Topic of the Month: August 2004:
Winning with Exercise-induced asthma
 As the summer Olympics approach, many athletes are developing training regimens that take into consideration their exercise-induced asthma (EIA). EIA affects up to 20% of highly competitive athletes, including many Olympic athletes, and EIA affects 90% of all asthmatics. Athletes of all levels need to remember to take proper precautions if they have exercise-induced asthma.
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What is exercise-induced asthma (EIA)?
Patients with EIA have airways that are overly sensitive to sudden changes in temperature and humidity, especially when breathing colder, drier air. During strenuous activity, people tend to breathe through their mouths, allowing the cold, dry air to reach the lower airways without passing through the warming, humidifying effect of the nose.
With mouth breathing, air is moistened to only 60-70% relative humidity, while nose-breathing warms and saturates air to about 80 to 90% humidity before it reaches the lungs. In addition to mouth-breathing, air pollutants, high pollen counts, and viral respiratory tract infections can also increase the severity of wheezing with exercise.
What are the symptoms of EIA?
- Wheezing
- Chest tightness
- Coughing
- Chest pain
- Prolonged shortness of breath, often beginning 5-10 minutes after brief exercise
How can EIA be treated?
If you think you have exercise-induced asthma, you should be seen by a physician to make the proper diagnosis. For the majority of patients, a short-acting beta2-agonist inhaled 5 to 30 minutes before exercise (preferably as close to the start of exercise as possible) will ease attacks. When appropriate to treat underlying asthma, you may also be directed by your physician to use long-term controller medications (for example, an inhaled steroid or a type of drug called a leukotriene modifier). Many of the same drugs that are used to treat asthma are used to treat exercise-induced asthma.
What can I do to help my EIA?
Exercise-induced asthma can be treated effectively by following this basic treatment checklist:
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Use a short-acting inhaler 15 minutes prior to exercise. This will help ease asthma exacerbations, and lasts between 4 and 6 hours |
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Warm-up for 6-10 minutes before beginning a full-exercise program |
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Drink plenty of fluids |
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Stop exercising if symptoms arise |
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Cool down at the end of your exercise |
Should I stop exercising if diagnosed with exercise-induced asthma?
No, it is a myth people with EIA should stop exercising. Exercise is good for all people, including those with exercise-induced asthma. If you have been diagnosed with exercise-induced asthma, talk with your doctor about a personalized management plan for your EIA and start exercising again.
 What activities are best for those with EIA?
Although the type and duration of recommended activity varies with each individual, some activities are better for those with EIA, such as:
- Swimming – sport of choice for asthmatics because of its many positive factors: a warm, humid atmosphere, year-round availability and toning of upper body muscles
- Walking
- Leisure biking
- Hiking
- Free downhill skiing – in cold weather, wearing a scarf or surgical mask over the mouth and nose can decrease symptoms by warming inhaled air
With proper care from a physician, medication, and a training regimen, you can perform at the top of your game. An allergist/immunologist can provide more information on exercise-induced asthma and including a personalized management plan for your condition.
Additional points of interest
This month's topic was reviewed on 07-26-2004 by Stuart Friedman, MD, FAAAAI, Patients and Consumers Center Editor.
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