Exercise-induced asthma doesn’t mean you can’t exercise

With the weather warming up, your children are raring to get outdoors. And who can blame them?

They’ve been cooped up all winter long. To help, you’ve signed your son up for a local soccer league, where he can expend some energy while getting to know a new group of friends.  

The problem is he’s benched during the middle of the first game after struggling to keep up with the other players.

Could he just be winded, or is his wheezing and decreased endurance indicative of something else – something like exercise-induced asthma?  

What is exercise-induced asthma (EIA)?

Exercise-induced asthma, also known as exercise-induced bronchoconstriction (EIB), is a narrowing of the airways in the lungs triggered by strenuous exercise.

While the name might suggest that exercise causes asthma, this isn’t the case.  

In fact, 90% of people with asthma will experience EIA during exercise, but you don’t have to have asthma to experience symptoms of exercise-induced asthma.  

What causes EIA?

Inhaling cold, dry air is thought the be the primary cause of exercise-induced asthma. Kids who exercise or play hard tend to breathe more quickly and shallowly through their mouths, so when air reaches their lungs, it’s not as warm or humidifying as air breathed through their noses.  

This cold, dry air can result in a narrowing of your child’s airways, blocking the flow of air (hence the name bronchoconstriction) and making it harder to breathe.  

Interestingly, certain types of sports and weather conditions are more likely to trigger EIA than others.

For example, sports that require constant activity (soccer, long-distance running, and basketball) and sports played in cold weather (ice hockey, figure staking, and cross-country skiing) cause exercise-induced asthma more than sports with short bursts of exercise or activities are done in warm, humid environments.   

Some of the following irritants might also play a role in EIA: 

• Air pollutants  
• High pollen counts 
• A recent cold or asthma episode 
• Chlorine from a swimming pool 
• Chemicals used by Zambonis to resurface ice 

What are the signs & symptoms of exercise-induced asthma? 

If you think your child might be experiencing exercise-induced asthma, watch for signs and symptoms like:  

• Shortness of breath 
• Wheezing 
• Coughing  
• Decreased endurance  
• Chest tightness 
• Upset stomach 

These symptoms typically begin 5 to 10 minutes after kids start exercising and peak 5 to 10 minutes after stopping an activity.

Some kids, however, only get symptoms after they stop exercising, and these symptoms can last up to an hour or longer.  

How do you test for EIA?

Exercise-induced asthma in children can easily be diagnosed by a pediatrician or allergist. During an appointment, your doctor will typically complete a medical history to determine if asthma or other breathing difficulties run in the family.  

They will also perform an exercise-induced asthma test to rule out other conditions that might be causing the symptoms. Your child will be asked to run a treadmill or ride a stationary bike to help trigger the symptoms he or she was experiencing while exercising. Their breathing will be monitored before, during, and after the activity with a spirometer that measures air volume.  

Your healthcare provider might perform this test twice, a second time after giving your child an inhaled medication to open up the lungs.

A comparison between the two will show whether the medication improved airflow.  

How do you manage & treat EIA?

Depending on your child’s test results, your doctor might prescribe a medication to help with symptoms of exercise-induced asthma. The best course of asthma treatment will be based on your child’s unique condition and the kinds of activities he or she wants to participate in.   

• Short-acting bronchodilator – This type of treatment is designed to stop symptoms right away. It can be taken 15 to 30 minutes before strenuous activity to prevent symptoms for 2 to 4 hours. Short-acting bronchodilators can also be used after the onset of symptoms to reverse their effect. 
• Long-acting bronchodilator – This type of treatment needs to be taken 30 to 60 minutes before strenuous activity and can help prevent symptoms for 10 to 12 hours. It should only be administered once in a 12-hour period. Since long-acting bronchodilators don’t offer immediate relief, they shouldn’t be used once symptoms have begun.  
• Mast cell stabilizer – This type of treatment is also used to prevent EIA symptoms before they begin. They should be taken 15 to 20 minutes before strenuous activity and are not effective once symptoms have started. Sometimes mast cell stabilizers are used in conjunction with a short-acting bronchodilator.  

Besides medication, there are also natural treatments for exercise-induced asthma that can help your children perform at their best. These include: 

• Warming up before intense physical activity to prevent chest tightening (with 10 to 15 minutes of light activity such as jogging or stretches) 
• Cover your mouth and nose with a scarf if exercising in cold weather.
• Breathing through your nose instead of your mouth when exercising  
• Avoiding triggers by making changes to your exercise routine  
• Avoid exercising during times when you are also afflicted by seasonal allergies
• Cooling down after exercise to slow the change in temperature in your lungs 

Bottom line: Your children can still exercise with EIA

If you think it’s best for kids with exercise-induced asthma to avoid playing sports, think again. Not only is most exercise good for children with EIA, but it can also help improve lung function by strengthening breathing muscles in the chest.  

You should encourage your child to remain active while working to control any exercise-induced asthma symptoms. Should your child suffer from severe EIA, activities like walking, jogging, golf, football, gymnastics, and shorter track and field events might be better.  

But even world-class athletes, including some Olympic medal winners in ice hockey, figure staking, and cross-country skiing, have been able to excel in their sports with EIA. Don’t let it hold your children back from participating in the activities they love – take charge of your asthma!  

Not sure your child’s symptoms are exercise-induced asthma? Visit an urgent care in your neighborhood by saving your spot using the dropdown below. Our healthcare professionals are trained in treating patients with asthma attacks and wheezing and offer care during evenings, weekends, and holidays when you need it most.