Exercise and asthma aren’t mutually exclusive.
Everyone knows how it feels to struggle through a workout when your lungs are basically shrieking that you should just stop and go back to bed. But if working out always makes your lungs feel like you’re in the ninth circle of hell, you might actually have exercise-induced asthma. Here’s how you can spot the symptoms, plus expert-approved tips on managing exercise-induced asthma even if you’re a workout fiend.
As its name implies, exercise-induced asthma is when you experience trouble breathing while pushing yourself physically.
Asthma happens when the airways in your lungs narrow and produce excess mucus to the point where you experience issues like coughing, a whistling sound when you breathe (wheezing), chest tightness and pain, and shortness of breath, according to the National Heart, Lung, and Blood Institute (NHLBI). Some people only experience this domino effect while they’re working out, which is when exercise-induced asthma enters the picture.
Experts actually often refer to exercise-induced asthma with the more specific name exercise-induced bronchoconstriction. This is to clarify that while strenuous exercise may trigger the airways in your lungs to narrow (aka bronchoconstriction), it’s not actually an underlying cause of asthma, according to the Mayo Clinic.
Just like with asthma, exercise-induced bronchoconstriction can lead to symptoms like coughing, wheezing, chest tightness and pain, and shortness of breath. But you can also experience exercise-specific issues, like an abnormal level of fatigue during your workouts. Some people also feel out of shape when they’re actually not, Sadia Benzaquen, M.D., a pulmonologist and associate professor in the department of internal medicine at the University of Cincinnati College of Medicine, tells SELF. “It can impact your life—you may not be able to go for a hike with friends or play a soccer game without feeling uncomfortable,” he says.
These symptoms can start just a few minutes into a workout session, but like with most illnesses, everyone is different. “I’ve had patients be well into exercise and then [all of a sudden] they can’t function,” Raymond Casciari, M.D., a pulmonologist at St. Joseph Hospital in Orange, Calif., tells SELF.
Though there may be many causes at play behind exercise-induced bronchoconstriction, experts have pinpointed one main factor. “Because you’re inhaling a large volume of air beyond what you would normally, it creates an inflammatory reaction that causes narrowing of the airways and mucus production,” Emily Pennington, M.D., a pulmonologist at the Cleveland Clinic, tells SELF.
While physical activity is the main trigger of exercise-induced bronchoconstriction, different factors can make it worse, including cold or dry air, air pollution, high pollen counts, swimming pool chlorine, chemicals used with ice rink resurfacing equipment, having a respiratory infection or lung disease, or doing activities that require a lot of extended deep breathing, like long-distance running, swimming, or soccer, according to the Mayo Clinic.
If it feels way too hard to catch your breath when you’re exercising, see a doctor for testing.
For starters, your doctor will probably give you lung tests to figure out how well you can breathe when you’re not exercising. This helps them determine if you have underlying asthma unrelated to exercise or just exercise-induced bronchoconstriction, according to the Mayo Clinic.
First up, they may have you do a spirometry test, which uses a mouthpiece connected to an instrument called a spirometer to measure how much air you inhale and exhale, and how quickly you can exhale it. After you take the spirometry test, your doctor will probably give you a bronchodilator, which is an inhaled medication that opens up your lungs, the Mayo Clinic says. You’ll then do the spirometry test again, and your doctor will compare the results to see if the bronchodilator helped improve your airflow. If it did, you might have underlying asthma that just gets worse when you exercise instead of solely having exercise-induced bronchoconstriction.
Your doctor may also put you through something known as an exercise challenge, which is when you run on a treadmill or ride on a stationary bike to get your breathing up so they can see what’s happening in your body when you work out. They’ll also likely administer spirometry tests before and after to get evidence that you have bronchoconstriction from exercise, Dr. Benzaquen says.
Another diagnostic option involves tests where you inhale something that basically fools your lungs into behaving the way they would during a workout, according to the Mayo Clinic.
If you already know that you have asthma and it seems to get worse when you work out, your doctor might diagnose you without putting you through other testing, Khalid M. Eltawil, M.D., a pulmonologist with Torrance Memorial Medical Center, tells SELF.
You don’t have to just suffer through exercise-induced bronchoconstriction—there are a few things you can do to keep your airways clear during workouts.
The most common treatment is using an inhaler a set period of time before you exercise, Dr. Casciari says. The inhaler will contain medication to keep your lungs from going haywire, like a short-acting beta agonist to open up your airways. Though it will depend on your specific prescribing information, you’ll typically use inhalers with short-acting beta antagonists 15 to 20 minutes before exercise, according to the Cleveland Clinic.
Usually this kind of treatment does the trick, Dr. Benzaquen says, but if you’re still struggling, your doctor might tack on a longer-term treatment in addition to one you take before exercise. This might include daily medications like inhaled corticosteroids to help suppress inflammation in your airways, combination inhalers that contain a corticosteroid and a long-acting beta agonist to prevent inflammation and relax your airways, and leukotriene modifiers to can block inflammatory chemicals that can cause asthma symptoms, according to the Mayo Clinic.
There are also little exercise tweaks you can make. For example, since cold, dry air is a big trigger for a lot of people with exercise-induced bronchoconstriction, covering your mouth with something warm like a scarf when you work out outside can make a big difference, Dr. Pennington says. Warming up adequately before you go all-out can also help your body become accustomed to the extra airflow during exercise, Dr. Casciari says. So can breathing through your nose as you exercise (since it will warm and humidify air more than your mouth will), avoiding allergy triggers like exercising outside when pollen is at its peak, and avoiding working out if you’re sick since respiratory infections tax your airways.
Basically, there are a lot of options out there that can help if you struggle with exercise-induced bronchoconstriction. Don’t just assume working out isn’t for you—talk to your doctor about a treatment plan that can help you get through exercise sessions instead of throwing in the towel.