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Exercise-Induced Asthma: Symptoms, Diagnosis, and Treatments

Posted on February 03, 2021
Medically reviewed by
Deborah Pedersen, M.D.
Article written by
Amy Isler, RN

Exercise-induced asthma — more accurately described as exercise-induced bronchoconstriction (EIB) — is a common condition that affects 12 percent to 15 percent of the population. The main difference between EIB and asthma is, exercise is the sole trigger of EIB’s asthma-like symptoms whereas asthma has many triggers.

Around 90 percent of people with asthma are also diagnosed with EIB, which is most commonly induced by vigorous physical activity, cold weather, and winter sports such as ice hockey, cross-country skiing, and ice skating. EIB can also be present in people diagnosed with atopy or allergic rhinitis — or even people with no other known health conditions.

It is unclear why exercising can provoke narrowing of the small bronchial tubes connected to the airway. Scientists believe it’s triggered by cool and dry air stimulating bronchoconstriction, which can cause chest tightness and shortness of breath.

Symptoms

EIB symptoms typically occur a few minutes after you start exercising, and they may last for 10 minutes to 15 minutes after you’ve finished. EIB-like symptoms can occur in anyone while exercising, especially people who usually engage in little to no physical activity. However, for people with EIB, the symptoms are generally much worse.

The most common symptoms of EIB include:

  • Wheezing or shortness of breath
  • Decreased endurance
  • Tightness in the chest
  • Cough
  • Upset stomach
  • Sore throat

Sports that require continuous movement and are played outside, especially in cold weather, are most likely to trigger EIB symptoms. These physical activities include soccer, basketball, long-distance running, ice hockey, ice skating, and cross-country skiing.

Recreational activities that are least likely to cause EIB symptoms include walking, hiking, recreational bike-riding, and sports that require only short bursts of activity (e.g., football, gymnastics, volleyball, or baseball).

This condition is very treatable. With the right medications, treatments, and preparation, you will be able to continue engaging in the sports and activities you love.

Are There Differences Between Asthma and EIB?

Asthma and EIB share similar symptoms. However, asthma can be triggered by a number of factors, including allergens (e.g., pollen, dust mites), weather and temperature changes, and viruses. However, with EIB, exercise triggers the asthma-like symptoms — though environmental factors may be contributors or exacerbators. Because of these differences, you can be diagnosed with EIB but not asthma.

Diagnosis

An allergist or asthma doctor will be able to identify whether your symptoms are related to EIB. The assessment will typically include a physical and family history, questions about how often you exercise, and questions to rule out any other upper-airway and breathing conditions.

The doctor may also evaluate your lung function with a spirometer — a device that measures the volume of air you breathe in and out. This type of examination typically requires you to run on a treadmill for a certain length of time; the doctor will measure your air volumes before and after you run.

Should I Still Exercise if I Have EIB or Asthma?

The short answer to this is “absolutely.” Exercise is crucial to both physical and mental health, and you should not avoid it for fear of EIB symptoms. Studies have shown that 20 percent to 50 percent of Olympic athletes have EIB.

Exercise and physical activity produce many health benefits that can help control asthma and EIB symptoms, including:

  • Improved lung function, which can bolster stamina
  • Stronger muscles, which promote blood flow to your lungs and heart
  • Weight loss, which can prevent asthma flare-ups
  • Improved immune-system function, which can reduce respiratory infections
  • Improved sense of well-being and quality of life
  • Reduced stress, anxiety, and depression

Treatments for EIB

EIB is easily treatable, and your doctor should create for you an individualized pre- and post-exercise treatment plan that is easy to follow.

The most common and reliable EIB treatment is to administer a prescribed short-acting bronchodilator inhaler — such as Proventil (Albuterol sulfate) — 15 minutes to 20 minutes before you exercise. This approach has been found to be effective in preventing symptoms during physical activity for 80 percent of people with EIB.

Alternative treatments may include Singulair (Montelukast sodium) and inhaled corticosteroids, long-term medications usually taken daily to help manage EIB and asthma symptoms.

Changes to your exercise routine can also help you manage EIB symptoms, including the following:

  • Use gentle warm-up exercises for 15 minutes before engaging in more strenuous activities.
  • Breathe through your nose while exercising. This technique can warm and humidify the air entering your lungs. If you are exercising in cold weather, cover your mouth and nose with a scarf or face mask.
  • Create an exercise routine that avoids your most common asthma triggers. For example, avoid running outside on days with high levels of air pollution.
  • Keep your inhaler with you at all times to provide fast relief for EIB symptoms before they turn severe.

Children With EIB

If you have a school-aged child diagnosed with EIB, ensure their physician completes an emergency asthma action plan and a medication-at-school form. These should be kept with the school nurse, P.E. teacher, and or coach.

This type of plan not only ensures that school personnel knows your child has EIB; it provides clear guidance on how to help your child prevent and quickly relieve their symptoms. Make arrangements with your school for your child to carry their own inhaler or to have one stored in a secure, accessible place at school, such as the health office.

Get the Support You Need

If you are navigating an EIB diagnosis, you are not alone. By joining MyAsthmaTeam, you gain a community of members who share encouragement and reassurance. Members offer support and tips to overcome barriers to treatment and symptoms and can be a safe sounding board to express your feelings, triumphs, and frustrations.

Have you or a loved one been diagnosed with EIB? Do you have tips to share about exercising with asthma or EIB? Share your experiences below in the comments or post on MyAsthmaTeam. Your story could help someone facing the same challenges.

All updates must be accompanied by text or a picture.
Deborah Pedersen, M.D. has specialized in allergy and asthma care as well as pediatrics for over 16 years. Review provided by VeriMed Healthcare Network. Learn more about her here.
Amy Isler, RN is a registered nurse with over six years of experience as a credentialed school nurse. Learn more about her here.

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