Medically reviewed by
Christina J. Collura, DO, MPH
Exercise Induced Asthma Symptoms
Up to 85% of asthmatics have symptoms of wheezing during or following exercise. In addition, many non-asthmatic patients with allergies or a family history of allergy experience bronchospasm or constricted airways caused by exercise. Other asthma symptoms include an accelerated heart rate, coughing and chest tightness occurring five to ten minutes after exercise.
Exposure to cold air and low humidity tends to worsen symptoms since both are thought to increase heat loss from the airways. Nasal blockage worsens exercise related asthma because the inspired air is not humidified and warmed in the nose. Air pollutants (such as sulfur dioxide), high pollen counts, and viral respiratory tract infections also increase the severity of wheezing following exercise.
Exercise Induced Asthma That Cause Wheezing:
(In order of severity)
1. Free running (most likely to induce asthma)
2. Treadmill running
3. Bicycling
4. Swimming (least likely to produce symptoms)
Testing:
1. A patient history is taken
2. A breathing test is done while the patient is at rest to determine if the patient has undiagnosed asthma. This test may be repeated after exercise.
3. Specialized tests may be performed, which can include cycling, running or using the treadmill to diagnose asthma.
Treatment:
1. Careful selection of exercise activities such as walking, light jogging, leisure biking, and hiking may aid those who cannot tolerate strenuous outdoor running sports.
(However, it is important to remember that the majority of patients with asthma or exercise-induced bronchospasm should get pre-treatment with proper drugs to allow them to participate in any activity they choose.)
Swimming is often considered the sport of choice for asthmatics and those with a tendency toward bronchospasm because of its many positive factors: a warm, humid atmosphere, year-round availability, and the way the horizontal position may help mobilize mucus from the bottom of the lungs. Swimming also tones upper body muscles.
Other activities recommended for those with asthma include sports that involve using short bursts of energy, such as baseball, football, wrestling, short distance track and field events, golfing, gymnastics, and surfboarding.
Cold weather events (such as skiing and ice hockey) or long-distance, non-stop activities (like basketball, field hockey or soccer) are more likely to aggravate airways. However, many asthmatics have found that with proper training and medical care, they are able to excel as runners or even basketball players.
2. Drugs administered prior to exercise, such as albuterol, metaproterenol, terbutaline, cromolyn sodium, nedocromil, and theophylline are all helpful treatment options in controlling and prevention exercise-induced bronchospasm. However, it is very important for everyone with exercise-induced asthma to have a breathing test at rest to assure that they do not have undiagnosed chronic asthma.
3. Athletes should restrict exercising when they have viral infections, when pollen and air pollution levels are high, or when temperatures are extremely low.
4. Warm-up exercises before competition are important and have been shown to alleviate chest tightness.
5. Pursed (narrowed) lip breathing may also help reduce airway obstruction.
Conclusion
For years, the inability to participate in athletic programs and/or recreational sports had been a handicap for asthmatic children and adults alike. It was thought that asthmatics could not and should not take part in team sports and vigorous activities. Today, with proper detection and treatment, those affected by exercise-induced asthma and bronchospasm can become capable of exercise that is beneficial to both their physical health as well as their emotional well-being.
