6 Ways to Manage Exercise-induced Asthma

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Exercise-induced asthma also known as exercise-induced bronchoconstriction, or EIB is the symptom that develops when airways narrow as a result of physical activity. According to the ACAAI it is caused by loss of heat, water, or both from the airways during exercise when quickly breathing in air that is drier than what is already in the body. The symptoms can occur within the first few minutes of exercising and continue for 15 minutes after you finish your exercise. Here are some ways to help manage these symptoms:

  • Try different exercises: When individuals exercise, their breathing becomes faster the air becomes colder and drier which can cause the membrane that lines the lungs to swell. These membranes are sensitive in people with asthma, which could result in wheezing, coughing, shortness of breath, and fatigue. Try different exercises such as swimming- a study suggests “swimming induces less severe bronchoconstriction than other sports. The mechanisms for this protective effect of swimming are not clear, but there is some experimental evidence indicating that it results in part from the high humidity of inspired air at water level, which reduces respiratory heat loss”.
  • Don’t Skimp on Warm-ups and Cool-downs: Doing warm-ups before an exercise and cool-down after an exercise will get your lungs acclimated to the air which will reduce the chances of the lungs membranes swelling and causing asthma symptoms. A  study done on school-age children determined that “ Exercise after warm-up was significant in reducing EIA (exercise-induced asthma).”
  • Do Short Burst of Exercises: Types of exercises such as football, baseball, gymnastics, and track are known to be easier on the airway than sports requiring more endurance such as soccer, long-distance running, and basketball. Research done on exercise and asthma illustrated “Sports with low risk for the development of asthma and bronchial hyperresponsiveness are the ones in which the physical effort is of short duration and in which high ventilatory levels are not reached.” 
  • Avoid exercising outside during cold weather: What often triggers asthma symptoms while exercising is breathing in cold dry air into their lungs which irritates the membrane.  This would be intensified if someone was to exercise in cold weather where the air would be colder and drier. Research conducted on trained adolescent males concluded “results of this study suggest that adolescents (although trained) should avoid high intensity (95% maximal heart rate) exercise in winter (extremely low temperature)”.
When needed, use an inhaler to help with breathing during exercise.
  • Use Asthma medication as needed: This advice might seem obvious but make sure you’re taking your medication before you exercise to reduce the risk of having symptoms while exercising. According to the AAFA, taking a short-acting beta-2 agonist (such as albuterol) with two inhalations 15 to 20 minutes before exercise can prevent airway spasms for several hours. A study illustrated that “beta2-agonists, both SABA and LABA, are effective and safe in preventing EIA (exercise-induced bronchoconstriction) when administered in a single dose.” 
  • Use a face covering in cooler temperatures: This advice is simple and easy to implement. Since a common trigger for exercise-induced asthma is breathing in cold air, covering the nose and mouth creates an environment to retain warm humidified air during exercise. Research on this theory with children was done and the results were “on the control day, the average group forced expiratory volume in 1 s (FEV1) and maximal mid expiratory flow rate (MMEF) decreased from the pre-exercise baseline value to 66% and 47% of baseline, respectively, at six minutes; on the mask day, FEV1 and MMEF were 91% and 82% of the baseline values (increased in all subjects). A simple face mask may be an inexpensive, nonpharmacologic alternative for alleviation of EIA.”

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