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. 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 include:
- Coughing
- Tightness in the chest
- Wheezing
- 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 respiratory infections.
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 beta 2 agonist inhalers (i.e. albuterol); taken 15-20 minutes before exercise, these medications can prevent the airways from spasming and can provide control of exercise-induced asthma for as long as 4 to 6 hours.
Other medications that may be useful are the long-acting bronchodilators that provide 12-hour control (salmeterol, formoterol). When these medications are taken before work or school, exercise-induced asthma symptoms may be avoided with any physical activity throughout the day. It is important, however, to always have a short-acting bronchodilator available in case symptoms still occur.
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.
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 be less well-tolerated . 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 physical fitness.
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 and your child to fully benefit from an exercise program.
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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: 12/14/2006
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