What are the symptoms?
Symptoms of exercise-induced asthma include coughing, shortness of breath, chest tightness, and wheezing.   They typically start about 5-15 minutes into exercise, or shortly after exercising, then gradually resolve.   Symptoms often are worse when exercising outdoors in cold dry air.    Often, people who have difficulties exercising or competing in sports believe that this is because they are not “athletic” enough – however, it may well be because they have exercise-induced asthma.   Anyone who has any of those symptoms should see their physician for an evaluation.

What is the cause?
Since affected people usually have worse symptoms when running outdoors on a cold winter day and do better if swimming in a pool where the air is warm and humid, it is thought that the humidity and temperature of the air may adversely affect the airways.   When breathing quickly, the air does not have much time to warm up and humidify as it enters the lungs compared to when we breathe slowly. The dry cold air appears to cause the muscles surrounding the airways to spasms, resulting in the narrowing of the airways and thus difficulties in breathing.    

How is exercise-induced asthma diagnosed?
One way to diagnose exercise-induced asthma is to do what is called an exercisechallenge.    Basically, breathing tests are done before and after exercise. The information provided by the test will help your physician determine if you have this condition.  

How do you treat exercise-induced asthma?
Limiting exercise in the cold is helpful; consider running inside or breathing through a scarf to help keep the airways warm.   Warming up before exercise can be helpful, although the benefits may only last 30-40 minutes.   Short acting asthma rescue inhalers such as Proventil, Maxair, or Xopenex taken 15-30 minutes prior to exercise are usually very effective in preventing symptoms, with benefits lasting up to 3-4 hours.   

Singulair, a leukotriene antagonist, is an other good option - this little pill  can decrease exercise induced asthma symptoms for up to 8-10 hours after ingestion.  Other medications that can help include long-acting beta2- agonists (Serevent, Foradil) and inhaled steroids (Flovent, Pulmicort…).   Talk to your physician about what is right for your.

The key thing to remember is that exercise-induced asthma should not be a reason to stop exercising.   With proper treatment, you should be able to do any physical activity that you desire, including participate in competitive sports.