Asthma is a chronic inflammatory disease where inflammation in your airways causes them to narrow and produce mucus. Having narrow and mucus-lined airways can make it hard to get air into your lungs.

In people with exercise-induced asthma, now referred to as exercise-induced bronchoconstriction (EIB), this inflammation in the airways is triggered by exercise. People with this condition may experience asthma symptoms during or after exercise.

Read on to learn about the symptoms, causes, diagnosis, and treatment options for EIB.

Many symptoms of EIB are the same as regular asthma symptoms. They include:

  • coughing
  • wheezing
  • shortness of breath
  • chest tightness
  • tiredness or fatigue
  • decreased physical endurance

Like regular asthma, EIB symptoms usually occur after a trigger. The most common EIB triggers are from airborne irritants and hyperventilation, especially in cold and dry air. Symptoms often occur right after you begin exercise and may continue for about 10 to 15 minutes after you stop exercising.

If you notice that your child has the following symptoms, including any of those listed above, when exercising, it may be EIB:

  • easily fatigued after short periods of activity
  • winded easily during exercise or playtime
  • a noticeable cough after playing outside

The symptoms of EIB in children may not always be as noticeable as in adults. If your child has these symptoms when playing or exercising, or they avoid exercise activities, take them to see a doctor.

Breathing in cold, dry air is thought to be a common trigger for EIB. It was predominantly thought that the intake of cold air caused blood vessels in your airways to widen, and that in EIB, this response led to swelling and narrowing of the airways.

More recently, it’s thought that a major trigger of EIB is quickly breathing in larger amounts of dry air. This irritates the airways, causing them to be dehydrated from the airway inflammation and narrowing that follows. Also, cold air is usually drier than warm air.

Environmental triggers, similar to those that can trigger asthma, may also irritate the airways in people with EIB. Many sports, such as soccer, football, and track, take place outdoors where high levels of pollution and pollen can trigger inflammation. Even indoor sports, such as swimming and hockey, may expose you to chemical fumes or industrial pollutants, which may trigger an attack.

If you have EIB, you may not have an attack every time you exercise, but it’s important to be prepared in case you do have one. It’s also important to be aware of your triggers to help you prevent attacks.

Heavy breathing, muscle fatigue, and an increased heart rate are typical symptoms from exercise. If you don’t exercise often, you may experience these symptoms more frequently than people who exercise regularly.

If you notice that you’re also experiencing coughing, wheezing, shortness of breath, or chest tightness during exercise, it’s important to follow up with a doctor. These symptoms may be caused by EIB.

In addition to performing a physical exam and asking about your medical history and recent symptoms, your doctor may recommend you undergo some of the following functional tests to diagnose your EIB:

Your doctor can prescribe medications to help manage or prevent your symptoms during exercise, including:

  • Short-acting bronchodilators. These inhaled beta-2 agonist medications are used to open your airways and stop asthma symptoms and attacks almost immediately.
  • Inhaled corticosteroid. This treatment needs to be taken daily, usually twice per day, for reducing inflammation in your airways. It usually takes a few weeks before it takes full effect. It’s used as a long-term, preventive treatment.
  • Long-acting bronchodilators. These inhaled beta-2 agonists are used to prevent asthma attacks by helping keep your airways open for up to 12 hours. These are to be given with an inhaled corticosteroid.
  • Anticholinergics. These are an additional type of bronchodilator that may be used for asthma. They block the nerve activity that causes the muscles to tighten and narrow the airways. This keeps your airway muscle relaxed to allow proper air flow.

Your doctor may also recommend inhaled mast cell stabilizers. These medications prevent mast cells from releasing inflammatory substances into your airways. They’re taken multiple times per day and aren’t used for rescue treatment. They take a few weeks before they’re effective, but are a potential long-term treatment option.

If you have EIB, you can still exercise, but you may want to make some changes to your routine to reduce your risk for an attack.

  • Protect your airways. If you’re exercising in cold or dry air, cover your nose and mouth with a scarf or face mask. A heat-exchange mask may also be beneficial in cold air.
  • Try nose breathing. When exercising, try to focus on breathing through your nose instead of just your mouth. Breathing through your nose can help to pull warmer, moister air into your lungs.
  • Do a pre-exercise warmup. Before exercising, try to warm up for at least 10 minutes. This can help get your lungs and airways ready for physical activity.
  • Change your routine. Choose activities that require short bursts of energy, such as baseball, football, or gymnastics, as opposed to a long exertion, like long-distance running, especially in cold or dry weather.
  • Pay attention to your environment. Focus on activities that can be done in warm or humid environments, such as swimming. But, be aware of potential associated irritants in the air.

Once you know how to prepare for exercise when you have asthma, you can take the steps to avoid having an exercise-induced asthma attack.

You can still exercise if you have exercise-induced bronchoconstriction. Pay attention to triggers and look for activities that don’t trigger your symptoms.

If you have symptoms of exercise-induced bronchoconstriction during your workouts, it may be time to visit a doctor for a diagnosis.

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