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Asthma and Exercise

Source:, Asthma and Allergy Foundation of America (AAFA)

Exercise can cause symptoms such as shortness of breath and coughing in people who have asthma. This is called exercise-induced asthma, exercise-induced bronchospasm or exercise-induced bronchoconstriction.

Most mornings, I meet my friend Debbie for a 3- to 5-mile jog. Recently, I’ve started to cough and have shortness of breath about 15 minutes into the jog. My allergist said I’d developed exercise-induced asthma. I told him I couldn’t give up jogging—it’s my social time, plus it keeps me physically fit. She said that I should take asthma medicine and warm up with gentle exercises for about 15 minutes before I jog. I’m now able to keep up with Debbie and enjoy my jogs again. — Alyssa, age 57

Who gets exercise-induced bronchoconstriction?

Asthma is a lung disease that makes it hard to breathe at times. Most people with asthma have exercise induced asthma. Some people have asthma symptoms only when they exercise. When they exercise, their airways become narrower, which makes it hard to breathe.

What are the symptoms of exercise-induced bronchoconstriction?

Symptoms include coughing, wheezing (a whistling sound when a person breathes), a feeling of tightness in the chest, and shortness of breath. Symptoms usually start 5 to 20 minutes into non-stop exercise, peak 5 to 10 minutes after the exercise stops, and then slowly go away.

What causes the symptoms of exercise- induced bronchoconstriction?

Any exercise can cause asthma symptoms, but mainly exercise in a cold room or in cold weather. Indoor and outdoor air pollution, high pollen counts and colds also can cause symptoms during exercise.

Did you know... Coughing is the most common symptom of exercise-induced asthma and may be the only symptom you have?

How is exercise-induced bronchoconstriction diagnosed?

Your allergist will ask you about your asthma symptoms and medicines. To check how exercise affects your breathing, the allergist may measure your breathing before, during and after you run on a treadmill or ride an exercise cycle. The breathing will be measured with a spirometer. You will breathe into a tube that connects to the spirometer.

How can I prevent and treat symptoms of exercise-induced bronchoconstriction?

Work with your allergist to create an asthma action plan. You and your allergist can try to find out what causes your asthma symptoms, like high pollen counts or air pollution when you exercise. Then you can try to avoid these things.

  • Warm up with gentle exercises for about 15 minutes before you start more intense exercise.
  • Cover your mouth and nose with a scarf or face mask when you exercise in cold weather.
  • Try to breathe through your nose while you exercise. That helps warm the air that goes into your lungs.
  • Take medicine to prevent and treat this kind of asthma.

Did you know... People who do warm-up exercises before they start their main exercise activity may need to use less asthma medicine during exercise?

What medicines are used to treat exercise- induced bronchoconstriction?

Two types of asthma medicines are used for exercise- induced bronchoconstriction:

  • Quick-relief medicines. These medicines stop asthma symptoms right away.
  • Long-term control medicines. These medicines prevent and control symptoms.

Quick-relief asthma medicines used to treat exercise-induced bronchoconstriction

Type of Medicine:  Short-acting inhaled beta-agonists (also called bronchodilators)

When to Take: 10 to 15 minutes before exercise starts

How Long It Prevents Symptoms: 2 to 4 hours

Long-term control asthma medicines used to treat exercise-induced bronchoconstriction

Type of Medicine: Long-acting inhaled beta-agonists (also called bronchodilators)

When to Take: 30 to 60 minutes before exercise starts (use only once within a 12-hour period)

How Long It Prevents Symptoms: 10 to 12 hours

Type of Medicine: Cromolyn sodium and nedocromil

When to Take: 15 to 20 minutes before exercise starts

How Long It Prevents Symptoms: 1 to 2 hours

Athletes who compete should ask those who make rules about their sport what medicines they are allowed to take for exercise and asthma.

What types of sports are best for people with exercise-induced bronchoconstriction?

Sports and activities least likely to cause asthma symptoms:

  • Sports that require only short bursts of activity, including volleyball, gymnastics, baseball, wrestling, golf, swimming, football, and short-term track and field events. Some swimming events can be constant activity, but the warmth and humidity from the water make it easier for people with exercise-induced bronchoconstriction to breathe.
  • Activities such as walking, hiking, and recreational biking.

Sports and activities most likely to cause asthma symptoms:

  • Sports or activities that require constant activity or are done in cold weather, such as soccer, basketball, long-distance running, ice hockey, ice skating, and cross-country skiing.

If you have exercise-induced bronchoconstriction, you can still lead an active life and reach for your athletic dreams!

Who treats exercise- induced bronchoconstriction?

Your allergist can treat your exercise-induced bronchoconstriction.

Does health insurance cover treatment for exercise-induced bronchoconstriction?

Most health insurance plans cover asthma treatment, no matter the cause. Ask your insurance carrier:

  • Do I need a referral from my doctor to see an allergist?
  • Does my insurance cover patient education or special services for my exercise-induced bronchoconstriction?
  • Does my insurance cover a pre-existing problem? This usually means any health problem that you had before you joined your current health plan.
  • What medicines does my plan cover?
  • Are tests like spirometry covered?

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