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Exercise-Induced Asthma Can Leave You Breathless

Learn how to manage symptoms while keeping active.

Asthma image

Many people confuse being out of shape with having exercise-induced asthma. Because the symptoms of exercise-induced asthma are similar to poor fitness (shortness of breath and a tight feeling in the chest), it can be difficult to tell the difference between them. The symptoms of exercise-induced asthma may deter people from exercise. However, exercise-induced asthma can be controlled, and you can stay active.

What is exercise-induced asthma?
In asthma, the small airways of the lungs become irritated from various causes and begin to constrict. The bronchial muscles around the tubes go into spasm, and mucus builds up in the tubes. The cells that line the airways also start to swell, closing the airways even more. In exercise-induced asthma, this reac­tion is triggered by exercise. Although people with chronic asthma are more likely to have exercise-induced asthma, the presence of exercise-induced asthma does not lead to chronic asthma.

What causes exercise-induced asthma?
The exact cause of what trig­gers an exercise-induced asthma attack is unknown. One theory is that symptoms may be triggered by drying or cooling of the airways during heavy breathing.

During normal breathing, the airway warms and moistens incoming air, which is usually cooler and drier. In the pro­cess, the airways can sometimes cool down and dry out, which can irritate sensitive tissues. During exercise, the amount of air moved in and out of the lungs increases, which also increases the amount of cooling and drying.

What are the symptoms of exercise-induced asthma?
The symptoms of exercise-induced asthma include:

  • Shortness of breath during or after exercise
  • Tightness or pain in the chest
  • Coughing
  • Wheezing
The symptoms generally start a few minutes into exercise and may last for 30 to 60 minutes. In contrast, if the problem is poor fitness, the symptoms will usually disappear a few minutes after stopping exercise.

The symptoms generally start a few minutes into exercise and may last for 30 to 60 minutes.

What should I do if I think I may have exercise-induced asthma?
Speak with your doctor if you believe you are experiencing exercise-induced asthma. An exercise challenge test can be used to determine whether you have exercise-induced asthma. Many doctors will base their diagnosis on your history and symp­toms. Your doctor also may have you do a trial of bronchodilator therapy prior to exercise. Although chest pain is a symp­tom of exercise-induced asthma, it is important for your doctor to rule out cardiovascular disease.

Additional Workout Strategies

There’s an exercise-induced asthma loophole called the refractory period. This period lasts up to two hours after an exercise-induced asthma attack. During this time, your lungs are less likely to react as strongly. If you warm up 45 minutes to an hour before your workout, you may be able to exercise without too many symptoms. Some athletes have found they can exercise easier by alternat­ing work and rest periods, also called interval training.

How can I prevent an exercise-induced asthma attack?
For starters, breathe through your nose. This will help warm and moisten the air before it reaches the bronchial tubes. Stay out of cold, dry air. If you do exercise outdoors, wear a facemask or scarf to help warm the inhaled air with heat and moisture from your skin. If pos­sible, exercise indoors. You are less likely to have an exercise-induced asthma episode when doing so. Opt for lower-intensity sports, such as golf, baseball, and weightlifting.

No matter what your activity, if high amounts of airborne irritants (such as pollen) increase your chance of an attack, it makes good sense to exercise indoors on days when those irritants are high. Most importantly, don’t stop ex­ercising. Exercise training will improve fitness so that a lower level of breath­ing is needed at a given exercise level. Good cardiovascular fitness will enable you to exercise at a higher intensity be­fore experiencing an exercise-induced asthma attack.

Does exercise-induced asthma require medication?
In some cases, medicine is needed to treat exercise-induced asthma. There are two broad types of medications that your physi­cian might prescribe: bronchodilators and anti-inflammatory medication. Bronchodilators work to keep the airways relaxed and open. They are used before or during exercise. Anti-inflammatory medications include inhaled corticosteroids, which reduce the sensitivity to the airways.

No one medicine works best for everyone, and you may need a combi­nation for best control. If you are an elite athlete, it is important to check that the medication suggested for you is approved for use in your sport.


Adapted with permission from a brochure produced by the Consumer Information Committee of the American College of Sports Medicine ( Copyright © 2011 American College of Sports Medicine.

This article was originally published in Coping® with Allergies & Asthma magazine, Winter 2013-2014.