Face masks don’t impede exercise ... except for one type

Studies find most face coverings have little impact on performance during workouts

Few people who exercise don masks with enthusiasm when it comes to vigorous workouts, convinced that they will make our faces sweaty, breathing laboured and workouts more draining. Photograph: Rudi Suardi/iStock
Few people who exercise don masks with enthusiasm when it comes to vigorous workouts, convinced that they will make our faces sweaty, breathing laboured and workouts more draining. Photograph: Rudi Suardi/iStock

Exercising during the pandemic has been challenging for many of us. Gyms have closed, as have pools and other recreational facilities. If trails are open, they often are jammed, making it difficult to socially distance while we hike, stroll, ride, jog or otherwise work out.

Mask recommendations have created additional complications. Few people who exercise, including me, don masks with enthusiasm when it comes to vigorous workouts, convinced that they will make our faces sweaty, breathing laboured and workouts more draining. We rejigger the timing and locations of our runs and rides so we can exercise when few other people are about and leave our faces uncovered. Or we skip workouts altogether.

But for those of us convinced that wearing a mask will make exercise harder or more unpleasant, two new studies offer a bracing counterpoint. Both find that masks do not negatively affect vigorous workouts, whether the mask is cloth, surgical or an N95 respirator model. The findings may surprise, but also encourage anyone hoping to remain safe and active in the coming weeks and months.

Most of our expectations about masks and exercise are based on anecdotes and preconceptions. Little past science has examined whether and how masks affect serious workouts. The few relevant earlier experiments focused primarily on masked healthcare workers while they walked, to see if being active while masked affected their thinking or other capabilities. (It did not, the studies show.)

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But gentle strolling is not running, cycling or other more vigorous routines, and we have not had scientific evidence about how wearing a mask might alter those workouts. So, recently, two helpful groups of scientists separately decided to look into the issue.

The first of the groups to release their findings, which were published in the Scandinavian Journal of Medicine & Science in Sports, concentrated on surgical and N95 respiratory masks during exercise. The researchers, most of them affiliated with the Rambam Health Care Campus in Haifa, Israel, invited 16 healthy, active adult men to come into the lab, where they checked heart rates, blood pressure, oxygen saturation, respiratory rates and current carbon dioxide levels. Then they fitted the men with thin, nasal tubes that would collect their expired breaths for testing and, on three separate visits to the lab, asked them to ride a stationary bicycle.

At each visit, the men, in fact, completed a pedal-to-exhaustion test, during which the researchers gradually increased the resistance on the stationary bike, as if on a long, relentless hill climb, until the men could barely turn the pedals. Throughout, the researchers monitored the riders’ heart rates, breathing and other physiological measures and asked them repeatedly how hard the riding felt.

During one ride, the men’s faces were uncovered. But for the two other sessions, they donned either a disposable paper surgical mask or a tight-fitting N95 respirator mask.

Afterward, the scientists compared the riders’ physiological and subjective responses during each ride and found few variations. Masking had not made the cycling feel more draining and had not tired riders sooner. The only substantial effect was from N95 masks, which slightly increased levels of carbon dioxide in riders’ breaths, probably because the masks fit so tightly. But none of the riders complained of chest tightness, headaches or other breathing issues.

Most expressed some surprise, instead, that the masks had not bothered them, says Dr Danny Epstein, an attending physician in the internal medicine department at Rambam Health Care Campus, who led the new study. They "had believed that their performances would be decreased by masking", he says.

The findings suggest that anyone who hesitates to wear a mask during exercise should try one

Similarly, the researchers in the second masking study, which was published in the International Journal of Environmental Research and Public Health, hypothesised that masking would make exercisers uncomfortable and tired. For confirmation, they ran a group of 14 healthy, active men and women through the same ride-to-exhaustion sessions as in the Israeli study, while the volunteers alternately wore no mask or a three-layer cloth or a surgical face covering. The researchers monitored oxygen levels in the riders' blood and muscles, heart rates, other physiological measures and the riders' sense of how hard the exercise felt.

Afterward, contrary to their hypothesis, they found no differences in the riders' experience, whether they had worn a mask or not. "From the results of our study, I don't think masks are likely to make workouts feel worse," says Philip Chilibeck, a professor of kinesiology at the University of Saskatchewan in Canada, who oversaw the study.

Of course, both of the new studies recruited healthy, active adults. We do not know if the results would be the same in people who are older, younger, in worse shape or have existing breathing problems. The studies also involved cycling. The outcomes probably would be similar in running, weight training and other vigorous activities, both Epstein and Chilibeck say, but that idea, for now, remains a presumption. And, obviously, the studies looked at how masks affect the wearer, not whether and to what extent different facial coverings prevent the spread of respiratory droplets during exercise.

Still, the findings suggest that anyone who hesitates to wear a mask during exercise should try one – although not an N95 mask, Epstein says, since they slightly up riders’ carbon dioxide levels and, anyway, should be reserved for healthcare workers.

“Covid-19 changes almost every aspect of our lives and makes simple things more complicated,” Epstein says. “But we can learn how to keep doing the essential things, such as exercise.” – New York Times