4 Signs Of Exercise-Induced Asthma Every Runner Should Know

Here’s how you can train safely if you have this common condition.


Cassie Shortsleeve |

Breathing is one of those things you take for granted until, suddenly, you have a hard time doing it – as exercise-induced asthma sufferers well know.

It’s a scary feeling. But for anywhere between 5 and 20 percent of the population, these symptoms could point to something called exercise-induced bronchoconstriction (EIB), a condition you might know as exercise-induced asthma (Doctors are moving away from the term “exercise-induced asthma,” though, because it can suggest exercise is a risk factor for asthma, when it’s actually not).

With exercise-induced bronchoconstriction, your airways constrict during or after exercise. “Bronchoconstriction essentially refers to the narrowing of the larger airways in the lungs,” says pulmonologist Rachel Taliercio.

Doctors aren’t sure exactly why EIB occurs during exercise, but it could be that working out cools the cells on the surface of your airways, and when you stop moving, the airways rewarm, leading to inflammation and constriction, explains David A. Wang, M.D., a primary care sports medicine physician at the Hospital for Special Surgery. That’s why symptoms tend to pop up after you’ve exercised for a bit, or even when you’re done (more on that later). Plus, the surfaces of your airways also lose water from exercise, another change that could inflammation and constriction, too.

Fortunately, well-controlled EIB shouldn’t stop you from working out the way you want to, says Taliercio. “But if you’re a runner and you’re finding that you can’t do that, it’s time to check in with your doctor.”

Think you might have it? Here’s everything you need to know about the condition.

Who Gets Exercise-Induced Bronchoconstriction?

In people with a history of asthma, about 90 percent experience symptoms of EIB. But exercise-induced bronchoconstriction can also pop up in adults who have never suffered from asthma before.

It’s also more common in athletes, possibly because they take in and expel more air than the average person. Athletes also might spend more time exercising outdoors, and have higher levels of exposure to environmental triggers and airway irritants like pollution or pollen.

Plus, you may be more prone to the effects if you tend to exercise outdoors in cool, dry air, which can be more irritating to the lungs than a warm, humid environment is, Wang says.

What Are Symptoms of Exercise-Induced Bronchoconstriction?

If you have EIB, you’ll likely experience one or a combination of four symptoms: shortness of breath, a dry, non-productive cough, chest tightness, or wheezing (a whistling when you breathe).

Some of these symptoms—say, trouble catching your breath – can be easy to confuse with the effects of just pushing yourself too hard, or being a little out of shape. So how can you tell if it’s EIB?

Typically, symptoms of exercise-induced bronchoconstriction are pretty precisely-timed. They tend to begin during the first six to eight minutes of exercise, and peak five to 10 minutes post-workout, says Wang. That’s because, initially, exercise expands the airways. But as you continue to move with EIB, or when you stop, your airways can constrict more than usual.

If you have EIB, symptoms usually subside within 30 to 60 minutes, he adds. That’s different than a short-term exertion, like if you’re pushing yourself really hard in a sprint. In that case, you’ll regain your breath much faster than this, Wang notes.

“If you’ve done your run and shortly following your run, your chest is tight, maybe you’re coughing a little bit, that should go away,” notes Taliercio.

If those symptoms persist after that time frame, or get worse – especially if you have a history or asthma and have used a quick-acting inhaler – they may be signs of an asthma attack. In that case, you should seek immediate medical attention, as it can be life-threatening if not treated, notes Wang.

Still, any shortness of breath or chest tightness on a run deserves medical attention. Symptoms of EIB are also linked to other health conditions such as heart attack, congestive heart failure, arrhythmias, and congenital heart defects, Wang says. Make an appointment to see your doctor.

How to Know If You Have Exercise-Induced Bronchoconstriction

If you’ve already been diagnosed with asthma, you might not need further testing to confirm your symptoms are EIB. If you don’t have asthma? You’ll likely perform an exercise challenge: A doctor measures how much air you can inhale and exhale, and how quickly you can do it before and after working out on a treadmill or stationary bike.

“If you’re experiencing airway narrowing, the volume of air that you can forcibly exhale will drop and you can see that easily on a test,” says Taliercio.

How to Treat Exercise-Induced Bronchoconstriction

If left untreated, exercise-induced bronchoconstriction can pose serious health risks. And it can seriously mess with your workout, too: EIB might also impact how fast or how long you can run. So getting it treated is important.

There are medications and lifestyle changes that can treat exercise-induced bronchoconstriction. On the meds side, a short-acting inhaler can help smooth the muscle cells of the airways, allowing the airways to open and dilate, explains Wang. You take it five to 15 minutes before exercise and the medication helps for a few hours.

If the problems persist or the inhaler doesn’t help? Docs can also prescribe a daily, longer-acting inhaler with steroids, which prevent inflammation and swelling or a daily asthma pill, Wang says.

But lifestyle changes are also important, too. Adjusting your running environment based off of triggers can help sidestep flare-ups. If it’s cold, wear a face mask or cover your mouth and nose with a scarf to warm the air, Wang suggests. Breathe through your nose, too – it’s better at filtering the air than your mouth is. And if it’s simply too cold, take your run indoors.

Have pollen allergies? Check the pollen count, and know that dry, windy days tend to be worse than rainy ones. Pollution from big cities and cars can also irritate your breathing, so, when possible seek a more natural environment.

And don’t go all-in to your workout right away, either: A warmup can help, Wang says. If you’re prone to symptoms, warm up for at least 15 minutes (a short jog, for example) to elevate your heart rate and perhaps provoke symptoms. Then, use your inhaler and rest for 15 minutes or so before you start your workout. Says Wang: “When you then start running, the muscles in the lungs are in a refractory period, and are no longer as sensitive and less likely to cause constriction, so that you will not experience the symptoms while running.”

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