Exercising With Asthma

Exercise-induced asthma, or EIA, is one of the most common conditions among active children, adolescents and young adults. However, that doesn’t mean that they should stop being active.

Exercise-induced asthma is a temporary narrowing of the airways brought on by strenuous exercise. Fifty percent of people with hay fever and 10% of normal athletes have developed EIA. However, there are things these people can do to control these attacks.

Vigorous exercise increases breathing, which requires more oxygen. This causes cooling and drying of the airway. Eighty to ninety percent of asthmatics have difficulty breathing with vigorous exercise. Those with asthma have hypersensitive, or twitchy airways. When coming in contact with certain things (i.e. low humidity, fatigue, emotional stress, inhaled allergens, changes in airway temperature, and cold, dry air), the airways contract or tighten and become swollen. The swelling may close some of the air passages causing air to be trapped. In order to protect the airway, more mucus is produced. The mucus becomes thicker, which causes severe coughing and more irritation to the airways. This reaction gets out of control and may cause the following symptoms: shortness of breath with exercise, wheezing, chest tightness, dizziness, and stomach problems. An inhaler is given to relax the muscles of the airway and restore normal breathing.

There are three stages of EIA: an early phase, a refractory phase, or grace period, and a late phase. The early stage is the most severe. EIA occurs during the first six to eight minutes of vigorous exercise and lasts 30-60 minutes before ending on its own. The refractory phase next where little or no tightening of the airways occurs during exercise. Athletes should take advantage of this period so that they can compete without any problems. This phase occurs in about half of those with EIA. The late phase is the least severe and may not even occur in some people.

Several steps people can take to decrease the effects of EIA:

  • Avoid environmental factors such as inhaled allergens (dust, pollens, animals, smoke, and air pollutants) and cold, dry air.
  • Continue to exercise on a regular basis.
  • Allow a warm-up and cool-down period of 10-15 minutes when exercising.
  • Avoid exercise if symptoms are present before exercise.
  • Slowly increase the intensity of workouts.
  • Participate in sports that are well tolerated for those with EIA, such as: football, downhill skiing, tennis, baseball, volleyball, wrestling, short distance track and field events, golfing, and gymnastics. Swimming is the most effective because breathing warm, moist air can completely or partially prevent EIA.

EIA should not affect an athlete’s performance if the right medication is taken. Inhalers used to control asthma can be short acting or long acting.

Short-acting inhalers are taken during an asthma attack because they work within five minutes and usually last one to two hours. They have been effective in 80-95% of patients. Long-acting inhalers work within 20-25 minutes, but must be taken four hours before exercise to work the best.

When used 30 minutes before exercise, long acting inhalers can last up to 10-12 hours. If a long-acting inhaler is used, however, a short-acting inhaler should be carried along to stop an asthma attack.

The bottom line is athletes suffering from exercise-induced asthma should continue to exercise on regular basis. Wheezing that results from EIA is usually not severe and clears after a short time. If more severe wheezing occurs, it usually indicates poorly controlled underlying asthma. If proper precautions are taken and medications are used correctly, the athlete will be able to compete at their highest level with minimum difficulties.
 

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