Running and MCAS – The First Mile: Returning to Running After a Year with MCAS

I spent a long time thinking about how to write this article.

Originally, I imagined writing a detailed breakdown of the workouts, mileage, and progression that finally allowed me to run again after taking nearly a year off because of MCAS. Unfortunately, the problem is that I didn’t stumble across a magical combination of medications or supplements that suddenly made running possible again. I also didn’t discover a new style of training that somehow avoided all of the triggers that had left me covered in hives, with freezing skin and joints that hurt so badly I wondered how they were still attached.

Instead, I slowly came to the realization that running wasn’t actually the problem…sort of. Running wasn’t the thing I needed to fix. It became my measuring stick. If I could run, it usually meant I had done enough of the little things to keep my MCAS symptoms under control.

At first I assumed running itself was causing my symptoms. It took me almost a year to realize that running wasn’t really the problem—it was simply exposing a problem that was already there. Once I understood that, everything else started making sense.

Think of your ability—your capacity—to tolerate MCAS triggers as a bucket, and all the triggers you encounter throughout the day as water in that bucket. When the bucket overflows, you experience symptoms. This way of thinking about MCAS is something I call the Bucket Model, and I explain the idea in much greater detail here: Why MCAS Symptoms Change Everyday: The Bucket Theory Explained.

When I first started my MCAS journey, my bucket was already full or nearly full every day. Running didn’t fill the bucket by itself—it was simply the final drop that caused it to overflow. Runs would leave me covered in rashes and hives, with joints that hurt so much I was amazed they were still functioning in any capacity, and skin so cold it seemed incredible that it was still sweating somehow. For a year, that was my experience with running. It felt like it was always out of the question.
During that year I focused on healing and doing the “little things” right. As distance runners, we all know what the little things are, because we hate them: eating right, giving your body time to heal, getting adequate rest, cross-training, and so on.

I also started doing all the little things I could for my MCAS. I changed my diet to focus on low-histamine foods. I worked with all sorts of doctors and started mast cell stabilizers. I built a symptom-tracking system to understand which triggers affected me the most. I prioritized sleep and worked on reducing my stress levels.

None of those things made me a better runner. They made me healthy enough to become a runner again.

A year later, I still can’t run whenever I want, but the little things have paid off, and I can run. I’ll admit it—it still hurts every time I see someone jogging along the road. It still doesn’t look right when I look down at my legs and don’t see calves you could sharpen an axe on, but I am headed in the right direction…finally.

I have learned to estimate my bucket level by the symptoms I experience to judge how much I can push my body. Over time I stopped asking myself, “Can I run today?” Instead, I started asking, “How full is my bucket?”

Skin feeling like it’s covered in frozen acid? Probably not worth trying to run.

Some mild discomfort? Yup, go for it.

The First Mile and How It Became Possible

I started small on the days I had a good sense that my body could tolerate a run—literally 400-meter repeats at conversation pace. I did that for weeks until I had worked up to 8 to 12 repeats without experiencing symptoms. Then I went to a one-mile run without stopping, then two, then four, then six. For someone who used to think nothing of spending half a day running trails, that progression felt painfully slow.

The number of running days I’ve been able to have has been greatly impacted by a radical decision my wife and I made: sell our home, buy a camper trailer, and spend a year traveling the country, staying in different locations to see why my triggers are reduced.

Maybe to a lot of people selling your house to chase cleaner air sounds irrational. To someone with MCAS, it can be one of the only ways to answer the question, “How can I get back to some form of a normal life?”

We are still very early in that journey, only about 30 days in, but already we’ve seen encouraging differences. While staying in the higher elevations of Vermont’s Green Mountains, I could run almost every day. A week earlier, while we were staying near Niagara Falls, I couldn’t run at all.

The difference was my environment.

For me, my bucket seems to be lower in the mountains. Pollen and mold measure lower, the winds are more common, and for whatever reason my symptoms consistently improve there. The lower my bucket started each day, the more room I had for physical activity. More room meant more opportunities to run.

Distance runners are constantly searching for “the secret.” If you’ve ever had the opportunity to read John L. Parker Jr.’s Once a Runner, you already know there isn’t one.

“What was the secret, they wanted to know… The Trial of Miles; Miles of Trials.”
— Quinton Cassidy, Once a Runner

Distance running has never really rewarded shortcuts. Success comes from faithfully doing hundreds of little things well, day after day, until eventually they add up to something bigger.

Learning to deal with MCAS felt exactly the same for me.

There wasn’t one thing that made the difference. It was learning to listen to my body. It was improving my diet. It was finding medications that helped, even if only a little. It was getting enough sleep. It was learning my triggers. It was tracking my symptoms. It was reducing stress when I could and accepting that some days my body simply wasn’t going to cooperate.

None of those things, by themselves, brought me back to running.

Together, they slowly created enough room in my bucket that running became possible again.

When I sat down to write this article, I thought it was going to be about running. Looking back, I don’t think it was ever about running. It was about learning to live well enough with MCAS that running became possible again.

I don’t know what your path back will look like. It may be faster than mine, or it may take longer. But I do hope that, one day, you find yourself lacing up your shoes, heading out the door, and realizing that your first mile back was worth every bit of the work it took to get there.