This discussion just came up today at our affiliate; I've had it happen to me on numerous occasions in varying degrees. The PWO-cough, in my opinion, is exercise induced pulmonary edema secondary to high intensity metabolic conditioning. The "why(s)", well I'm not exactly sure on. My 2 cents:
- The pathophysiology lies somewhere in a transient V/Q mismatch, exacerbated by high intensity anaerobic work.
- Short duration, high intensity met cons seem to produce EIPE more often than longer duration.
- Forgoing a "cooldown", and lying, mostly likely, completely supine, and doing nothing more than moaning, potentially exacerbates it also.
- Buildup of blood lactate and H+ and decreased clearance via ventilation and metabolic buffering cause interstitial shifting of plasma.
- Actually inducing hemoptysis is probably a completely different, and much more severe etiology. My cough has always been non-productive.
There's way, way more to it than that, but there's no doubt in my mind it's a ventilatory and buffering issue, coupled with intensity. The workout I just did induced some of the worse coughing I've ever had in the past couple of years:
3 rounds, for time:
-10 Chest-to-bar pullups
-10 "Hip Smashers" (think MMA sprawl)
A short, intense workout lasting sub:2 minutes. Coughed like a madman for the next 45 minutes.