April 18, 2022

If you have asthma triggered by exercise (also known as exercise-induced bronchoconstriction), you may be wondering if you can still do your favorite activities. The good news? You certainly can.

Asthma is a chronic condition — with symptoms ranging from annoying to life-threatening — that causes swelling and narrowing of the airways. Triggers for asthma may be dust, pollen, pets, infections, cold weather, smoke, air pollution — and even exercise.

In fact, exercise is a relatively common trigger for people with asthma. For some people, exercise and other things cause asthma symptoms. For others, asthma symptoms only happen with exercise or physical activity. In both cases, this is called exercise-induced bronchoconstriction (EIB). This means that exercise causes the airways (bronchi) to narrow or constrict.

But living with EIB doesn’t mean you need to give up exercise. After all, exercise is important for overall good health, and helps keep the lungs and the muscles used for breathing strong. Asthma expert Basil Kahwash, M.D., of the Vanderbilt Asthma, Sinus and Allergy Program, helps us understand the cause of EIB, and the best way to move forward for patients who are diagnosed with the condition.

What causes exercise-induced asthma?

When we exercise, we take more breaths, and breathe more quickly. “This increased breathing in and out through the mouth may cause the airways to dry and cool,” Kahwash explained. “This may irritate them and lead to symptoms.” The increase in breathing means the lungs of exercisers are also exposed to a larger number of possible environmental triggers while working out: air pollution, chemicals (like chlorine in a pool), allergens, etc.

Symptoms of EIB

EIB symptoms are the same as asthma symptoms and include coughing, wheezing and chest tightness 5 to 20 minutes after starting exercise. In some people, the symptoms can start after exercise, which is often the case if the exercise is strenuous and short. “EIB can also include symptoms such as excessive tiredness (fatigue) and feeling short-of-breath during or after exercise,” Kahwash said.

But that doesn’t mean you should completely stop exercising. In fact, exercise is very helpful for people with asthma. It can improve your airway function by strengthening your breathing muscles. Talk with your asthma specialists for more information about exercising with asthma.

Safety tips for exercising with asthma

Having EIB doesn’t mean you should completely stop exercising. “In fact, exercise is very helpful for people with asthma,” said Kahwash. “It can improve your airway function by training your breathing muscles to handle physical activity.” If you are experiencing EIB symptoms, you should talk to your healthcare provider to make a plan. They’ll likely recommend the following safety tips for exercising with asthma:

  • Start and end slowly. Warm up before you start your actual exercise, and slowly cool down at the end of exercise or activity.
  • Carry your quick-relief inhaler with you. Use it 15 minutes before you start exercising or as your provider recommended.
  • Some people use daily controller medicines for EIB. If you do, take it exactly as told.
  • Think about exercising indoors if it is very cold, or if pollution or allergen levels are high.
  • If you do exercise outside during cold weather, wear a scarf or mask over your mouth and nose.

Recommended sports and activities for exercising with asthma

While it’s true that any activity can cause asthma symptoms, sports and activities with short bursts of activity are often better for people experiencing symptoms. A few examples include:

  • Swimming (unless chlorine is a trigger)
  • Baseball
  • Bike riding
  • Football
  • Downhill skiing
  • Golfing
  • Gymnastics
  • Hiking
  • Short-distance track and field
  • Surfing
  • Tennis
  • Walking

Sports that may increase the chance of symptoms include:

  • Basketball
  • Cross-country skiing
  • Ice hockey
  • Long-distance running
  • Soccer

“With the right guidance and preparation, however, most people with EIB can do any sport or physical activity safely,” Kahwash added.

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