink. The review advises avoiding large meals and drinks for at least 2 hours before exercise. The cause isn't settled; the leading idea is irritation of the lining of the tummy wall, not the way you breathe.
Nothing has been tested in a trial. Runners report deep breathing (40%), pressing on the sore spot (31%), stretching it (22%) and bending forward (18%), and the pain eases soon after you stop. Stronger trunk muscles went with fewer stitches in 50 runners, and runners with stitches reported more anxiety in a survey of 168, but these are links, not proof.
Stitches are mostly harmless, though they can spoil a run. A pain that isn't like a stitch, or doesn't ease when you stop, is different: see the warning signs below.
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Exercise can narrow the airways, causing coughing, wheezing, a tight chest or breathlessness, often worse just after you stop. Doctors call it exercise-induced bronchoconstriction (EIB). In one population of 3,838 teenagers, about 19% had it. For most people with asthma, symptoms with exercise mean their asthma isn't as well controlled as it could be, so see your GP or asthma nurse.
Across 7 randomised studies, warm-ups that included short, hard bursts reduced the fall in lung function after exercise by about 11 percentage points, while steady warm-ups didn't make a significant difference. It doesn't work for everyone, so keep your reliever with you. Our asthma warm-up follows this pattern.
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A US guideline strongly recommends a short-acting reliever before exercise for everyone with EIB. Many people now use an anti-inflammatory reliever or a combined inhaler instead, so follow your own asthma action plan, and if you need your reliever around exercise most of the time, ask for a review, as our asthma guide explains.
Exercise-induced laryngeal obstruction (EILO) is a narrowing of the voice box during hard exercise. It causes a noisy or difficult breath in, a tight throat or a change in your voice, and it settles quickly when you stop. About 6% of teenagers had it, and about a third of 88 athletes sent for asthma tests, many of them taking asthma medicines they didn't need. No symptom reliably tells it apart from asthma, so it needs testing, and there are no randomised trials of treatment.
Sometimes breathing stays fast, deep or high in the chest after the need has passed, causing breathlessness with sighing, yawning, dizziness or tingling. NHS physiotherapists treat this, and throat closure, with breathing retraining. Many breathless young people are reaching the normal limit of their fitness, which training improves.
Cold, dry air can tighten the airways. Breathe in through your nose so the air is warmed, and loosely wrap a scarf over your nose and mouth or wear a mask, as Asthma + Lung UK advises.
Walk, jog, then run, at a pace where you can still talk in full sentences: 1 minute of jogging and 90 seconds of walking in NHS Couch to 5K's first week, building to 30 minutes of easy running.
For calm and for settling after a run, not for running faster: no trial has shown these improve running. Leave out breath holds if you have asthma symptoms.
5 minutes easy, then 6 bursts of 20 to 30 seconds hard with 45 to 60 seconds easy, then moving stretches: our asthma warm-up's editorial starting point, adapted from the trials.
Learn to breathe on the move with our run-walk intervals: the walks give your breathing time to settle. Once 30 minutes of easy running feels steady, the easy run's 5-minute talk check keeps your pace honest. If exercise brings on asthma, use the asthma warm-up first.
A 30-minute beginner run-walk session: a brisk walk, then 1-minute jogs with 1-minute walks, building to 3-minute runs over your first three weeks.
30 minBeginner5 movesCardio machine, A wallA 40-minute easy run at a pace where you can talk in full sentences, with a brisk-walk warm-up and an easy cool-down: the base of every running plan.
40 minBeginner6 movesCardio machine, A wallA 15-minute warm-up for exercise-induced asthma: easy movement, then short hard bursts that can reduce symptoms in the session that follows, then moving stretches.
15 minBeginner5 movesCardio machine, A wallAn 8-minute dynamic warm-up for runners: ankle and hip mobility, lunges, skips and pogo hops.
8 minIntermediate8 movesA wallA 10-minute cool-down for after a run, a class or a gym session: a few minutes of easy movement, stretches for the muscles you used, then slow breathing.
10 minBeginner9 movesCardio machine, A wallA 6-minute breathing routine: slow breathing, crocodile breathing, alternate nostril breathing, box breathing and 4-7-8 breathing.
6 minBeginner5 movesNo equipmentCouch to 5K builds from 1-minute runs to 30 minutes of running at a talking pace; if a slow jog still leaves you gasping, start with the walking plan.
A 9-week beginner plan with the same walk-to-run shape as Couch to 5K: three run-walk sessions a week, from 1-minute jogs to 30 minutes of running.
3 training days35 minBeginner6 days a weekA free 8-week walking plan for beginners: build to 150 minutes of brisk walking a week, with intervals, hills and two short strength sessions.
6 training days40 minBeginnerIf you get chest pain or pressure, feel faint or dizzy, are unusually breathless, or your heart races or beats irregularly during exercise, as our plans advise.
For chest pain that comes on suddenly and doesn't go away, feels tight or like squeezing, spreads to your arms, neck, jaw, stomach or back, or comes with sweating, feeling sick, light-headedness or breathlessness; severe difficulty breathing; someone who faints while exercising; palpitations that don't go away, or come with chest pain, shortness of breath or feeling faint; or a headache that starts suddenly and is extremely painful, especially while lifting or straining, or comes with numbness or weakness, difficulty speaking or loss of vision. The NHS says a bleed on the brain may be more likely when lifting something heavy. Don't drive yourself to A&E.
Sit up straight and try to stay calm. Then:
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Call 999 (911 in the US) if you or someone else is having an asthma attack and:
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If you're no better after 10 minutes and the ambulance hasn't arrived, use your inhaler again, up to the same maximum dose. If you're still no better and it still hasn't arrived, call 999 again straight away. Don't drive yourself to A&E.
See a GP within 2 days, even if you feel better. Asthma + Lung UK suggests a same-day appointment if you managed the attack yourself. Don't exercise again until your symptoms and breathing have recovered.
Carry your reliever every time. Stop the session if symptoms don't settle, and call 999 if your breathing doesn't go back to normal after exercise.
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Being unfit or carrying extra weight makes anyone breathless with exercise, and that breathlessness eases quickly when you stop. Inducible laryngeal obstruction (ILO), where the voice box narrows, causes noisy or difficult breathing in, a tight throat or a change in your voice that start and stop suddenly, and your reliever may not help much; it is found in about 3 in 10 people whose asthma is hard to control. Breathlessness with dizziness or tingling points to a breathing pattern problem, and breathlessness on exertion with swollen ankles needs a GP check.
Call NHS 111 (in the US, your doctor or an urgent care centre) if you're suddenly more short of breath than usual, or have chest pain with feeling sick or a heartbeat that races, skips or flutters.
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Breathlessness that gets worse during normal activities or when you lie down, or comes with swollen ankles.
If you've felt tired for weeks without a clear reason, or if tiredness, breathlessness or palpitations seem out of proportion to your effort. The NHS also suggests speaking to a GP before you start if you haven't exercised for some time or have a health condition.
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A stitch is a sharp or cramping pain at the side of the tummy, usually along the lower ribs, sometimes with an ache at the tip of the shoulder, that eases soon after you slow down or stop. Chest pain, pain spreading to the arm, neck or jaw, or pain with breathlessness, feeling faint or a racing heartbeat is not a stitch: stop and follow the warning signs above. See a GP for tummy pain that comes on without running, keeps getting worse, or doesn't settle after you stop (our suggestion).
Breathe in through your nose so the air is warmed, loosely wrap a scarf around your nose and mouth or wear a mask, and check the weather: shorten your time outside if it's very cold or windy. In an Asthma + Lung UK survey, 7 in 10 people said cold air made their symptoms worse. Very hot air can tighten the airways too, and GINA advises athletes to avoid training in extreme cold or pollution.
In the heat, tiredness, dizziness, a headache, feeling sick, heavy sweating and intense thirst can be heat exhaustion: stop, get somewhere cool, drink and cool your skin, and you should feel better within 30 minutes. If you don't, or there's confusion, hot skin that has stopped sweating, a fit or a collapse, call 999 or 911: that's heatstroke.
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Lie down with your legs raised, or sit with your head lowered between your knees, and drink some water. Crossing your legs while standing, rocking up and down on your toes or clenching your fists can help. Call 999 if someone faints while exercising.
Ask for an urgent GP appointment or get help from NHS 111 for a headache that's triggered or made worse by coughing, sneezing, bending down or exercising. In the US, contact your doctor or urgent care.
Speak to a GP first if you haven't exercised for some time, or if you have a medical condition or concerns. Get advice first, too, if you have a health problem, an injury or symptoms, have recently had a heart attack or an operation, or are pregnant or have recently given birth.
Answer the 7 questions of the Physical Activity Readiness Questionnaire (PAR-Q+) before you start. A yes to any (a heart condition or high blood pressure, chest pain, dizziness or fainting, another long-term condition or its medicines, a bone or joint problem, or being told to exercise only under medical supervision) means checking with your doctor or a qualified exercise professional first. It also asks people over 45 who aren't used to hard, all-out effort to check before exercising that hard: think races and time trials, not easy runs. The NHS suggests speaking to a GP first if you're worried about your health.
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If you have a heart condition, follow your cardiac team's advice on how hard to work, and stop for the warning signs above. People with long-term conditions may wish to ask their specialist before starting. With uncontrolled high blood pressure, avoid straining against a held breath; the high blood pressure guide has more.
We found no trial behind it. Most people switch to nose-and-mouth breathing as effort rises without thinking, and nose-only breathing holds back hard efforts.
Runners couple breaths to strides on their own, in several ratios, and no trial has shown that a counted pattern helps. The odd-count advice is expert opinion. Trying a count, as NHS Couch to 5K suggests, is fine if it helps you relax.
Runners who trained nose-only for months reached the same maximum either way, and 4 weeks of breathwork didn't raise fitness.
At easy paces the breathing route made little difference; mouth breathing becomes necessary as the effort rises.
The cause isn't settled. Stitches are linked with eating and drinking beforehand, younger age and the jolting of running, not with a breathing style.
Being unfit makes anyone breathless, exercise-induced asthma can happen without asthma, and a narrowing voice box can mimic it. See a GP for a proper diagnosis.
The effects in trials are modest and larger in less fit people.
However feels natural: through your nose at an easy pace if you like, and through your mouth and nose together as you speed up. Most runners fall into a rhythm with their strides without trying, so there's no need to count. If you're too out of breath to talk in full sentences, slow down or walk for a minute.
Both are fine at easy paces, but once you're working harder, breathe through your mouth too. In a lab test on a bike, nose-only breathing cut peak exercise capacity, and on a treadmill most people couldn't keep it up at faster speeds. Runners who trained nose-only for months didn't gain fitness from it.
We found no study showing it helps. It's fine at an easy pace if it feels comfortable, but there's no need to force it.
Whichever happens naturally. Runners lock their breathing to their strides on their own, most often one breath every 2 strides (4 footsteps), and no trial has shown that a set count makes running easier or prevents stitches. NHS Couch to 5K suggests trying 3 steps in and 2 out, which is fine if it helps you settle.
Usually because the pace is too fast for your current fitness. Slow to a pace where you can talk in full sentences and use walk breaks; fitness improves within a few weeks. Breathlessness that's new, much worse than usual or comes with chest pain is different: see the warning signs.
Slow down or walk until it passes; it usually eases soon after you stop. Runners say deep breathing, pressing on the sore spot and bending forward help, but none has been tested in a trial.
Avoid large meals and drinks in the 2 hours before you run, especially fruit juice, which brought on more stitches than water in a trial. About 70% of runners get one in a year, and they become less common with age.
Breathe through your nose when you can, so the air is warmed, and loosely cover your nose and mouth with a scarf or a mask if cold air makes you cough or wheeze. With asthma, keep your reliever with you.
Yes, for most people. Warm up with a few short, hard bursts, which reduced the drop in lung function after exercise in trials, follow your asthma action plan, and carry your reliever. If exercise often brings on symptoms, ask your GP or asthma nurse for a review.
A noisy breath in, a tight throat or a change in your voice that comes on during hard exercise and settles quickly when you stop can be the voice box narrowing (exercise-induced laryngeal obstruction). Inhalers don't help it. See your GP, who can refer you for tests and breathing techniques.
A little: in trials, breathing muscle training modestly improved time trials and endurance, more in less fit people. A typical trial dose was 30 breaths twice a day, 5 days a week. It's optional; regular running does far more.
Breathing low, so your tummy rises gently as you breathe in, is the relaxed resting pattern NHS physiotherapists describe, and it's fine to practise. No study has shown it makes running easier.
Exercise education, not a personal prescription, and clinical review of these guides is pending. Check with a GP before starting hard training if you have a heart condition, chest pain, dizziness or breathlessness when active, and stop for sharp or increasing pain. Health disclaimer.
