Exercise-Induced Asthma

Also called: EIA, Exercise-Induced Bronchoconstriction

What Is Exercise-Induced Asthma?

Many people with asthma have symptoms when they exercise if their asthma is not well-controlled. But some people have asthma symptoms only during or after exercise: This is known as exercise-induced asthma (EIA). The asthma symptoms happen because the airways tighten up (called bronchoconstriction) during exercise. This blocks the flow of air and makes it hard to breathe.

What Are the Signs & Symptoms of EIA?

Someone with EIA may:

• have wheezing, tightness or pain in the chest, coughing, or shortness of breath during or after exercise
• get winded or tired easily during or after exercise
• cough after coming inside from being active outdoors
• not be able to run for more than a few minutes without stopping

People with exercise-induced asthma might begin having symptoms 5–10 minutes after starting to exercise (though some only get them after they stop being active). Symptoms usually peak 5–10 minutes after stopping the activity and may take an hour or longer to end.

If you think you have EIA, let your parents know. You'll need to see a doctor.

What Causes EIA?

Things that trigger symptoms during exercise can be different in different people. One common trigger is breathing in cold, dry air. It gets even worse during exercise, because when people exercise or play hard, they tend to breathe quickly, shallowly, and through the mouth. So the air reaching their lungs misses the warming and humidifying effects that happen when they breathe more slowly through the nose. 

Sometimes people with EIA feel symptoms when the air is warm but polluted or full of pollen. Other people might get symptoms when swimming if they are sensitive to the chlorine fumes from the pool.

How Is EIA Diagnosed?

To decide if you have EIA, a doctor will probably start by asking about your medical history. The doctor will also examine you. You might run on a treadmill for 6 to 8 minutes, run outside, or do the activity that caused your symptoms. Then, the doctor will look at how you're breathing.

Some people with EIA think they're having breathing trouble because they're not in shape. But someone who's winded from being out of shape will start breathing normally again soon after exercise stops. Someone with EIA may take up to an hour to recover.

How Is EIA Managed?

The most important way to manage EIA and prevent symptoms is to make sure that your asthma is under control, even when you're not exercising. This means avoiding triggers and taking asthma medicines as prescribed.

When a person knows that exercise usually leads to asthma symptoms, a doctor will likely recommend that they take medicine before exercising or being very active. Two kinds of medicine are used to prevent asthma symptoms during exercise:

• bronchodilators: These work quickly to relax the muscles around the airways. When taken before exercise, they prevent the airway narrowing that it triggers. Bronchodilators also help to provide quick relief of symptoms whenever they happen. That's why they're sometimes called "quick-relief," "rescue," or "fast-acting" medicines.
• anti-inflammatory medicines: These work over time to ease inflammation in the airways. This helps to prevent swelling and excess mucus production, which can make the airways even narrower. A person usually needs to take these every day, even when they feel fine and have no symptoms. These are sometimes called "controller," "maintenance," or "long-term control" medicines. Some people get anti-inflammatory medicines together with bronchodilators from one inhaler device, and can use this combination before exercise for symptom prevention.

If you take medicine before exercising but still have breathing trouble while being active, let your doctor know. They might recommend that you take medicine every day, if you don’t already, or that medicine dosages be adjusted for better control.

How Can I Deal With Exercise-Induced Asthma?

Exercise is a great idea for everyone, including people with exercise-induced asthma. Besides keeping you fit, exercise can improve lung function by strengthening the breathing muscles in the chest.

To be active while also keeping asthma symptoms under control, follow your asthma action plan. When asthma is well-controlled, people with asthma can do anything their peers can do. In fact, many Olympic athletes have EIA, which doesn’t stop them from doing their sport and winning medals.

Here are some tips:

• Take the prescribed asthma medicine about 15–30 minutes before exercising.
• Warm up before exercise to prevent chest tightening. Warm-up exercises can include 5–10 minutes of walking or any other light activity, plus stretching or flexibility exercises.
• Breathe through the nose during exercise.
• Take short rest breaks if you find it helpful.
• If symptoms start, slow down the exercising. If symptoms get worse, you may need to stop and take some medicine.  Don’t try to “play through” symptoms — this can be dangerous and bring on a severe flare-up.
• It's best not to exercise outside during very cold weather. If you do exercise in the cold, wearing a ski mask or a scarf over your mouth and nose can help.
• If air pollution or pollen are triggers, you can exercise indoors when air quality is poor or pollen counts are high.
• Cool down after exercise to help slow the change of air temperature in the lungs.

You should always have access to your asthma medicines. Keep extras on hand and be sure to check all supplies so you're not carrying an empty inhaler.