Exercise-induced asthma, also known as exercise-induced bronchoconstriction (EIB), occurs when the airways in your lungs become constricted during strenuous exercise. Symptoms include coughing, fatigue, and shortness of breath during and after physical activity. While EIB can interrupt daily life, effective treatment methods are available to help you continue exercising in the way you love.
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What Is Exercise-Induced Asthma?
Exercise-induced asthma, also called exercise-induced bronchoconstriction (EIB), occurs when strenuous movement causes asthma symptoms. With this condition, your airways become inflamed and tight during exercise, usually triggered by breathing dry air.
EIB can affect your ability to participate in exercise and other activities you enjoy.
How common is exercise-induced asthma?
Exercise-induced asthma is very common for people who are already diagnosed with asthma —up to 90% of people with asthma also have EIB. But up to 20% of people without asthma may also have exercise-induced asthma.
What causes exercise-induced asthma?
Breathing in dry, cold air through the mouth during physical activity is the main trigger for EIB. When you are exercising, you are breathing deeper and faster, usually through the mouth, which can dry and tighten the airways.
Exercising in cold climates can trigger exercise-induced asthma more quickly than in humid or warm temperatures. Ice hockey, ice skating, skiing, and running outside in the winter can all cause asthma symptoms.
Exercise-induced asthma risk factors
Researchers aren’t sure exactly what causes exercise-induced asthma, but there is evidence that suggests certain conditions may trigger or increase the risk of the condition, including:
- Cold, dry, or polluted air.
- Chemicals used in pools (such as chlorine) or for ice-rink resurfacing.
- High pollen counts.
- Lung disease.
- Respiratory infections.
Complications of exercise-induced asthma
If not treated, exercise-induced asthma can lead to a lower quality of life and poor breathing, which can lead to serious health conditions.
How can I prevent exercise-induced asthma?
Although you may not be able to prevent exercise-induced bronchoconstriction itself, there are a few things you can do to prevent flare-ups, including:
- Follow your doctor's instructions for using your medicine.
- Use a rescue inhaler 10 minutes before beginning strenuous exercise.
- Warm up and stretch before strenuous exercise.
What Are the Signs and Symptoms of Exercise-Induced Asthma?
Symptoms of exercise-induced asthma usually begin a few minutes after exercise and may continue after stopping exercise if left untreated.
Symptoms may include:
- A feeling of tightness in the chest.
- Avoidance of physical activity.
- Chest pain.
- Coughing.
- Fatigue.
- Reduced athletic performance.
- Shortness of breath.
- Wheezing.
For some people, coughing is the only symptom they experience. It can be hard to determine if the coughing is related to exercise-induced asthma or not, so it’s essential to understand the typical conditions.
In EIB:
- Coughing begins 10 to 15 minutes after beginning strenuous activity.
- Coughing typically ends within 90 minutes after exercise is completed.
- If you start exercising again within the next three hours, coughing does not occur.
Some people may get another wave of symptoms (late-phase) up to 12 hours after ending exercise. These symptoms can become severe and last up to a day.
When should I see a doctor about my exercise-induced asthma symptoms?
If you experience severe wheezing or shortness of breath during exercise — or wheezing or shortness of breath that persists even after you stop exercising — call 911.
If you are experiencing any of the above symptoms and they do not feel life-threatening, schedule an appointment with your primary care provider to receive a proper diagnosis.
How Do You Diagnose Exercise-Induced Asthma?
First, your doctor will ask you a series of questions related to your symptoms, health history, and family history. They will want to measure your breathing before, during, and after exercise, as well as run some tests to rule out other conditions and provide a formal diagnosis.
Tests to diagnose exercise-induced asthma
- Skin testing — Also called scratch testing, this test exposes your skin to small amounts of allergens (allergy-causing substances) to identify environmental allergy triggers, such as pollen, dust mites, pets, and mold, that may be causing or worsening your exercise-induced asthma.
- Pulmonary (lung) function tests — Lung function tests are noninvasive and provide information about how well your lungs are working. There are several types of lung function tests, including:
- Lung volume test. A lung volume test measures the volume of air in your lungs and how much air is left in your lungs at the end of a normal breath.
- Spirometry. A spirometry test measures how much air your lungs can hold and how forcefully you can breathe out.
After your first round of lung function testing, your health care provider may give you an inhaled medication called a bronchodilator and ask you to repeat the test(s). Your provider will compare your test results to determine if the medication was effective.
Exercise-induced asthma prognosis
Many people with exercise-induced asthma can still enjoy full lives of physical activity and adventure by managing their symptoms with medication and other treatment methods.
How Do You Treat Exercise-Induced Asthma?
Treating exercise-induced asthma successfully requires a combination of medication and physical conditioning. It’s important for all people to be physically active — even people with asthma. Working with your doctor to find the best medication and lifestyle changes can keep you living a full life, even with exercise-induced asthma.
Medications for exercise-induced asthma
Medications may help treat exercise-induced asthma. Some medicines are taken before exercise to prevent exercise-induced asthma, and others are taken daily to provide long-term control. Your doctor may also prescribe quick-relief medications in the form of an inhaler for use if symptoms appear suddenly.
Your health care provider will let you know what type of medication is right for your condition.
Patient education for exercise-induced asthma
Understanding how to manage your exercise-induced asthma, including asthma inhaler instruction, less-strenuous exercise options, and healthy lifestyle choices, can all improve your asthma symptoms. Talk with your care team about what options are best for you.
