Exercise-induced asthma is asthma that is triggered by vigorous
or prolonged physical activity. Most people who have chronic asthma will
experience symptoms when they exercise. However, many people without chronic
asthma develop symptoms only during exertion.
During normal breathing, the air we breathe is first warmed and
moistened by the nasal passages. One of the reasons that exercise-induced asthma
may occur is that during exercise, people tend to breathe through the mouth,
which means that they inhale colder and drier air. In exercise-induced asthma,
the muscle bands around the airways are sensitive to these changes in
temperature and humidity of the inhaled air and react by contracting (or
spasming), which narrows the airway. This results in symptoms of asthma, which
- Tightness in the chest
- Unusual fatigue while exercising
- Feeling short of breath while exercising
Other factors that can influence the degree of symptoms with
exercise are the presence of pollens and pollutants in the air and upper
The symptoms of exercise-induced asthma generally begin within
five to 20 minutes after the start of physical activity, or 5-10 minutes after
brief exercise has stopped. If you are experiencing any of these symptoms with
physical exertion, tell your doctor.
You should not avoid exercise because of exercise-induced
asthma. There are steps you can take to control the symptoms and allow you or
your child to maintain normal physical activity.
Inhaled medications taken prior to exercise can control and
prevent exercise-induced asthma symptoms. The preferred medications are the
short-acting beta2 agonist inhalers (i.e., ProAir®,
Proventil HFA®, Ventolin HFA®,
Xoponex HFA®); taken 15-20 minutes before
exercise, these medications can prevent the airways from contracting and can
provide control of exercise-induced asthma for as long as 4 to 6 hours.
Other medications that may be used are long acting
bronchodilators (LABA). These medications, salmeterol (Serevent®)
and formoterol (Foradil®), are taken about 30
minutes before exercise and keep the airways open for 12 hours. Recently the
Food and Drug Administration issued a warning that these medicines may increase
the risk of asthma attacks in certain people, therefore they are always used in
combination with an inhaled corticosteroid and are never used alone in the
treatment of asthma. If you are on one of these combination medications you
should still keep a short acting bronchodilator with you in case symptoms occur
with exercise. If these measures fail to control exercise-induced asthma
symptoms, your physician may determine that you need daily therapy to control
the underlying inflammatory process that results in unstable airways. It is
important to communicate with your health care provider how treatment of your
exercise- induced symptoms is working.
In addition to medications, a warm-up phase before exertion and
a cool-down period afterward can help prevent exercise-induced asthma. Exercise
should be limited during high pollen days (if allergic) or when temperatures are
extremely low and air pollution levels are high. The presence of viral upper
respiratory infections can also increase symptoms, so you should restrict
exercise if you have such an infection.
For people with exercise-induced asthma, some activities are
better tolerated than others. Activities that involve short, intermittent
periods of exertion, such as volleyball, gymnastics, baseball, walking, and
wrestling are generally well-tolerated. Activities that involve long periods of
exertion (soccer, distance running, basketball, and field hockey), as well as
cold weather sports (ice hockey, cross-country skiing, ice skating), may not be
tolerated as well. However, many people with asthma are able to fully
participate in these activities. Swimming, which is a strong endurance sport, is
generally well-tolerated by asthmatics because it is usually performed in a
warm, moist air environment. It is also an excellent activity for maintaining
Maintaining an active lifestyle is important for both physical
and mental health. The goal of treating exercise-induced asthma is to allow full
participation in sports and activities. It's important to communicate with your
or your child’s health care provider when the treatment plan is not effectively
controlling exercise-induced asthma. Appropriate treatment will allow you or
your child to fully benefit from an exercise program.
© Copyright 1995-2011 The Cleveland Clinic Foundation. All rights reserved.
Can't find the health information you’re looking for?
This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 12/1/2009...#4174