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Exercise-Induced Asthma

Medically Reviewed by Kumar Shital, DO on October 22, 2020

What Is Exercise-Induced Asthma?

Like it sounds, exercise-induced asthma is asthma that is triggered by vigorous or prolonged exercise or physical exertion. Most people with chronic asthma experience symptoms of asthma during exercise. However, there are many people without chronic asthma who develop symptoms only during exercise.

Why Does Exercise Trigger Asthma?

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. This results in symptoms of exercise-induced asthma, which include:

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

If I Have Asthma, Should I Avoid Exercise?

No. You shouldn't avoid physical activity because of exercise-induced asthma. There are steps you can take for prevention of asthma symptoms that will allow you to maintain normal physical activity. In fact, many athletes -- even Olympic athletes -- compete with asthma.

Can My Exercise-Induced Asthma Be Prevented?

Yes. Asthma inhalers or bronchodilators used before 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 ipratropium, which helps the airways to relax.

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 such as beclomethasone dipropionate (Qvar) or budesonide (Pulmicort). An inhaled long-acting beta-2 agonist combined with a corticosteroid, such as Advair or Symbicort, may be added to the treatment regimen. Tiotropium bromide (Spiriva Respimat) is a long-acting anticholinergic medication to use along with your regular maintenance medication. This drug may be used by anyone age 6 years and older. It should not be used as a rescue inhaler.

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.

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.

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 better tolerated by those with asthma 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.

How Do You Treat Exercise-Induced Asthma?

Call 911 right away if the person:

  • Is struggling to breathe
  • Has blue lips
  • Can’t walk or talk
  • Shows other signs of a severe attack

1. Stop the activity.

  • Have the person sit down and rest.

2. Follow the person’s asthma plan, if possible.

  • Find out if the person has an individualized asthma action plan from a doctor.
  • If so, follow its directions.

3. Give asthma first aid.

4. Resume activity when it’s safe.

  • Wait until the person can breathe easily and is symptom-free before resuming exercise.
  • If symptoms return when person starts exercise again, repeat treatment and stop exercise for rest of day.

5. Follow up.

  • If symptoms do not improve with treatment, call the person's doctor for advice.

If an attack happens at school:

  • Notify a school nurse or other designated staff member if the child does not have asthma medication or symptoms do not go away within 5 to 10 minutes after using an inhaler.
  • Notify the child’s parents.
  • Do not let the child leave the gym or play area alone.

Are There Tips to Prevent and Treat Exercise-Induced Asthma?

  • Always use your pre-exercise inhaled drugs.
  • Do warm-up exercises and have a 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 avoid exercising outdoors when there is high air pollution.
  • Limit exercise when you have a viral infection.
  • Exercise at a level that is appropriate for you.

Again, asthma should not be used as an excuse to avoid exercise. With proper diagnosis and treatment of asthma, you should be able to enjoy the benefits of an exercise program without asthma symptoms.

WebMD Medical Reference

Sources

SOURCES:

American Academy of Allergy Asthma & Immunology: "Allergic Conditions: Exercise-Induced Asthma (EIA)."

American College of Allergy, Asthma, & Immunology. Exercise-Induced Brochoconstriction (EIB) American Lung Association: "Search LungUSA."

Boehringer Ingelheim: "US FDA Expands Approval of Tiotropium Respimat® for Maintenance Treatment of Asthma in Children."

FDA. Prescribing Information: Spiriva Respimat.

National Heart, Lung, and Blood Institute: “First Aid for Exercise-Induced Asthma,” "How Is Asthma Treated and Controlled?"

Asthma Foundation (Australia): “Exercise-Induced Asthma.”

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