Is It More Than Being Out of Shape?

Do you have trouble exercising because of tightness in your chest, coughing or wheezing? Do you feel short of breath when you exercise? If so, you may be one of many people with exercise-induced asthma.

About 20 million people in America reportedly have asthma and estimates indicate that 80 percent of these patients experience increased symptoms during exercise, or what we call exercise-induced asthma. While some non-asthmatics experience asthma only during exercise, the majority of these patients have underlying asthma that worsens with exercise. Studies suggest that these symptoms are common in athletes with more than 15 percent of athletes suffering from exercise-induced asthma.


Most people tend to breathe through their mouths during exercise allowing cold, dry air into the lower airways without passing through the nose. Exercise-induced asthma is due to over sensitivity to sudden changes in temperature and humidity especially when breathing colder, drier air. Air pollution, respiratory tract infections, and high pollen counts can also worsen symptoms.


Symptoms usually begin within 5 to 15 minutes after starting exercise and include wheezing, coughing, chest tightness, or prolonged shortness of breath after exercise.


The diagnosis is usually established after a careful medical history and physical examination. Spirometry, a breathing test, should be performed when the patient is asymptomatic. Sometimes, a breathing test is performed after exercise. If there is a significant decrease in the breathing test following exercise, this indicates possible exercise-induced asthma.


Certain activities may be better than others. Swimming is often considered the sport of choice in patients who have symptoms of asthma with exercise. Team sports that require short bursts of energy such as baseball, golfing, and gymnastics are less likely to trigger asthma than those requiring continuous running such as soccer and basketball. Cold weather sports may also be more likely to induce symptoms of asthma.

Always warm up and cool down as part of an exercise routine. Restrict exercising when fighting an upper respiratory infection, when it is very cold, or when pollen counts are high.


A bronchodilator is the medication of choice to help prevent symptoms. It is taken by inhalation prior to exercise. These medications are effective in up to 90 percent of patients. They can also be used to treat symptoms of exercise-induced asthma once the symptoms occur. If the symptoms can't be controlled with medications used prior to exercise, daily maintenance medications may be needed. This should be discussed with your physician.

With increased knowledge and proper treatment, athletes with exercise-induced asthma can still enjoy their favorite sport or activity.