Understanding Exercise-Induced Asthma
Do you experience coughing, wheezing or chest tightness when you exercise? Do you feel extremely tired or short of breath when you exert yourself? If you have these symptoms, you may have exercise-induced asthma (EIA).
EIA occurs during or after vigorous exercise, according to the Physician and Sports Medicine (PSM). EIA causes coughing, wheezing, chest tightness and shortness of breath, usually 10 to 15 minutes after beginning exercise, or up to 20 minutes after stopping exercise. It may occur more easily on cold, dry days than on warm, humid days.
Nearly everyone who has chronic asthma experiences EIA. It also affects about 40 percent of people with hay fever (allergic rhinitis) or atopic dermatitis, the PSM says. EIA also can occur in people who do not have asthma symptoms at other times.
"Without proper diagnosis, EIA may cause people to avoid physical activity altogether, but this doesn't have to be the case," says Donald W. Russell, M.D., an allergist and immunologist in private practice in Asheville, N.C., and a spokesman for the American Academy of Allergy, Asthma and Immunology. "Almost everyone with EIA should be able to exercise to their full ability with appropriate diagnosis and treatment."
What causes EIA?
A person with EIA or chronic asthma has lungs that are overly sensitive to certain stimuli, the PSM says. When a stimulus irritates the airways, the muscles around the airways tighten, and the mucous membranes in the airways swell and produce extra mucus. The combination of these two changes in the airways makes breathing difficult.
A person with EIA is sensitive to sudden changes in air temperature and dry air. Other factors, including smog, tobacco smoke, molds and pollens, can make EIA worse.
Researchers aren't sure exactly how air temperature or humidity triggers EIA. Breathing through the mouth -- common during vigorous exercise -- doesn't warm the air or add as much humidity as breathing through the nose -- the usual way of breathing when not exercising. During exercise, the airways are forced to warm and humidify the air themselves and this change may be what leads to EIA symptoms.
People who have EIA have many activities to choose from that are less likely to trigger their asthma, including walking, swimming and biking.
Team sports that require short bursts of energy, such as baseball, football, wrestling, gymnastics and short-duration track and field events, are less likely to trigger asthma than sports requiring continuous activity, such as soccer, basketball, field hockey or long-distance running.
One way to control EIA symptoms is to avoid exercising in cold, dry air. Medication also can be prescribed to control EIA. For most people with EIA, a short-acting bronchodilator inhaled five to 30 minutes before exercise will ease attacks. Also, you should warm up for six to 10 minutes before you begin your full exercise program. Getting regular aerobic exercise may reduce the sensitivity of your airways. If you want to exercise during cold, dry weather, work out indoors or wear a scarf over your mouth and nose.
Your health care provider may also have you use long-term controller medications (an inhaled steroid or a type of drug called a leukotriene modifier). For children, a long-acting inhaler may be best, because youngsters may not plan their exercise or have their medication handy before exercising.
"If you think you have exercise-induced asthma, you should see a doctor for a proper diagnosis and treatment," says Dr. Russell. "Asthma is a common disorder -- as many as one out of every 10 young people has it. Don't let asthma disable you. Work with your doctor to find the best way to treat it so you can continue to have fun as you exercise and participate in the activities of your choosing."