How to Control Exercise-Induced Asthma for Sports

Exercise-induced bronchoconstriction is a form of asthma that is triggered by physical activity. Asthma causes inflammation and sensitivity of the small airways of the lungs. When triggered by exercise or other environmental substances, the lung's airways can spasm or constrict.

People with exercise-induced bronchoconstriction typically experience asthma symptoms only when they exercise. Exercise-induced asthma (EIA) is more common when the weather is cold and dry, or the level of pollution or allergens in the air is high. EIA is extremely common in elite athletes, including competitive swimmers. It is also more common in those with poor physical conditioning or respiratory infections.

Symptoms

Symptoms of EIA vary from person to person, but the most common symptoms include:

  • wheezing
  • coughing
  • shortness of breath
  • chest tightness

Controlling Exercise-Induced Asthma

EIA is best managed when a patient and their doctor work together to identify, eliminate, and control triggers. Choose the most effective preventative and maintenance medications, and have an asthma emergency plan.

EIA is often treated with the same medications used for a standard asthma diagnosis. The most common medications prescribed for EIA include short-acting inhaled bronchodilators that are used prior to exercise in order to relax and open up the airway. Other medications your doctor may prescribe include longer-acting bronchodilators, mast cell stabilizers, and leukotriene modifiers.

If you have asthma symptoms during exercise, it's important to see a doctor and get a complete physical evaluation before taking any medications.

Know Your Triggers

To manage EIA, it's important to know what triggers your asthma symptoms. For example, if your symptoms occur most often during strenuous activity in cold, dry air, you may need to exercise indoors during the winter or wear a scarf or face mask when you exercise outside. Other things you may need to do include adjusting your routine during high pollution and high allergen days, or stop exercising when you feel tired, or have a cold or other illness.

Improved physical conditioning has been shown to decrease the incidence of asthma attacks. For this reason, those with asthma are encouraged to continue exercising. Another key to minimizing symptoms of exercise-induced asthma during sports is to be sure to perform a thorough warm-up before workouts. About 15 minutes of gradually increasing exercise before an intense workout is important for someone with asthma.

Managing an Asthma Attack

If an asthma attack does occur, it's important to act quickly to stop the episode. The onset of asthma symptoms generally come on slowly and increase over time. The symptoms of asthma can actually get worse when exercise stops and last for several minutes to an hour. Treatment with an inhaled short-acting bronchodilator would result in rapid improvement of symptoms within minutes. Here are the steps to take to treat an asthma attack:​​​

  1. Stop all activity and try to stay calm.
  2. Get away from or remove any obvious triggers (smoke, dust, cold temperatures).
  3. If you have prescription medication, take it.
  4. Try to slow or control any erratic breathing.
  5. If the symptoms continue, get medical attention quickly.

EIA doesn't have to keep you from physical activity. In fact, exercise is an important part of your treatment plan. Many successful athletes have exercise-induced asthma that they manage with a combination of medication and environmental control. You too can remain healthy and physically fit with proper education and use of medication for your asthma.

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Article Sources
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  1. American Lung Association. What is asthma? Updated May 15, 2020.

  2. Asthma and Allergy Foundation of America. Exercise-induced bronchoconstriction (Asthma). October 2015.

  3. Del Giacco SR, Firinu D, Bjermer L, Carlsen KH. Exercise and asthma: an overviewEur Clin Respir J. 2015;2:27984. doi:10.3402/ecrj.v2.27984

  4. American College of Allergy, Asthma & Immunology. Exercise-induced bronchoconstriction.