Exercise Induced Asthma

woman in park with asthma inhaler

When vigorous or prolonged exercise is the cause of an asthma attack, it is called Exercise-Induced Bronchospasm (EIB).   Second only to allergies, exercise is the most common trigger for asthma.  An EIB attack usually lasts only a few minutes, but in rare cases, may last up to several hours.  Exercise-Induced Bronchospasm can severely hamper athletic performance.  Even worse it can cause individuals to withdraw from physical activities. 

EIB is caused when the athlete’s breathing rate increases during exercise causing water loss and cooling of the airways.  During normal breathing, the air we take in is warmed and moistened by the nasal passage.  Athletes tend to breath through their mouths when exercising causing the air to be colder and drier.  The muscle bands around the airways are sensitive to these changes in temperature and humidity and react by contracting causing narrowing of the airways. 

Symptoms of Exercise-Induced Asthma include wheezing, coughing, chest tightness, unusual fatigue while exercising or shortness of breath when exercising.  Most symptoms will begin 5-20 minutes after the start of exercise or 5-10 minutes after brief exercise has stopped.  Some athletes may experience a coughing episode as long as 2-3 hours after an exercise session.  Awareness of the symptoms is important in diagnosis.  If an athlete is experiencing symptoms of EIB, he or she needs an evaluation by their physician.  The evaluation will most likely include a lung function test to measure lung capacity.  In most cases, if lung capacity decreases by more than 15% after exercise the athlete should be treated for EIB.

Individuals with asthma need to be aware it is a chronic disease and requires constant daily care.  There are many prescription medications that are effective in controlling asthma.  For example, one of these is inhaled albuterol.  It is a bronchodilator which relaxes the muscles of the airways allowing air to flow more freely.  Albuterol is a rescue medicine for acute asthma attacks.  A bronchodilator that is long acting is salmeterol.  It has proven effective as a preventative medication.  It is important to note if one medication is unsuccessful in controlling asthma, two or three may be combine to provide better protection against an asthma attack.    Become familiar with the rules governing asthma medications if the athlete is involved in competitions requiring drug testing.  Some medications are allowed, others must be reported in writing by the treating physician prior to the competition and testing. 

Additionally, there are several ways to assist in the control of EIB.  These include a thorough warm-up prior to vigorous exercise and maintaining an appropriate cool down period after exercise.  Make it a habit to exercise in a warm, humid environment, if the weather is cold exercise indoors or wear a mask or scarf over your nose and mouth.  If you have allergies avoid exercising outdoors when pollen counts are high and restrict exercise if you have a viral infection. 

With the proper management and physical conditioning studies show athletes with asthma can be competitive with other athletes.  Many athletes such as Jerome Bettis- NFL,  Amy Van Dyken- swimming, Jackie Joyner-Kersee –track and field, Dennis Rodman – NBA competed successfully despite having asthma.    Asthma should not be used as an excuse to avoid exercise.   With the proper diagnosis and treatment plan athletes should be able to enjoy exercise and competition.

Submitted by Dr. Richard E. Uhler.  Dr. Uhler is the team physician for the University of San Diego Toreros (USD), Murrieta Valley Nighthawks and the Southern California Elite Gymnastics Academy (SCEGA).  His clinic is located at 27720 Jefferson Ave. Ste. 100B, Temecula, CA.  Phone (951) 693-9678 for more information.