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Exercise-Induced Asthma (EIB)

Exercise-induced asthma occurs when your airways become constricted while engaging in physical activity. Exercise-induced asthma can result in wheezing, coughing, and shortness of breath. These symptoms can happen both during and after exercise. They may even come back after you have rested up for a little bit. 

Basics of Exercise-Induced Asthma

Exercise-induced asthma, also known as exercise-induced bronchoconstriction (EIB), is when your airways become smaller, specifically when you are exercising. 

This can result in asthma symptoms such as wheezing, shortness of breath, and coughing. These symptoms can be worse under specific conditions, such as when pollution levels are high, when pollen counts are high, or when the air is cold and dry. 

It is vital to warm up before you start exercising if you have exercise-induced asthma. Different medications and devices, such as inhalers, can prevent an EIB episode from occurring and keep your airways open.

Commonness of Exercise-Induced Asthma

Exercise-induced asthma is common in people who have asthma. If you have asthma, there is a 90% chance that you will experience asthma symptoms either while you exercise or shortly after. 

Around 10% of people who don’t have regular asthma experience exercise-induced asthma. If you have asthma or allergies, you are more likely to experience exercise-induced asthma. Anyone from children to adults can experience EIB. This includes many elite and professional athletes too. 

Symptoms of Exercise-Induced Asthma

Exercise-induced asthma symptoms may start just a few minutes after you start exercising, or they could appear after you finish a workout. Symptoms will usually subside and improve if you stop and rest for about half an hour. 

Exercise-induced asthma symptoms are a little tricky, as they can also appear up to 12 hours after you finish exercising, i.e., when you are resting. These symptoms are referred to as “late-phase” symptoms and take up to a day to disappear. 

The most common exercise-induced asthma symptoms include: 

  • Coughing
  • Wheezing
  • Shortness of breath
  • Tightness in the chest
  • Severe fatigue

Causes of Exercise-Induced Asthma

Certain conditions can make exercise-induced asthma both more likely, and worse. 

  • When the air is cold and dry.
  • When the pollen count is high. 
  • When the pollution levels are high, resulting in poor air quality. 
  • When you are recovering from a respiratory illness or cold. 
  • When you are breathing in smoke, chemicals, or fumes from cleaning supplies or construction. 

When you engage in rigorous physical activity, cold, dry air can trigger your EIB. This is because you tend to breathe more through your mouth than your nose while exercising. 

When you breathe in air through your mouth, the air stays about the same temperature as outside. If the air is cold and dry, it will remain cold and dry when you breathe through your mouth. This can cause the muscles in your airway to respond to the cold, dry air by becoming narrow and constricted. 

When you are not exercising, cold, dry air isn’t usually an issue because you breathe in through your nose, which warms the air and adds moisture to it before it hits your airways.

Activities That Commonly Cause Exercise-Induced Asthma Symptoms

If you have exercise-induced asthma, there are certain activities you may want to avoid. 

Exercise that requires constant physical exertion: Any activities that require constant exertion, such as endurance sports, where you have to breathe heavily with little to no rest, can cause exercise-induced asthma. Examples include: 

  • Soccer
  • Basketball
  • Long-distance running

Activities that take place in cold weather: Sports that specifically occur in cold weather, where you constantly breathe in cold air, can trigger exercise-induced asthma, such as:

  • Skiing
  • Snowboarding
  • Ice hockey
  • Ice Skating

Continuously breathing in cold air can constrict the airways and trigger asthma symptoms.

Activities That are Less Likely to Cause Exercise-Induced Asthma

If you have exercise-induced asthma, certain types of activities are less likely to cause EIB. 

Exercise that requires short bursts of energy: Sports or activities that require short bursts of energy, followed by periods of rest, are less likely to trigger asthma symptoms. Examples include:

  • Volleyball
  • Baseball

Less-rigorous activities and sports: Sports that are not as rigorous, and allow for slower, more controlled motions, are less likely to trigger EIB. 

  • Golf
  • Walking 
  • Biking
  • Lifting Weights
  • Yoga

Activities in warm or humid environments: Activities that take place in warm or humid environments reduce the risk of triggering your EIB. Water sports, where the pool air makes the air moist and warm, are good examples of activities in warm or humid environments. Try out activities such as:

  • Swimming
  • Diving
  • Water Polo
  • Water aerobics 

Indoor sports: Any activities that take place indoors, where the air temperature and humidity are more controlled, can help reduce the chance of triggering exercise-induced asthma symptoms. Examples include:

  • Gymnastics
  • Basketball
  • Bocce ball
  • Indoor track 

You can still work out if you have exercise-induced asthma; you just need to be conscious about the type of activities you choose. 

Diagnosing Exercise-Induced Asthma

To determine if you have exercise-induced asthma, we will start by learning about your symptoms to determine if you have exercise-induced asthma. Be sure to let us know when you have them and how long they last. This information will help us with our diagnosis. 

Then, we will listen to your lungs while you engage in an activity that tends to trigger your symptoms. After that, we will measure your lung function using a spirometry test. 

With a spirometry test, you need to exhale as much as possible and as quickly as possible into a tube attached to a machine. The spirometer machine measures how your lungs work after you have worked out. 

We will use this information to determine if you have exercise-induced asthma. 

Managing Exercise-Induced Asthma

Exercise-induced asthma isn’t something you cure; it is something you manage. That means you need to learn to prevent and relieve symptoms when they occur. 

This starts with the right warm-up. You should warm up for at least six to eight minutes before exercising. The West Hills Allergy & Asthma Associates team will help you figure out the best warm-up routine based on your fitness level, age, and the type of activities that interest you. 

There is also a combination of medications to prevent an episode and others that can open your airways when you are actively experiencing an episode. 

  • Mast cell stabilizers: This medication is taken with a nebulizer, which turns the medicine into tiny droplets you can easily breathe into your lungs. It is used before you start exercising to prevent symptoms. 
  • Leukotriene modifiers: These are taken before exercising to keep your airways open and stop inflammation. Note that this medication can cause mood swings and behavior changes in some people. 
  • Inhaled corticosteroids: You breathe these in to help reduce swelling in the airways and allow you to breathe comfortably again.
  • Short-acting beta-agonist (SABA):  SABA is administered when you are experiencing an episode. You take them through a rescue inhaler, breathing them directly into your airway. They can also be used before exercise to prevent symptoms. 
  • Long-acting beta-agonist (LABA): LABA is not as effective as SABA once symptoms have started. Instead, they are taken between thirty minutes and one hour before you start to exercise. 

We will work with you to determine the best course of treatment to keep your exercise-induced asthma under control while allowing you to stay active. You can manage this condition and still enjoy an active lifestyle. 

Treatment for Exercise-Induced Asthma in Portland, Oregon

At West Hills Allergy & Asthma Associates, Dr. Anderson-Cowell has more than two decades of experience diagnosing and treating patients with exercise-induced asthma.

Her training and expertise make Dr. Anderson-Cowell an expert in treating patients who are dealing with asthma. 

If you’re looking for expert diagnostic experience and effective treatment history, Dr. Anderson-Cowell can help. For a consultation, please call (503) 297-4779 or request an appointment online.

9701 SW Barnes Road
Suite 130
Portland, Oregon 97225


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