Abstract
Respiratory function is crucial for runners' performance, recovery, and overall health. The unique physiological demands of endurance running subject the respiratory system to sustained high ventilatory efforts, increased exposure to environmental triggers such as allergens and pollutants, and a higher risk of exercise-induced respiratory issues, including exercise-induced bronchoconstriction and airway hyperresponsiveness. Runners often suffer from respiratory conditions such as asthma, allergic rhinitis, and exercise-induced bronchoconstriction. While cardiovascular and musculoskeletal adaptations are well-studied, the respiratory aspect often receives less attention despite its significant clinical and performance implications. This review discusses the physiological basis of respiratory health in runners, highlights common respiratory challenges, reviews evidence-based interventions, and suggests integrated strategies to optimize lung function in both competitive and recreational runners. A new section focuses on nasal physiology and care during running. Structured respiratory care—including preventive, therapeutic, and rehabilitative approaches—can improve performance, lower morbidity, and promote long-term respiratory health in runners.