About one in 10 people experience bronchospasm during physical activity, whether it’s running a marathon, bicycling a few miles or swimming laps in a pool. Many don’t recognize the problem and simply avoid strenuous exercise.
Healthcare professionals call it EIB – exercise-induced bronchospasm. Airway muscle spasms constrict airflow and cause shortness of breath, coughing, wheezing, chest tightness and fatigue. It may happen during exercise, or not until after you stop. Often these symptoms are a sign of underlying asthma and lung inflammation. Sometimes, they are a totally separate condition.
A doctor experienced in EIB can tell the difference and recommend a treatment plan that may include medication, hydration and modifying your exercise routine.
“Warming up, cooling down, pre-treatment with albuterol and hydration will help the body function better whether your EIB is caused by asthma or not,” according to Timothy J. Craig, DO, Vice Chairman of the Asthma Diagnosis and Treatment Committee of the American Academy of Allergy, Asthma & Immunology (AAAAI).
Craig says a proper exercise routine for those with EIB should include 15-20 minutes of warm-ups. “Also, cooling down after a run may decrease post-exercise bronchospasm,” he adds.
Staying hydrated can also minimize symptoms. “It’s the dryness of the airway that causes EIB, which is more prevalent in cold, dry weather,” Craig says. “Control your allergies and rhinitis since the humidity provided by your nose may decrease dryness of your lower airway.”
In cold weather, cover your mouth and nose with a scarf or heat-exchanging mask to help with humidity and warm your breath, he advises.
Exercise And Endurance
Running a marathon with asthma was once unthinkable. It’s now well within reach of otherwise physically fit patients who know how to manage their symptoms.
“Make sure your asthma is stable before long distance runs and that you use your routine daily controlled therapy regularly if indicated,” Craig says. “Albuterol inhalers should be used 10 to 20 minutes before any moderate to aggressive exercise, even in well-controlled asthma, since recurrent EIB can lead to frustration and even result in a loss of commitment to exercise. And always keep your albuterol with you during exercise, in case you need it as you go.”
Other medications may be prescribed to keep lung inflammation and asthma in control.
“Inhaled corticosteroids, if used regularly when indicated, can have a very positive effect on EIB,” Craig says. “Montelukast and other leukotriene receptor antagonists may also help. Do not use long-acting beta-agonists unless required and indicated for asthma
First published in Allergy & Asthma Today, Fall 2012. Reviewed by Tera Crisalida, PA-C, and Michael Foggs, MD.