Exercize & Activity

Don't Let Exercise-Induced Asthma Slow You Down!

If you have exercise-induced asthma (EIA), rest assured that you are not alone. According to the American Academy of Allergy, Asthma and Immunology (AAAAI) an estimated 5 to 7 percent of Americans are living with the condition.¹

EIA is a condition characterized by symptoms of coughing, wheezing, shortness of breath, and chest tightness during or after exercise and is also associated with airway obstruction after exercise. Some patients with EIA only experience these symptoms during or after exercise and have no symptoms of asthma while at rest. Others, however, may have chronic asthma where exercise simply acts as one of many symptom triggers (including pet dander, pollen, etc.).

EIA is likely triggered by a variety of situations. When air is too cold, humidity is too low or too high, or when there are a lot of allergens in the air, a person with EIA may have an exacerbation of symptoms. For instance, competitive athletes in cold weather sports have a high incidence of EIA: 35% in figure skaters, 35% in ice hockey players, and an astounding 50% of cross-country skiers! EIA appears to be less prevalent in warm-weather sports as the incidence was only 14% in cross-country runners and 16% in athletes at the 1996 Atlanta summer Olympics. ² How does cold air cause more problems than warm air?

The exact mechanism of EIA is not fully understood, yet it seems that inflammation of the airways is indeed involved. Breathing cold air, for example, may stimulate mast cells to produce histamine, proteases, leukotrienes, etc. which act as inflammatory mediators in the lungs and cause the airways to narrow. At the same time other cells may be recruited to the site of inflammation via signals known as chemotactic factors. These cells also release inflammatory mediators, and the inflammatory reaction is simply perpetuated.²

Although EIA can be frustrating to deal with, it does not have to interfere with athletic performance! For recreational athletes you may consider changing the type, duration, or location of exercises you do. Also, warming up to 80-90% of your maximum workload prior to your formal workout may also reduce occurrence or severity of symptoms.² You may also want to discuss various pharmacological treatments with your physician. The first medication usually tried is an inhaled bronchodilator such as albuterol (Ventolin, Proventil). Your physician will show you how and when the inhaler is to be used – usually two puffs of the medication 15-30 minutes before starting your workout.³ Other medications may be beneficial, and you should discuss your options with your healthcare provider if you think you may have EIA.

Don’t let exercise-induced asthma keep you from reaching your athletic goals. Many great athletes have learned how to deal with EIA, and so can you!!

1. American Academy of Allergy, Asthma and Immunology (AAAAI). Tips to remember: exercise-induced asthma. 2003. www.aaaai.org
   
   
2. University of Michigan Health System. Patient handouts: exercise-induced asthma. 2003. www.med.umich.edu
   
   
3. Storms WW. Review of exercise-induced asthma. Med Sci Sports Exercise. 2003; 35: 1464-1470.