Running with epilepsy: a safety plan for solo runs

What epilepsy organizations say about exercise

The Epilepsy Foundation New England says that although physical exercise can very rarely trigger seizures, for the vast majority of people with epilepsy the benefits of exercise far outweigh the risks. The CDC says exercise may reduce the risk of seizures and that exercising safely can benefit physical health, mental health and emotional well-being.

The same sources are consistent about a few precautions. The Epilepsy Foundation New England advises taking frequent breaks, drinking plenty of fluids, and always wearing a medical alert bracelet or necklace and carrying a medical alert card. Its advice for bike riding, avoiding busy streets in favor of bike paths or quiet residential streets, carries over naturally to running. For people whose seizures are not controlled, it says a buddy system can go a long way toward preventing harm.

This page is general information, not medical advice. The CDC's advice is to talk to your health care provider about which types of physical activity are safest for you. Your neurologist knows your seizure type, your control and your medication, and they are the right person to decide with you whether, where and how you run alone.

Questions to take to your doctor

The CDC lists common seizure triggers including lack of sleep, missed medication, stress, alcohol, and flashing lights or certain sounds. Going into the appointment with specific questions about running helps you leave with a plan rather than a general "be careful".

• Is my seizure control good enough for running alone, or should I run with someone for now?
• Which of my triggers matter on a run, and do heat, dehydration or hard efforts affect me?
• Do I get any warning before a seizure, and what should I do if I feel one coming mid-run?
• Does my seizure action plan need a section for exercise, and who should have a copy?
• When should I skip a solo run: after a bad night's sleep, a missed dose, or while a medication change settles?

Choosing routes with a seizure in mind

Route choice is where most of the risk reduction happens. The goal is a place where, if you had a seizure, you would be unlikely to be hurt by your surroundings and likely to be found quickly.

• Favor paths away from traffic, like park loops, bike paths separated from the road, or a track. Avoid running along busy roads without a buffer.
• Stay away from open water, cliff edges and steep drop-offs. The CDC says swimming alone should be avoided by people with epilepsy, and a seizure that happens in water is one of its reasons to call 911, so a riverside path is a poor choice for a solo run.
• Shorter loops that pass your home, car or a staffed building mean you are never far from help.
• Places with other people around, at times they are likely to be there, make it more likely someone sees you.
• Carry water and plan shade in warm weather. Our guide on heat safety for runners covers timing and warning signs.

How Holler fits, and what it cannot do

Holler cannot detect a seizure. What it can do is notice two things that often follow one: you stop moving, or you do not come back when you said you would. Either one can bring your Guardian in.

A stationary alert asks "Are you OK?" if you stop moving for the time you choose, and alerts your Guardians if you do not answer. Choose a time with your doctor's advice about seizure duration and recovery in mind: long enough that stopping at a crossing does not set it off, short enough to be useful. After a seizure you may be confused or unable to respond, which is exactly the case this is for. Read more in how a stationary alert works.

Set a return time on every solo run. If you have not checked in five minutes after it, your Guardians get an overdue alert from Holler's server, even if your phone app is closed or the phone was damaged. Share your live location link so they can see your route and last known location. In a phone browser, sharing and the stationary alert only work while the page is open and the screen is on.

Holler does not contact 911. Your Guardian, or someone who finds you, makes that call.

A solo run, set up start to finish

Here is how one runner might put this together for an easy 5 km on a weekday evening, with a plan already agreed with their neurologist. They slept normally and took their medication on time; if either had slipped, the plan says to run with a friend or skip it.

They choose the park loop that passes their building twice instead of the river path. Before leaving they start an outing with a return time 45 minutes out and a stationary alert set to the length their doctor suggested. Medical alert bracelet on, card in the shoe pocket, phone in a belt. At the halfway point they stop for water for a minute, well under the stationary time. Back home, they end the outing, which is the check-in.

The message they sent their Guardian once, when setting this up: "When I run alone I'll share a Holler link. If you get an 'Are you OK?' or overdue alert from me, call me once. If I don't answer within two minutes, call 911, say I have epilepsy and may have had a seizure, and give them the location from the link. My seizure plan is in our shared notes."

Medical ID: help for whoever reaches you first

The first person to reach you after a seizure is likely to be a stranger. A medical ID tells them you have epilepsy and who to call. Wear a medical alert bracelet or necklace, set up the medical ID on your phone so it shows on the lock screen (see how to set up Medical ID on iPhone), and carry a card. Our answer on what to put on a medical ID covers the contents, and the emergency card generator makes a printable card with your condition, medications and contacts.

If your doctor has given you a seizure action plan, a one-line version on the card, such as "Epilepsy. Time the seizure. Call 911 if it lasts over 5 minutes," helps a bystander do the right thing. Use the instructions your doctor gives you.

What your Guardian should know

Your Guardian is probably not beside you, so their job is to notice, reach you or someone near you, and call for help when needed. An alert may mean a seizure, a fall, a phone problem or a forgotten check-in. Call you first. If you do not answer within a couple of minutes, they should not wait longer: call 911, say you have epilepsy, and give the location from the link. Our guide on what to do if someone's location stops moving walks through the same steps.

They should also know basic seizure first aid, in case they are nearby or talking a bystander through it on the phone. The table below follows the CDC's first aid guidance. Keep a copy of your seizure action plan and medication list where they can find it quickly.