Most kids and teens with asthma have symptoms when they exercise. But some people (including those who don't have asthma) have asthma symptoms only during or after exercise. This is known as exercise-induced asthma (EIA) (also called exercise-induced bronchoconstriction, or EIB).
What Are the Signs & Symptoms of EIA?
Symptoms of exercise-induced asthma include wheezing, tightness or pain in the chest, coughing, and in some cases, lasting shortness of breath.
Someone with EIA may:
get winded or tired easily during or after exercise
cough after coming inside from being active outdoors
not be able to run for more than a few minutes without stopping
Kids with EIA often begin having symptoms 5–10 minutes after starting to exercise (though some kids only get them after they stop being active). Symptoms usually peak 5–10 minutes after stopping the activity and may take an hour or longer to end.
Of course, there's a difference between someone with exercise-induced asthma and someone who's out of shape and winded. It takes much longer for someone with EIA to recover. And temperature extremes, especially cold weather, can make it even worse.
What Causes EIA?
Inhaling cold, dry air during exercise is thought to be the main cause of EIA symptoms. When kids exercise or play hard, they tend to breathe quickly, shallowly, and through the mouth. So the air reaching their lungs misses the warming and humidifying effects that happen when they breathe more slowly through the nose. The cool, dry air makes the airways in the lungs narrower, which blocks the flow of air and makes it harder to breathe. This is called bronchoconstriction.
It's important to remember that staying fit and exercising regularly can actually help to reduce asthma symptoms. So kids and teens with asthma should exercise as much as they can.
How Is EIA Diagnosed?
A doctor will ask about the family's asthma and allergy history and about the symptoms and what has triggered them in the past.
After taking a medical history and doing a physical exam, the doctor may ask your child to take a breathing test after exercising. This can be done in the office on a treadmill, after your child runs outside for 6 to 8 minutes, or after doing an activity that's triggered flare-ups in the past.
How Is EIA Treated?
Doctors sometimes recommend pretreatment for EIA. This means taking medicine before exercising or being very active. The medicine often is the same quick-relief medicine (also called rescue or fast-acting medicine) used during flare-ups. Taking it before exercise can help prevent the airway narrowing triggered by exercise.
If pretreatment doesn't control symptoms, the doctor may recommend using long-term control medicine (also called controller or maintenance medicine). This asthma medicine is usually taken regularly over time to reduce airway inflammation.
If your child still has breathing trouble during exercise, let the doctor know. The medicine dosages may need to be adjusted for better control.
Which Activities Are OK for Kids With EIA?
Exercise is a great idea for everyone, including kids with exercise-induced asthma. Besides keeping kids fit, exercise can improve lung function by strengthening the breathing muscles in the chest.
Encourage your child to be active while also keeping asthma symptoms under control by following the asthma action plan. Ask your doctor which exercises, sports, and activities are safe for your child.
These activities usually are OK for people with EIA:
easy walking, jogging, or hiking
shorter track and field events
Endurance sports (long-distance running, cycling, etc.) and those requiring extended energy output (like soccer and basketball) can be more challenging. So can cold-weather sports, like cross-country skiing and ice hockey.
But that doesn't mean kids can't play these sports if they enjoy them. In fact, many athletes with asthma have found that with proper training and medicine, they can do any sport they choose.
Tips for Kids With Exercise-Induced Asthma
For the most part, kids with exercise-induced asthma can do anything their peers can do. But be sure to follow the suggestions given by your child's doctor.
Here are some tips for kids and teens:
If symptoms start, don't exercise until they stop.
Warm up before exercise to prevent chest tightening. (Warm-up exercises can include 5–10 minutes of walking or any other light activity, plus stretching or flexibility exercises.)
Take quick-relief medicine as close to the start of exercise as possible.
Breathe through the nose during exercise.
Take brief rests during exercise and use quick-relief medicine, as prescribed, if symptoms start.
Cool down after exercise to help slow the change of air temperature in the lungs.
It's also best not to exercise outside during very cold weather. If your child plays outside when it's cold, wearing a ski mask or a scarf over the mouth and nose should help.
If air pollution or pollen are triggers, your child may want to exercise indoors when air quality is poor or pollen counts are high. And kids shouldn't exercise when they have a cold or other upper respiratory infection.
Kids should always have access to their quick-relief medicine. Keep extras on hand and be sure to check all supplies so your child isn't carrying an empty inhaler.