respiratory "crackling" post-set

Medical Q&A [Moderated]
1

Hi,

Very brief background. Age: 32, height: 5’7", weight: 195/ waist 38" (working on this), training since late 2016. Non-smoker.

A few years back, after experiencing wheezing from exercising, I was diagnosed with exercise-induced asthma via a spirometry test. For the next couple of years, I took montelukast, and my breathing improved. After having some issues with depression, knowing there are some potential links there, I went off montelukast, and I was fine for some time. I would very occasionally experience a “rattle”/crackling sensation in my breathing after a set, but it was infrequent. By this time, I was regularly doing conditioning, which I believe helped. After a respiratory infection approx. 6 months ago, that sensation has returned, and it’s rather consistent now.

The best way to describe it is the sensation you get when dealing with a respiratory infection where you exhale/cough and you feel a rattle. There’s zero pain. It seems to only occur after lifting in which I’m actively bracing. It doesn’t occur with purely respiratory activities, such as HIIT on a rower or bike. It also seems to get more prevalent toward the end of a workout, when I’m somewhat fatigued. It never happens during the set, but after, only upon exhaling, during the first few “normal” breaths I take after a set.

My GP is at a loss as to the cause - I was tested on a spirometer today, and my lung capacity was excellent, estimating me to be < 20 years old, which, again, I attribute to conditioning. She ordered a chest x ray for me just as a first “rule out” step, but doesn’t have any firm hypotheses on what could be going on, aside from something caused by the pressure built up when doing a hard valsalva for a set. She doesn’t deal regularly with powerlifters, though.

Given the much higher percentage of strength-training clients/patients you advise relative to most MDs, I wondered if either of you has any ideas as to what might cause something like this, or if you’d encountered it in other clients.

Thanks,
Scott

2

I don’t think this is anything specific / common to lifters. Unfortunately I don’t have other ideas at this time, but I think your GP’s initial plan is reasonable. They may eventually pursue more advanced imaging like a chest CT if this is deemed to need more investigation.

With that said, if you aren’t having any cough or shortness of breath and the imaging looks normal, it’s unlikely that you’ll ultimately uncover a “cause” for this symptom.

3

Thanks so much for your reply! The progression from X Ray to CT is exactly what my PCP suggested doing if needed.

I suspected this wouldn’t be correlated with the lifting population but figured it couldn’t hurt to ask given your unique insights into both medicine and the lifting population.

Thanks again for the reply, thanks for all you do, and congrats to your raw nats lifters!

Edit/Follow-up: Just thought I’d let you know, my x-ray results were entirely normal, so as you suggested, I guess this will be something that remains a mystery. Thanks again for answering!

Scott
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