It comes as a surprise to many people, but exercise is one of the biggest triggers of asthma attacks. In fact, up to 90% of people who have asthma experience exercise-induced asthma during or after a workout.
This condition (which is often referred to by its preferred name, exercise-induced bronchoconstriction, or EIB) occurs when the airways tighten or constrict as a result of an inflammatory response to physical activity, explains Purvi Parikh, MD, an allergist and immunologist with the Allergy & Asthma Network. The resulting symptoms include coughing, wheezing, shortness of breath, sore throat, or tightness in the chest. Symptoms typically begin within five to 20 minutes of starting a workout, but they can also flare up five to 15 minutes after a workout ends.
While it’s normal to feel out of breath when exercising, with EIB, these symptoms are more severe; if not treated, patients may feel like they’re unable to catch their breath for 30 minutes or longer. Certain environments may also trigger a reaction, such as overly cold or dry air, air pollution, or a high pollen count.
If you suffer from asthma or have allergies, you also have a higher risk of getting EIB, explains Dr. Parikh. But that doesn’t mean the asthma-free can’t develop it: around 11% of the population experiences EIB but does not have general asthma. Unlike asthmatics, these people usually only experience symptoms during or after exercise. But it’s not always that clear-cut.
“It depends on the individual,” says Dr. Parikh. “Some only have [EIB] during and immediately after exercise, but others who also suffer from allergies and allergic asthma can have [symptoms] at other times as well.”
This is why it’s so important to get a diagnosis and treatment by a board-certified pulmonologist or allergist, she says. If you suspect you have EIB, voice your concerns to your doctor. They can give you a spirometry test to assess your lung function, and may perform additional tests to rule out the possibility of other conditions, such as allergies.
While exercise-induced bronchoconstriction can make working out extremely difficult, it is possible for EIB patients to remain active. In fact, there are plenty of highly successful star athletes—from Olympic runners to NBA basketball players—who have been able to manage their symptoms. While there’s no cure, there are a number of medications and preventative measures that treat EIB symptoms and can help you establish a healthy exercise routine.
Common treatments include short-acting inhaled beta2-agonists (bronchodilators) that treat symptoms during an attack (they can also be taken shortly before exercise as a preventative measure), as well as long-term control medications such as inhaled corticosteroids, which are taken daily and help open up the airways.
Lifestyle changes can also help reduce the frequency of EIB attacks. The most important thing is to understand what typically causes your symptoms to flare up, Dr. Parikh explains.
“If you know you have triggers that make the asthma worse, such as cold air, humidity, or exercising during pollen season, there are steps you can take to ameliorate your symptoms,” she says. For example, if you react to high pollen counts, monitor them using a weather app and run indoors on days they’re particularly high. Or if cold weather affects you, wearing a scarf or face mask while you exercise may help you breathe easier.