Exercise Induced Asthma Symptoms, Causes, Diagnosis, Treatment and Prevent

Exercise Induced Asthma Symptoms, Causes, Diagnosis, Treatment and Prevent


What Is Exercise-Induced Asthma?


Asthma is a chronic inflammation of the breathing passages (bronchi) of the lungs. Asthma is characterized by sudden attacks or periods of bothersome or severe symptoms separated by periods of mild symptoms, or no symptoms at all. The inflammatory reaction of asthma is triggered by external factors or specific situations. When a person with asthma is exposed to one of his or her triggers, the inflammation worsens and symptoms begin.

Exercise Induced Asthma Symptoms, Causes, Diagnosis, Treatment and Prevent
Exercise Induced Asthma

Triggers include contaminants in the air, such as smoke, pollution, vapors, dust, or other particles; respiratory infections, such as colds and flu (viruses); allergens in the air, such as molds, animal dander, and pollen; extremes of temperature or humidity; and emotional stress.
Exercise is a common trigger of asthma attacks.

Exercise can even induce an asthma attack in people who have no other triggers and do not experience asthma under any other circumstances.

People with exercise-induced asthma are believed to be more sensitive to changes in the temperature and humidity of the air.

For some forms of asthma, it is important that chronic maintenance medication are used to prevent the development of COPD. Asthma cannot be cured, but it can be controlled by medication. Fortunately, in those with only exercise-induced asthma (EIA), maintenance therapy is often not required and medication can simply be taken before exercise.

With appropriate treatment, almost everyone with EIA can enjoy the mental and physical benefits of regular exercise.

Exercise-Induced Asthma Causes


During normal breathing, the air we take in is first warmed and moistened by the nasal passages. Because people tend to breathe through their mouths when they exercise, they are inhaling colder and drier air.

In exercise-induced asthma, the muscle bands around the airways are sensitive to these changes in temperature and humidity and react by contracting, which narrows the airway.

Exercise Induced Asthma Symptoms, Causes, Diagnosis, Treatment and Prevent

We do know that exposure to a trigger causes asthma attacks. In exercise-induced asthma, that trigger is rapid movement of air into the lungs before it is warmed and humidified. This often occurs because of mouth breathing during exercise.We do know that exposure to a trigger causes asthma attacks. In exercise-induced asthma, that trigger is rapid movement of air into the lungs before it is warmed and humidified. This often occurs because of mouth breathing during exercise.

Sports and games that require continuous activity or are played in cold weather are most likely to trigger an asthma attack.

  • Long-distance running
  • Basketball
  • Soccer
  • Hockey (ice and field)
  • Cross-country skiing
Sports that are less likely to trigger an asthma attack are those that require short bursts of activity interspersed with breaks.

  • Walking
  • Recreational biking (not racing)
  • Hiking
  • Swimming
  • Short-distance running and track/field events
  • Baseball or softball
  • Golfing
  • Football
  • Volleyball
  • Wrestling
  • Gymnastics
  • Downhill skiing

Exercise-Induced Asthma Symptoms


The symptoms of exercise-induced asthma generally begin within 5-20 minutes after the start of exercise, or 5-10 minutes after brief exercise has stopped. If you are experiencing any of these symptoms with exercise, inform your doctor. Symptoms include one or a combination of the following:

Exercise Induced Asthma Symptoms, Causes, Diagnosis, Treatment and Prevent
Exercise-Induced Asthma Symptoms


  • Coughing
  • Wheezing
  • Chest tightness
  • Chest pain
  • Prolonged shortness of breath
  • Unusual fatigue while exercising
  • Extreme fatigue

Symptoms of asthma may be more subtle in children.

  • Children may complain of not being able to keep up with peers in games and sports.
  • They may say they don't like games or avoid participating.
  • This can lead to problems with socialization or self-esteem in some children.

How Is Exercise Induced Asthma Diagnosed?


In known asthma patients or patients with typical symptoms during or after exercise, your physician will often make a presumptive diagnosis of exercise induced asthma by discussing your symptoms with you. Many times your doctor will not conduct further diagnostic tests unless your symptoms persist, or they are not prevented by other measures such as taking albuterol 30 minutes before exercise.

If you do not have an asthma diagnosis but develop chest tightness, coughing, shortness of breath, or wheezing during or after exercise, further investigation by your doctor is necessary to make sure the symptoms are not due to some other condition, like heart disease.

Most often, spirometry before and after physical activity is used to confirm a diagnosis of exercise induced asthma. Generally, you will exercise on a treadmill or stationary bicycle until you reach 85% of your expected maximum heart rate. You are considered to have exercise induced asthma if your FEV1 falls more than 10% with exercise. Some asthma care providers may recommend a bronchoprovocation challenge test, but this is not specific to exercise induced asthma diagnosis. Similarly, measuring peak flows pre- and post-exercise is not recommended to diagnose exercise induced asthma, as results are often inaccurate.

Exercise-Induced Asthma Treatment


Exercise Induced Asthma Symptoms, Causes, Diagnosis, Treatment and Prevent
Since exercise-induced asthma is a chronic disease, treatment goes on for a very long time. Some people have to use medication for the rest of their lives. The best way to improve your condition and live your life on your terms is to learn all you can about your asthma and what you can do to make it better.

  • Become a partner with your health-care professional and his or her support staff. Use the resources they can offer information, education, and expertise to help yourself.
  • Follow the treatment recommendations of your health-care professional. Understand your treatment. Know what each drug does and how it is used.
  • Visit your health-care professional as scheduled.
  • Promptly report any changes or worsening of your symptoms.
  • Report any side effects you are having with your medications.
  • The goals of treatment are as follows:
  • To prevent attacks
  • To carry on with normal activities
  • To maintain normal or near-normal lung function
  • To have as few side effects of medication as possible
If the person doesn't have an asthma plan:

  • For an adult, follow directions for first aid and using an inhaler in Acute Asthma Attack Treatment for Adults.
  • For a child, follow directions for first aid and using an inhaler in Acute Asthma Attack Treatment for Children.
If symptoms do not improve with treatment, call the person's doctor for advice.

If attack happens at school:

  • Notify school nurse or other designated staff if child does not have asthma medication or symptoms do not go away within five to 10 minutes after using inhaler.
  • Notify the child’s parents.
  • Do not let child leave the gym or play area alone.

Can My Exercise-Induced Asthma Be Prevented?


Yes. Asthma inhalers or bronchodilators used prior to exercise can control and prevent exercise-induced asthma symptoms. The preferred asthma medications are short-acting beta-2 agonists such as albuterol. Taken 10 minutes before exercise, these medications can prevent the airways from contracting and help control exercise-induced asthma.

Another asthma treatment that may be useful when taken before exercise is inhaled cromolyn sodium, such as Intal or Tilade 15, to 20 minutes before exercise. 

Having good control of asthma in general will also help prevent exercise-induced symptoms. Medications that may be part of routine asthma management include inhaled corticosteroids. In some cases, a long-acting beta-2 agonist, such as Serevent or Foradil, may be added to the treatment regimen. 

In addition to taking medications, warming up prior to exercising and cooling down after exercise can help in asthma prevention. For those with allergies and asthma, exercise should be limited during high pollen days or when temperatures are extremely low and air pollution levels are high. Infections can cause asthma (colds, flu, sinusitis) and increase asthma symptoms, so it's best to restrict your exercise when you're sick.

Some Tips to Prevent and Treat Exercise-Induced Asthma


  • Always use your pre-exercise inhaled drugs before beginning exercise.
  • Perform warm-up exercises and maintain an appropriate cool down period after exercise.
  • If the weather is cold, exercise indoors or wear a mask or scarf over your nose and mouth.
  • Avoid exercising outdoors when pollen counts are high (if you have allergies), and also avoid exercising outdoors when there is high air pollution.
  • Restrict exercise when you have a viral infection.
  • Exercise at a level that is appropriate for you.

What Are the Best Exercises for Someone With Asthma?


For people with exercise-induced asthma, some activities are better than others. Activities that involve short, intermittent periods of exertion, such as volleyball, gymnastics, baseball, walking, and wrestling, are generally well tolerated by people with exercise-induced asthma.

Exercise Induced Asthma Symptoms, Causes, Diagnosis, Treatment and Prevent

Activities that involve long periods of exertion, like soccer, distance running, basketball, and field hockey, may be less well tolerated, as are cold weather sports like ice hockey, cross-country skiing, and ice skating. 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.

Maintaining an active lifestyle, even exercising with asthma, is important for both physical and mental health. You should be able to actively participate in sports and activities.