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Exercise-Induced Asthma

Asthma is a (continuing) problem affecting the airways. When someone has asthma, the airways can become swollen, narrowed, and clogged with mucus. Some people with asthma can have flare-ups, during which they have a hard time breathing.

What Happens?

Most people with asthma have symptoms when they exercise. Some people have asthma symptoms only when they exercise: This is called exercise-induced asthma (EIA).

Symptoms of EIA include:

  • wheezing
  • tightness or pain in the chest
  • coughing,
  • shortness of breath that lasts for a while

People with exercise-induced asthma often start having symptoms 5 to 10 minutes after they begin working out. Symptoms usually peak 5 to 10 minutes after the person stops exercising, then go away within an hour. For some people with EIA, asthma symptoms last for hours after they exercise. Sometimes symptoms appear only after the person has stopped exercising.

Really cold weather can make EIA worse.

Some people with EIA think they're having breathing trouble because they are out of shape. But there's an easy way to tell the difference. A person who is just winded from being out of shape will start breathing normally again soon after exercising. For someone with exercise-induced asthma, it may take up to an hour to recover.

If you think you have EIA, let your parents know. You'll need to see a doctor.

To decide if you have EIA, a doctor will probably start by asking about your . The doctor will also examine you. You might run on a treadmill for 6 to 8 minutes, run outside, or do the activity that caused the flare-ups. Then, the doctor will look at how you're breathing.

What Can You Do?

If it turns out you have exercise-induced asthma, your doctor might want you to take asthma medicine before any kind of strenuous activity. This is often the same quick-relief medicine used for flare-ups. You breathe the medicine directly into your lungs before exercising and it works immediately to open up the airways. Doctors sometimes call this pretreatment.

If pretreatment isn't enough, your doctor may recommend that you also take daily long-term control medicine. This kind of medicine works over time to help keep the airways in the lungs open. You need to take it every day, even when you feel well.

Many people find that if they take medicine as prescribed by their doctors, they can work out with few or no problems.

There's no reason to stop playing sports or working out because you have EIA. Exercise is great for everyone. As well as keeping you fit, exercise can strengthen the breathing muscles in the chest and help your lungs work better. For this reason, doctors no longer tell people with asthma to avoid exercising and might, in fact, recommend it as part of asthma treatment.

Some sports are less likely to cause problems, though. These recommended activities include:

  • walking
  • jogging
  • hiking
  • golf
  • baseball
  • football
  • gymnastics
  • shorter track and field events

Some sports are more challenging for people with exercise-induced asthma:

  • long-distance running, cycling, or other endurance sports
  • soccer, basketball, and other sports that demand a lot of energy
  • cold-weather sports like cross-country skiing or ice hockey

You can probably still do even the most challenging sports if you truly enjoy them. It just takes careful management, the right medicine, and proper training. Some of the athletes competing in the 2014 Winter Olympics have asthma, including figure skating gold medalist Yuzuru Hanyu.

Tips for Dealing With EIA

When it comes to EIA, staying one step ahead of your symptoms is a good strategy. Ask your doctor what you should do before exercising or playing sports.

Here are some of the things doctors suggest for people who have EIA:

  • Warm up carefully before any exercise to prevent chest tightening.
  • If you do pretreatment, take your medicine as close to the start of exercise as possible.
  • Breathe through your nose during exercise.
  • Take brief rests during exercise and use quick-relief medicine as prescribed if symptoms start.
  • Cool down after exercise.
  • Avoid exercising outside during really cold weather; if you have to, wear a scarf around your nose and mouth or a ski mask.
  • If pollen or pollution trigger your asthma, exercise indoors on days when the air quality is bad or the pollen count is high.
  • Don't exercise when you have a cold or the flu.
  • Don't exercise if you are having asthma symptoms.

Taking medicine exactly as your doctor prescribes is the most important tip of all. Skipping long-term control medicine can make symptoms worse. Forgetting to take medicine before exercise can lead to severe flare-ups and even ER visits.

Finally, always keep your inhaler with you when exercising. You may feel shy about your asthma, but don't hide it from coaches or teammates — they can help you. Coaches especially should know about your asthma so they will understand if you need to take a break and use your medicine.

Reviewed by: Elana Pearl Ben-Joseph, MD
Date reviewed: February 2014