Managing Exercise-Induced Asthma

Asthma is a chronic lung disease. When asthma strikes, airways in the lungs become swollen and constricted, causing coughing, wheezing, and difficulty breathing. There are several circumstances that could cause someone to have an asthma attack, one of which exercise.

Imagine that you just finished a great workout when you start coughing. You are having a hard time breathing and your chest feels tight. Did you push yourself too hard? Maybe, but you are not out of shape. If this is not the first time this has happened after exercise, then you may have exercise-induced asthma (EIA). Simply put, EIA is asthma that is triggered by exercise. It most commonly strikes 5-10 minutes after exercise and may go away 20-60 minutes after you are done.

Symptoms of EIA include:

• Wheezing
• Coughing
• Tightness in the chest
• Shortness of breath
• Excess mucus
• Lacking endurance during exercise

Symptoms often increase when air pollutants, pollen, or cold, dry air is present. This accounts for why EIA is more common in cold weather sports like speed skating, figure skating, and cross-country skiing.

Causes and Risk Factors

It is not completely clear what causes EIA. One theory is that during exercise you breathe differently, usually more quickly and through your mouth. This affects your lungs because the air that you are inhaling has not had time to be warmed and moistened, the way that it is when you breathe through your nose. The cooler and dryer airways cause the muscles around the airway to tighten, which, in turn, leads to asthma symptoms.

Certain factors increase your risk of developing EIA. For example, if you have asthma or severe rhinitis (hay fever), you may be more likely to experience EIA. It also is more prevalent in competitive athletes.

Diagnosis and Treatment

EIA often goes undiagnosed because many patients stop exercising and do not resume exercising because of it. Physicians use patient history and breathing function tests in order to help diagnose patients with EIA. Treatment options for EIA are numerous, but the best option varies from person to person. It may involve using medications that are either inhaled or swallowed, such as short-acting beta-2 agonists.

Other interventions include avoiding exercising in dry, cold environments and other irritants that may trigger an asthma attack. It can help to wear a mask or scarf over your mouth in a cold, dry environment. Warming up prior to exercise also may help reduce symptoms. Because treatment is available, EIA should not stop you from being active.

Preventing EIA

The key to preventing or reducing the frequency of EIA is to exercise sensibly. Talk to your doctor about what measures might work best for you. Some general guidelines to follow are:

• Use your inhaler—Use an inhaler 15 minutes before exercising if your doctor recommends it. Carry it with you while you are exercising and use it if you experience asthma symptoms. If you do not have medicine with you when you experience EIA, move into the warmest, most humid place you can find.
• Consider adding swimming to your exercise program—Because the air is warmer and moister when swimming, there is less chance of an EIA attack. The only water sport that people should be cautious about participating in is scuba diving. See your doctor if you are interested in scuba diving and have asthma. Also, keep in mind that a heavily chlorinated pool may trigger your asthma symptoms.
• Take precautions during colder weather—Wear a face mask or scarf over your nose and mouth when exercising in cold weather. This warms the air before it reaches your lungs.
• Breathe through your nose—Although this may be difficult as the intensity of your workout increases, breathing through your nose helps warm the air before it reaches your airways.
• If you are sensitive to pollen, exercise indoors when pollen counts are high—If you have to exercise outside, talk to your doctor about adjusting your medication to manage your asthma.
• Warm up before exercising—If advised by your doctor, warm up for 15 minutes before starting your routine.
• Take a break if your daily asthma is not under control.
• Watch the intensity of your workouts—Athletes participating in high-intensity aerobic sports, especially with cold air exposure, are more likely to experience EIA symptoms.

Exercise does not have to trigger an asthma attack. Talk to your doctor about the best ways to keep your exercise-induced asthma under control. Samantha Smart, FNP, is available to ensure you have the proper medication and offer a fitness routine. To schedule an appointment, call the office at (540) 265-1607 or  schedule an appointment online below.