Allergies Get the Facts on Exercise-Induced Asthma

Then Get Moving!

Woman ice skating on pondWhether you are training for  the next Winter Olympics or enjoying winter sports on your own, exercise-induced bronchoconstriction should not force you to be a spectator in your favorite sporting activities.

Exercise-induced bronchoconstriction, also called exercise-induced asthma, is a narrowing of the airways in the lungs that is triggered by physical activity. An estimated 300 million people worldwide have asthma, according to the World Health Organization, and strenuous exercise can make it worse.

EIB is common in people with chronic asthma, who frequently experience flare-ups while exercising. But it can also occur in otherwise healthy individuals who experience asthma symptoms only when they exercise. People with allergies may also have trouble breathing during exercise.

Symptoms  If you have EIB, you may have problems breathing within 5 to 20 minutes after exercise. Symptoms of EIB are similar to those of chronic asthma, but the timing of the symptoms is closely linked with physical activity. Your symptoms may include wheezing, tight chest, cough, shortness of breath, and, rarely, chest pain. 

Triggers  People with EIB are typically very sensitive to both low temperatures and dry air. Air is usually warmed and humidified by the nose, but during demanding activity, people breathe more through their mouths. This allows cold, dry air to reach your lower airways and your lungs without passing through your nose, triggering asthma symptoms. Air pollutants, high pollen levels, and viral respiratory infections may also be triggers. Other causes of symptoms while exercising include being out of shape, poorly controlled nasal allergies, or vocal cord issues.
People with EIB are still able to exercise – and should exercise regularly. Diagnosis  Your physician will begin by getting your health history, conducting a physical examination, and performing a breathing test called spirometry. If your breathing test shows that you might have asthma, your physician may give you a drug to inhale, such as albuterol. If your breathing test numbers improve after inhaling the medicine, then the diagnosis of asthma is more likely.

You may be asked to take an additional test, called a bronchoprovocation challenge test. Your physician will have you exercise in the sport you play, run outside, or have you cycle or run on a treadmill. Before and after the exercise, your physician will test the amount of air you force out of your lungs with a spirometry test. If you exhale air less forcefully after exercise, the problem may be EIB.

Exercising with EIB  People with EIB are still able to exercise – and should exercise regularly. But you need to be sure that you are doing the right kind and right amount of exercise.

If you have been diagnosed with EIB, talk with your doctor before you begin an exercise program. Together, you can develop a management plan that will allow you to participate in activities with minimal asthma symptoms.

To prevent asthma flare-ups, your doctor may prescribe that you take an inhaled short-acting medication prior to exercise. These medications are effective in preventing EIB symptoms in 80 to 90 percent of people with the condition. Drinking water, warming up, and cooling down as part of your exercise routine can also help minimize EIB.   

The sport you choose can affect your symptoms. Swimming is considered less likely to cause asthma symptoms because the warm, humid environment of the pool does not aggravate the airways. Hiking, walking, and leisure biking are also good sporting activities for people with EIB. Team sports that require short bursts of energy, such as baseball, football, and short-term track and field, are less likely to cause symptoms than sports that have a lot of ongoing activity, such as soccer, basketball, field hockey, and long-distance running. Cold weather activities like cross-country skiing and ice hockey are more likely to make symptoms worse, but with proper diagnosis and treatment, many people with EIB can participate and excel in almost any sport or activity.

Exercise is important and provides many health benefits, especially for people with asthma. So don’t give up on an active lifestyle.

Source: American Academy of Allergy, Asthma & Immunology,

This article was originally published in Coping® with Allergies & Asthma magazine, WINTER November 2014-February 2015.