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Exercise-Induced Asthma: Symptoms, Triggers and Management

separator About 18 million Americans have asthma. That’s about 7 percent of the population. Many people who have asthma experience symptoms when they exercise strenuously. This is called exercise-induced asthma, or EIA. But there are many non-asthmatic people who experience this type of asthma as well. Often, they also have allergic rhinitis or a family history of allergies.

What are the symptoms?
Most people with EIA experience difficulty breathing within 5 to 20 minutes after exercise. Symptoms can include

  • Wheezing
  • Tightness in the chest
  • Coughing
  • Chest pain

What triggers EIA?
If you have EIA, your airways are more sensitive than average to sudden changes in air temperature and moisture. Normal breathing generally occurs through the nose, where air is warmed and humidified. When you exercise, you tend to breathe through your mouth. The air goes into your lower airways and lungs without the benefit of the warmth and humidity of the nose. If you’re exercising outside, air pollutants and allergens can increase the severity of your wheezing.

Some activities are better than others
Activities less likely to cause EIA include:

  • Swimming
  • Walking
  • Leisurely bike riding
  • Hiking
  • Baseball
  • Football
  • Wrestling
  • Golfing
  • Gymnastics
  • Short-term track and field
  • Surfing

Activities more likely to trigger an attack include

  • Soccer
  • Basketball
  • Field hockey
  • Long-distance running

Treatment is highly effective
For the vast majority of people—80 to 90 percent in fact—inhaled medications are extremely effective in controlling and preventing EIA symptoms. Most people use what’s called a “short-acting bronchodilator.” It’s a spray that you use 15 minutes before exercising. It acts quickly and lasts for about 4 to 6 hours. You can also use it for relief after symptoms occur.

School children benefit from treatment as well
Children who have EIA are also able to use the short-acting bronchodilator. Teachers can administer the medications during school. There are also longer-acting sprays that last for 12 hours, which children can take before they go to school. These medications enable children with EIA to participate fully in activities along with the rest of their class.

Warm-ups, cool-downs can also help
If you have EIA, warming up with light activity before exercise may help reduce chest tightness that’s caused by exertion. And cooling down by doing light activity after hard exercise may help the air in the lungs to change from cold to warm more gradually.

When should you avoid exercising?
If you have EIA, conditions under which you might want to restrict activity include:

  • When you have a viral infection
  • When the temperature outside is extremely low
  • When air pollution and pollen levels are very high

Journal of the American Medical Association, June 2005
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