The Athletic Respiratory Therapist

For years I have enjoyed the Roche 5K Fun Run during the AARC National Convention. Typically, the event fills the streets with runners and walkers who are attending the congress, and among the crowd are scores of respiratory therapists-and many of these clinicians are running or walking extremely fast.

Participating in the Roche Fun Run has strengthened my theory that there are many respiratory therapists active in sports or fitness programs. You would be surprised by the number of times I randomly meet respiratory therapists who are runners, cyclists, triathletes, or involved with other sports.

Over the years, I have given the occasional ‘sports’ lecture based on the respiratory research I have done with athletes. [1,2] In June, I prepared lecture for a major sports workshop. As the keynote speaker, my lecture — Mental Aspects of Training and Racing — was based on decades of competitive sports and having been trained by coaches from the US, UK, Belgium, and South Africa. In consideration of the significant number of respiratory therapists participating in sports, this writing will hopefully pass on a few pearls shared with me.

Create A Plan 
Adults participating in sports are frequently self-coached, and regardless of how the coaching is achieved — through online programs, text books, tips and best practices learned from friends, etc. — the act of implementing an annual training and event participation plan is a must for personal gratification and competitive success.[3] The annual plan becomes the pathway to achieving athletic goals and is paramount to keeping an athlete focused on these goals. I recommend writing it down and keeping it in a convenient place for easy access and updating.

The annual plan should have a combination of short- and long-term goals and evolve over time. As an example, at the beginning of my triathlon career, my annual plan was pretty simple, sign up for a few events and be sure to accomplish three things:

1. Get out of the water under my own power
2. Don’t crash on my bike
3. Don’t finish last in the run.

As I improved, my goals became more serious and competitive.

Prior to becoming a triathlete, I was a competitive cyclist. One of my coaches, a USA National Team coach, Nestor Gernay, would stress, “If you want to go 30 miles an hour, you have to go 30 miles an hour,” The point being that my training had to match my competitive goals and that I shouldn’t expect a miracle on race day. For non-training time, Coach Gernay stressed the important of saving my legs: “Don’t stand when you can sit and don’t sit when you can lie down.” An annual training and event plan must include rest and recovery. Sleep is good.

An anxious David Lain prior to the beginning of Ironman Eagleman 70.3

Stay Driven 
Over the years, I’ve had the good fortune to train and compete with many Olympians and world champions. Several stand out in my mind: John Howard (3X Olympian), Vince Maggoni, PharmD, Howard Taylor, PhD and Bruce Buchanan, DMD.

Dr. Buchanan is one of many health care professionals who regularly and successfully participate in athletic events. He has won the Ironman World Championships in Kona, Hawaii seven times in his age group. Some consider him one of the greatest age groupers of all time for Kona. Dr. Buchanan began his career in sports as a collegiate swimmer and marathoner. Despite numerous injuries and problems, including chondromylacic, Achilles tendonitis, plantar fasciitis, broken toes, broken collarbones, broken ribs, hip injuries, two concussions, and three knee surgeries, he has continued to pile up victories.[4] Dr. Buchanan is an extreme example of the desire and mental focus required to push pain aside.

One of my coaches from South Africa said to me, “I don’t see how Bruce does it. He can somehow always get up for a race.” During one particularly painful steep climb on a bicycle, this same South African coach gently encouraged me.”What’s wrong with you?! It’s all in your head. Just go.” That was easier said than done as I recall. However when I glanced over my shoulder at Dr. Buchanan, he seemed to be riding almost relaxed, such was his focus.

Focusing and sticking to a training plan can be tough, particularly when shift work is involved. As respiratory therapists, we are often subjected to shift work, and it can hurt both physically and mentally. Permanent shifts, at least, give us a schedule from which we can organize our lives. When I was on night shifts as a therapist, I slept as soon as possible after my shift and used my afternoons to train. When I worked a 3:00pm- 11:00pm shift, I trained in the morning. Today, I have a relatively fixed 8:00-5:00 schedule, so I train before and after work. I schedule workouts on both sides of my day job because “stuff” always happens and any plans to get in some training at lunch time will inevitably be interrupted.

I recently read about yet another medical professional/athlete whose stats are mighty impressive, ranging from running a 5K at 19:55 to completing a full marathon at 3:03:27. Barbara Stoll, PhD at Baylor University Medical Center, is identified as an “Age-Group Ace” by Running Times Magazine. [5] Her work, training and event schedules are exhausting to read, and I am filled with admiration.

Build Confidence 
When planning competitive events, plan small and work your way up. Try to find an event that you truly feel you can do well in and use it to build your confidence. In the 70’s my Belgian coach had me going to events to win. Not the national competitions, but small races — regional and local events. He was teaching me to win and to build confidence. Eventually, he prepared me for national and international competition.

A proper plan is key, even for the most seasoned athletes. Chris McCormack, Ironman World Champion, winner of over 300 triathlons and a ‘Wheaties Box’ athlete, commented on Lance Armstrong’s triathlon comeback: “I only see improvement for Lance, as his confidence grows, so does his drive to win.” [6] Unfortunately, the recent USADA banning of Armstrong ended his quest for Kona.

Nevertheless, planning your participation and choosing races that will allow you to do well and place highly, helps build confidence. For example, you may be seeking a personal goal, like running a marathon. Don’t expect to sign up for a marathon and finish a 26.2 mile run a month after you begin training. Even if your goal is to complete a marathon, regardless of time, it is critical that you give your body the time it needs to prepare for a 26.2 mile run. And this takes time. To achieve your goal, put some shorter distance events like 5K, 10K, and a 13.1 mile run into your training and competitive event plan.

As part of a training plan, consider the “4 Cs”, as described by Brian Mackenzie:


  • Concentration:

your ability to maintain focus.

  • Confidence: believing in your ability.
  • Control: your ability to maintain emotional control regardless of the distraction.
  • Commitment: your ability to continue working toward your goal. [7]
  • If your hospital or department has a group of athletes who train together, join the group. A group dynamic serves well to help individuals maximize their potential using “4 Cs”, even if informally.

    See the Finish Line 
    Finally, consider visualization an important part of your annual plan. Visualize yourself on the course, and crossing the finish line. Play the event over and over in your head. If possible, ride over the course by car, bike or on foot if it is a local event and time allows. Visualize yourself reviewing your plan at the end of the year, having completed all the events and achieved training goals.

    It is always a pleasure to meet other respiratory therapists at competitive events. It occurs more often that you might imagine. I look forward to seeing you out there. Now get out there and train.


    1. Lain D., Jackson C. Exercise-induced hypoxemia desaturation zones: a use in athletic training. Chest, Vol 118, No 4, pp 203S, 2000
    2. Lain D., Shakar U. Practical pulse oximetry during high altitude hiking. Chest, Vol 118, No. 4, page 203S, 2000.
    3. Baird C. The Natural. Inside Triathlon. May/June, pp 33-42, 2012
    4. Carlson, T. The Top 10: Kona’s Greatest Age Groupers, Jeff, Triple Fitness Training, Nov 14, 2008
    5. Tymn, M. Surprisingly Simple. Running Times. Sept. Issue 400. 2012: 35
    6. McCormack. C. The Lance Factor, Inside Triathlon, May. June 2012: 20-30
    7. Mackenzie, B. (1997) Psychology [WWW] available from: http//

    Dr. Lain is a competitive cyclist, runner, and triathlete. He has raced in the US, Europe and Japan. Foremost, he is a respiratory therapist and has been involved in the profession for over 35 years.

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