Exercise-induced asthma

Originally Published: August 28, 2009 - Last Updated / Reviewed On: March 17, 2014
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(1)

Dear Alice,

I have heard of exercise induced asthma but not been able to find a whole lot about it. Just what is it? What are its symptoms and how do you control it?

—Wheezer

(2)

Alice,

I started an on land sport (I am a swimmer), lacrosse, and my coach is a hard core runner. I have noticed that after running, I cough a lot and have trouble breathing. We do six 100 yard sprints and by the end of the third one I can't breathe, my chest feels all tight and, the scariest thing is that my lungs and my throat feel like they are bleeding. It is so much worse during sprints (I don't know why-do you?) but this also happens when we have long runs. But does asthma do that? Is it just because I'm out of shape? Even deep into the season, I would just nearly give up during sprints because of my breathing. Help?

Sincerely,
Loves lax-hates running

Dear Wheezer and Loves lax-hates running,

A good aerobic workout can make you feel the burn, but gasping for air may be a sign of exercise-induced asthma constricting the airway. Despite the extra hurdle, asthma doesn't have put a stop to your athletic endeavors. In fact, according to the American Academy of Allergy, Asthma, and Immunology  at least 16 percent of Olympic athletes have a history of asthma. With the right treatment, you can control your asthma and get back on the field.

Although the triggers may be different, exercise-induced asthma or EIA is similar to other forms of asthma. That tight feeling in your chest occurs when the main air passages in your lungs, the bronchial tubes, become inflamed (also known as a bronchospasm). During an asthma attack, your bronchial muscles tighten and the lungs produce extra mucus, further clogging the airway. EIA can flare up during a workout or five to ten minutes after exercise. Symptoms may include:

  • wheezing
  • accelerated heart rate
  • coughing
  • chest tightness
  • unusual paleness or sweating
  • vomiting

Thankfully there are several treatments for EIA, so there's no need to hang up your lacrosse stick. Like other kinds of asthma, EIA can be controlled with prescription medications, usually delivered through an inhaler. Depending on the severity of your asthma, you may be able to use a short-acting inhaler that you pump just before exercise, or you may need a longer-acting inhaler that you use every day. An allergist or pulmonary specialist can perform specific tests to diagnose your condition and prescribe the best meds.

In addition to medications, simple changes to your exercise routine may ward off asthma. People with EIA have airways that are overly sensitive to rapid changes in temperature and humidity. Normally, inhaling through the nose delivers moist warm air to the lungs. However, during strenuous exercise people often breathe in heavily through the mouth, which sends colder drier air to the lungs. To avoid an asthma attack, the Mayo Clinic recommends the following prevention techniques:

  • Cover your mouth and nose while working out in cold weather.
  • Warm up for 10 minutes before an intense workout.
  • Breathe through your nose while exercising.
  • Take a break or use your inhaler if you have trouble breathing.
  • Avoid exercise if you have a cold.

The type of physical activity you do also affects exercise-induced asthma. Swimming is a good choice because it's done in a warm, humid environment and in a horizontal position, which helps mobilize mucus from the bottom of the lungs. For Loves lax-hates running, this may explain why your asthma did not kick in until you started to play lacrosse. Sports involving short bursts of energy are also recommended, such as short distance track and field events, golf, baseball, football, wrestling, and gymnastics. For those who cannot tolerate these activities, walking, light jogging, and leisurely biking and/or hiking are recommended. Free running is the activity most likely to induce asthma. Other sports that are more likely to aggravate airways include long distance non-stop activities like treadmill running, cycling, basketball, field hockey, and soccer.

Having asthma doesn't mean you have to give up on lacrosse or other on-land sports. A health care provider can assess your condition and recommend treatment options to keep your asthma at bay. Students at Columbia can make an appointment at Medical Services (Morningside) or the Student Health Service (CUMC)

Hope this information leaves you breathing easier!

Alice