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Exercise-Induced Asthma: A Primer

Overview

Exercise-induced asthma, also referred to as exercise-induced bronchospasm, is a relatively common problem found in athletes, as well as the general population. People who suffer from exercise-induced asthma experience shortness of breath, among other symptoms, when they exercise or breathe heavily. Exercise-induced asthma sufferers can have a 15 percent decrease in breathing capacity after exercising 10-15 minutes. An episode can last anywhere from 20 minutes to two hours.

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Exercise-induced asthma is different from mild, chronic, or persistent asthma because it can be treated prior to exercise, while other forms of asthma must be treated with anti-inflammatory therapy on a daily basis and with special pre-exercise measures.

How Exercise-Induced Asthma Happens

Exercise-induced asthma happens when exercise causes the main air passage of the lungs to tighten and inflame. The body responds by producing extra mucus, which makes it difficult to breath. Many athletes breath through their mouth instead of their nose. This makes the air that goes into their lungs colder and drier compared to the warm air normally in the lungs. The inhaled cold air can trigger an attack. People who suffer from exercise-induced asthma are believed to be particularly sensitive to low temperatures and dry air.

Exercise-Induced Asthma by the Numbers

80
Percentage of people with ordinary asthma that also have exercise-induced asthma.

9
Percentage of people without asthma or allergies that have exercise-induced asthma.

3-11
Percentage of elite athletes affected by exercise-induced.

Who’s at Risk for Exercise-Induced Asthma

Athletes who participate in winter sports like skiing, hockey, figure skating, and snowboarding, are more likely to develop exercise-induced asthma than athletes who participate in warm-weather sports. Endurance athletes, such as distance runners and soccer, basketball, and lacrosse players, are also more likely to suffer from exercise-induced asthma. People with a family history of asthma and people exposed to secondhand smoke and other environmental pollutants are also susceptible to exercise-induced asthma.

Symptoms of Exercise-Induced Asthma

The symptoms of exercise-induced asthma usually appear within 15-20 minutes after the start of exercise or 5-10 minutes after shorter-term exercise has ended. Symptoms include:

  • Wheezing
  • Tightness in the chest and/or chest discomfort
  • Sensitivity to cold air
  • Shortness of breath
  • Coughing
  • Unusual feeling of fatigue

Initial Treatment

Athletes who have exercise-induced asthma can get immediate help by using an over-the-counter or prescription inhaler or medication. If you believe that you have exercise-induced asthma, consult with your doctor as soon as possible. Doctors will often prescribe bronchodilators, such as Proventil, Ventolin, ProAir, or Maxair 15 minutes before exercise. These devices prevent symptoms for up to four hours.

Other prescription devices include mast cell stabilizers (15-60 minutes before exercise), long-acting beta-2 agonists Foradil (taken 30 minutes before exercise), leukotriene modifiers (Singulair, Accolate) that last up to 24 hours, and corticosteroid inhalers (Flovent, Asmanex, Pulmicourt, Azmacort), which may be recommended for daily use and may be prescribed in addition to other bronchodilators.

Keep in mind that some over-the-counter and prescription medications are banned by sports governing bodies.

Comeback Strategy

Exercise-induced asthma shouldn't  prevent you from participating in sports, even at the highest level. Take the appropriate medication prescribed or recommended by your doctor, follow the prevention guidelines below, and you should be able to participate in sports and other vigorous physical activities for a lifetime.

How to Avoid Exercise-Induced Asthma

  • Use medications before exercising to ward off symptoms.
  • Exercise in warm, humid environments.
  • Warm up before an event.
  • Cool down after exercising (jogging, walking, swimming slow laps).
  • Participate in activities that require only short bursts of energy (volleyball, tennis, gymnastics, baseball, walking). Exception: endurance swimming because it's usually performed in a warm, wet environment
  • Be cautious of activities that require long periods of aerobic exercise (soccer, distance running, basketball, field hockey, lacrosse).
  • Be cautious of cold-weather activities (ice hockey, cross-country skiing, ice skating).
  • Breathe through your nose instead of your mouth.
  • Use slow, deep, rhythmic breathing patterns.
  • Cut back on exercise if you have a viral infection.
  • Exercise at a level that is consistent with your level of fitness (don’t overdo it).

 


Tags: Health, Injury, Disease, Injury Prevention

References

  1. American Lung Association
  2. MayoClinic.com
  3. Penn State Sports Medicine Newsletter
  4. Science Daily
  5. William W. Storms, MD, Colorado Springs, CO

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