You have just finished a great workout when you start coughing. You have a hard time breathing and your chest feels tight. Did you push yourself too hard? Maybe. But you are not out of shape. At least, you did not think so. But this is not the first time this has happened after you have exercised.
Sound familiar? If so, then you may have exercise-induced
Simply put, EIA is asthma that is triggered by exercise. It most commonly strikes 5-10 minutes after exercise. It may go away 20-60 minutes after you are done exercising.
- Tightness in the chest
- Shortness of breath
- Excess mucus
- Lacking endurance during exercise
Symptoms often increase when air pollutants, pollen, or cold, dry air is present. That is why EIA is more common in cold weather sports like speed skating, figure skating, and cross-country skiing.
It is not completely clear what causes EIA. A theory is that during exercise, you breathe differently, usually more quickly and through your mouth. This affects your lungs because the air that you are inhaling has not had time to be warmed and moistened, the way that it is when you breath through your nose. The cooler and dryer airways cause the muscles around the airways to tighten, which in turn leads to asthma symptoms
Certain factors increase your risk of developing EIA. For example, if you have asthma or severe rhinitis (hay fever), you may be more likely to experience EIA. It is also more prevalent in competitive athletes.
EIA is often undiagnosed because many patients stop exercising and do not resume exercising because of it. Physicians use patient history and breathing function tests in order to help diagnose patients with EIA.
Treatment options for EIA are numerous. The best option varies from person to person. Although uncommon, it may involve using medications that are either inhaled or swallowed such as short-acting beta-2 agonists.
Other interventions include avoiding irritants and exercising in dry, cold environments. It may help to wear a mask or scarf over your mouth in a cold, dry environment. Warming up prior to exercise may also help reduce symptoms.
Because treatment is available, EIA should not stop you from being active.
The key to preventing or reducing the frequency of EIA is to exercise sensibly. Talk to your doctor about what measures would work best for you. Here are some general guidelines to follow:
- Use your inhaler.—Use an inhaler 15 minutes before exercising if your doctor recommends it. Carry it with you while you are exercising, and use it if you experience asthma symptoms. If you do not have medicine with you when you experience EIA, move into the warmest, most humid place you can find.
- Consider adding swimming to your exercise program.—Because the air is warmer and moister when swimming, there is less chance of an EIA attack. The only water sport that people should be cautious about participating in is scuba diving. See your doctor if you are interested in scuba diving and have asthma. Also, keep in mind that a heavily chlorinated pool may trigger your asthma symptoms.
- Take precautions during colder weather.—Wear a face mask or scarf over your nose and mouth when exercising in cold weather. This warms the air before it reaches your lungs.
- Breathe through your nose.—Although this may be difficult as the intensity of your workout increases, breathing through your nose helps warm the air before it reaches your airways.
- If you are sensitive to pollen, exercise indoors when pollen counts are high.—If you have to exercise outside, talk to your doctor about adjusting your medication to manage your asthma.
- Warm up before exercising.—If advised by your doctor, warm up for 15 minutes before starting your routine.
- Take a break if you your daily asthma is not under control.
- Watch the intensity of your workouts.—Athletes participating in high-intensity aerobic sports, especially with cold air exposure, are more likely to experience EIA symptoms.
Asthma and exercise: tips to remember. American Academy of Allergy Asthma and Immunology website. Available at: http://www.aaaai.org/conditions-and-treatments/library/asthma-library/asthma-and-exercise.aspx. Accessed February 6, 2014.
Davies MJ, Fisher LH, Chegini S, Craig TJ. Asthma and the diver. Clin Rev Allergy Immunol. 2005 Oct;29(2):131
Exercise-induced bronchoconstruction. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated December 17, 2013. Accessed February 6, 2014.
Exercise-induced asthma. Kids Health website. Available at: http://kidshealth.org/parent/medical/asthma/exercise_asthma.html#. Updated January 2014. Accessed February 6, 2014.
Last reviewed February 2014 by Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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