Shortness of breath and prolonged coughing brought on by exercise or after workouts and races are often ignored or ascribed to an athlete either being unfit or having pushed his/her body to its limit. Sometimes this assumption is correct but at other times it is not and results in exercise-induced asthma (EIA) going undiagnosed and untreated with detrimental effect.

Gasping for breath

People usually associate EIA with an athlete gasping for breath after a tough workout or race only to recover soon after, fit as a fiddle. In South Africa we are used to seeing the top Comrades marathon athletes flying over the finish line gasping for breath, even collapsing sometimes, only to get up and go shortly afterwards. They obviously do not have exercise-induced asthma.

Cause

EIA, also referred to as exercised-induced bronchospasm or restriction, occurs when exercise causes the airways to constrict and narrow making breathing difficult. It is believed that this happens because an athlete/individual breathes faster, more heavily and often through their mouths during exercise. This in turn causes the lining of the airways to dry out and become inflamed, thereby prompting the release of constrictor chemicals that cause muscles in the airways to contract and narrow.

Coughing

The most common symptom of EIA is “the cough”. Those with EIA often find that they keep on coughing for 24 to 36 hours after a race or set of exercises and that the cough produces gooey mucus similar to the mucus being coughed up during bouts of bronchitis. Other warning symptoms include wheezing, difficulty breathing and a feeling of tightness in the chest. These symptoms usually start five to 20 minutes into non-stop exercise, reach a peak five to 10 minutes after activity has stopped and usually disappear after an hour or two. There is often also a mismatch between the athlete’s level of fitness and the unusual state of fatigue he/she experiences. Non-athletes and even children may experience the same symptoms following strenuous exercise.

Solution

Having EIA does not mean that you will never be able to exercise or do sport. In fact many famous athletes, even Olympic medal winners, suffer from asthma or EIA, for example Justine Hennin, four times French Open Tennis champion; Greg Louganis, considered one of the greatest divers of all times; Jackie Joyner, Olympic track and field star; and Jim Ryun, former Olympic medallist and record holder in the mile and 1 500 metre races.
How did they do it? They had a comeback strategy and followed an EIA treatment and prevention plan. Preventing EIA from taking over your life starts with a visit to your doctor or specialist to obtain the right diagnosis and medication.

Medication

Two types of asthma medicines are usually prescribed for EIA:

    1. Quick-relief medicines, such as short-acting inhaled beta-agonists (bronchodilators), stop symptoms right away when taken 10 to 15 minutes before exercise starts and last for two to four hours
    1. Long-term control asthma medicines taken every day over longer periods of time prevent and control symptoms.

Other precautions

    • Find out what else triggers your allergies and asthma, for example high pollen counts, air pollution and dust, cigarette smoke, certain foods, etc. and avoid at all costs
    • Exercise in warm, humid environments and avoid cold dry conditions. Cold air aids constriction of the airways. Cover your nose and mouth if necessary or exercise indoors
    • Warm-up before you start exercising. Not only does it improve lung function but it may also help reduce the release of constrictor chemicals that cause the symptoms of asthma
    • Breathe through your nose instead of your mouth to warm the air that passes to the lungs
    • Cool down after exercising: walk, swim or jog slowly
    • Exercise activities that require short bursts of activity such as gymnastics, aerobics, tennis, swimming, volleyball, wrestling, golf, walking and short-term track and field are less likely to exacerbate EIA
    • Exercise activities that require prolonged activity and high exertion or are done in cold weather such as cross country skiing, ice skating, ice hockey mountain biking, triathlon and long distance running are more likely to exacerbate EIA
    • Prevent long exposure to altitude
    • Stay fit; the fitter you are the less heavily you will need to breathe while exercising
    • Don’t exercise if you have a viral infection.

The good news is that apart from very rare and difficult cases of asthma and EIA, most individuals with EIA are able to participate in exercise and sport, even at the highest level and for the rest of their lives. If managed properly, the sky is the limit and anything is possible!

Sources
Asthma and exercise. Retrieved from: http://www.acaal.org/allergist/asthma/Pages/asthma-and-exercise-.aspx
Asthma brought on by exercise. Retrieved from:http://www.netdoctor.co.uk/diseases/facts/asthma_exercise.htm
Bernhardt, G. Endurance athletes and exercise-induced asthma. Retrieved from: http://www.Action.com
Exercise-induced asthma: a primer. 2012. Retrieved from: http://www.coreperformance.com/knowledge/injury-pain/exercise-induced-asthma-a-primer.html