Exercise is the most common trigger of breathing problems in people with asthma. Up to 90 percent of all individuals with asthma will have breathing problems at some point during exercise. This is called exercise-induced bronchospasm (EIB). About 10 percent of the general population without asthma have EIB when they exercise.

Symptoms

EIB occurs when airflow to the lungs is reduced due to narrowing and closing of the airways in association with exercise. EIB can moderately impact athletic performance or be severe enough to incapacitate the athlete or, in rare cases, even put his or her life at risk. Symptoms can start within five to 15 minutes of beginning exercise or five to 20 minutes after stopping exercise. The most common symptoms are:

• Wheezing
• Coughing
• Shortness of breath
• Chest tightness
• Fatigue
• Poor exercise performance

Competitive and recreational athletes have a much higher rate of EIB. In studies of Olympic and other elite athletes, EIB occurred 20 to 50 percent of the time in athletes without asthma. Many of these athletes did not even know they had EIB.

Diagnosis and Treatment

Athletes often ignore symptoms of EIB, perceiving the condition as an indication of poor performance or simply being out of shape.

The initial visit to the Asthma in Athletes program will include a comprehensive history and physical examination. The appropriate diagnostic tests will be scheduled based on the needs of each individual athlete. Those tests may include specialized pulmonary function testing, electrocardiography, echocardiography, allergy testing or evaluation for vocal cord dysfunction. Additionally, the Asthma Center at the Ohio State’s Wexner Medical Center is the only facility in central Ohio that offers Eucapnic Voluntary Hyperventilation (EVH) testing, the International Olympic Committee’s preferred test for diagnosing exercise-induced asthma.

Based on our clinical evaluation, we offer an individualized treatment plan and education tailored to the specific needs of each athlete. We can also communicate treatment plans with the athlete’s coaching staff, athletic trainers or other physicians if requested.

Exercising with Asthma 

Here are some other options to help control EIB:

Asthma inhalers or bronchodilators: Short-acting bronchodilators like albuterol or levalbuterol are the most common medicines used to treat EIB. To prevent EIB, the medicine should be taken 15-20 minutes before exercise.

Inhaled corticosteroids: These are recommended in patients with EIB who:

• Continue to have symptoms despite using an inhaled bronchodilator before exercise
• Require an inhaled bronchodilator daily or more often
• Have impaired lung function at rest

Warm-up and cool down: Warming-up before exercising and cooling-down after exercise can help prevent breathing symptoms. The warm-up should last five to 10 minutes. Good warm-up activities include walking, jumping rope or slowly pedaling a bike. Once you are warmed-up, you should stop and rest for five minutes before starting to exercise. Begin cooling down during the last five to 10 minutes of exercise. You can do this by lowering the intensity of your exercise or walking. Once you have finished exercising, take a few minutes to stretch your muscles so they will not feel tight.

Also, limit exercise when there is high pollen, high air pollution or low temperatures, and avoid exercising when you’re sick.