Become a Member

Get access to more than 30 brands, premium video, exclusive content, events, mapping, and more.

Already have an account? Sign In

Become a Member

Get access to more than 30 brands, premium video, exclusive content, events, mapping, and more.

Already have an account? Sign In


Backpacking Fitness

Think You Can’t Hike Fast With Asthma? Think Again.

Record-setting thru-hiker Jeff Garmire suffered for years before discovering he had exercise-induced asthma—but the struggle taught him a thing or two about sticking with it.

Heading out the door? Read this article on the new Outside+ app available now on iOS devices for members! Download the app.

The asthma attack hit as I was going up the first peak. My pace slowed to a crawl. Breathing became a wheezing struggle as my irritated airway narrowed; it was like panting through a straw. I was in the midst of an FKT attempt on Nolan’s 14, a collection of 14 fourteeners in Colorado’s Sawatch Range, and all of a sudden, the already-thin air felt even thinner. 

I tried using my inhaler, but the attack didn’t stop. I pushed over the peak and toward Mt. Elbert, the second mountain of the route, but I continued to wheeze. It was the first time I had ever attempted a speed record, and, as I was rapidly realizing, I had already failed. 

Technically, exercise-induced asthma—the kind I have—should be called exercise-induced bronchoconstriction (EIB). Its symptoms overlap, but EIB constricts the airway, while traditional asthma begins in the lungs. Studies have found a link between exercising in cold or dry air and EIB. Mine started when I was in high school: Basketball conditioning became much more difficult out of nowhere. I ignored it for years, hesitant to speak up about the breathing issues that kept hitting me at the most inopportune times. I didn’t know the feeling was asthma until I told a friend and borrowed an inhaler. The first time I used it, the symptoms subsided. 

I grew to learn the signs, conditions, and symptoms of these attacks, and I now use a rescue inhaler of my own  to keep them in check. But here’s the thing: It doesn’t always work. 

During a 100K (62 mile) trail race last summer, I was thrown off by a spontaneous attack at mile one. Yes, mile one: As the race was just beginning, I started struggling to breathe. I used my inhaler over and over again. But, the constriction of my airway wouldn’t subside. I pushed on. At the first aid station, I ignored all volunteers and medical staff, hoping they wouldn’t notice the wheezes and gasps escaping my mouth. Time might reverse the problem, but I couldn’t get pulled from the race in the meantime. Slowly over the next two hours, my breathing returned to normal, but the episode crushed my hopes of a good finish. 

For people like me, who find joy in pushing hard, asthma is just another obstacle to overcome, one that takes tools and experience. I think of it like having feet prone to blisters, weak ankles, or migraines. It can be debilitating at the moment and require attention, but it is not a reason to avoid the adventure. That 100K trail race that began with an asthma attack is the finish I am most proud of: I stuck it out, worked with what I had, and finished in the top 10. Rather than dissuading me, it taught me a lesson about perseverance. 

Asthma is a quirk I have to deal with, as many others do. But it is more than a hindrance. It has become an invitation to be in tune with my body, my breathing, and the conditions around me during long days in the mountains. It is a reason to enter the wilderness more prepared and to accept that things may not go perfectly. 

At times, asthma may hurt an FKT attempt or force me to rest at the top of a hill, but it is not a deterrent from getting out there. The tools to deal with it are essential, but so is the mindset to accept it as a possibility on an adventure. No one sets out expecting a gear failure, but whether it is a patch kit, a needle and floss, or duct tape, we leave civilization with the tools to overcome unexpected obstacles. They are small lifelines and items of confidence. An inhaler is no different.

Preparation is Key

It took years before I even knew I had asthma and more years before I understood how to manage it. Since then, staying on top of it has become a critical part of my pre-trip planning. After the attack during my ultramarathon, my doctor prescribed a different type of inhaler. Next time it happens, I’ll have two options to deal with it.

Cultivating the Right Mindset Helps…

Whether or not you have asthma, every adventure has the potential to go south. The first step to dealing with it is by cultivating a positive, problem-solving mindset from the beginning. At mile 200 of my John Muir Trail FKT attempt, I had an asthma attack on top of Forrester Pass. It was the middle of the night, and I was already cutting it close to the record. I could have panicked or lost myself in frustration, but instead I took a quick puff on an inhaler and did some deep breathing. Within a few minutes, I was back to my normal speed within a few minutes. 

That attitude will help you with more than breathing problems. Case in point: Shortly after that attack, both shoulder straps broke off the prototype backpack I was carrying. A manufacturer defect (the reason we test gear) presented itself after hundreds of miles. Rather than sit in sorrow, I dove into fixing it. With a few strategic knots, I was able to make it into a wearable pack, and carried it to a successful JMT record. 

…But Sometimes, Bailing Is the Right Call

No matter how good your mindset is or how well you’ve prepared, sometimes the tools and resources with you are not enough. Injuries, medical emergencies, and severe problems on the trail can (and should) lead you to abandoning the plan. With experience, you should be able to tell when an asthma attack or another issue is serious enough to pull the plug, versus when it’s an excuse you’re using to quit. It’s not always easy—I am still learning to differentiate between excuses and serious problems—but embracing that lifelong process will help you be more mindful on your adventures.

From 2023

How to Pack for Backcountry Skiing

Get to know the winter safety gear you need in your pack.