Are you or someone you care about running into breathing difficulties when playing sports or working out? Exercise-induced bronchoconstriction, or EIB, is a serious but treatable condition that affects as many as 9 in 10 people with asthma, as well as 10 percent of people without it.  Get back in the game by knowing your risk and taking steps to prevent symptoms.

What is EIB?

EIB causes the linings of the lungs’ airways to become inflamed and swollen during or after exercise. Muscle spasms constrict airflow, making it difficult to breathe. Symptoms include:

  • Shortness of breath
  • Wheezing or noisy breathing
  • Coughing
  • Trouble getting a breath
  • Chest tightness
  • Unusual fatigue

Symptoms may start after a few minutes of hard, continuous exercise, or may not appear until several minutes after you stop.

About 80 percent to 90 percent of the 23 million adults and children with asthma, including 7 million children, have EIB. One in 10 members of the general population has EIB, too. The condition also is common among elite athletes who exercise strenuously over prolonged periods.

Can I still exercise?

People with EIB and asthma should not have to stop exercising if their condition is properly treated to prevent symptoms before they occur.

What causes EIB?


Rapid breathing during exercise can cause the airways to dry out and become irritated. As a result, the airways actually get smaller, and it’s hard to get air in and out of your lungs.  This is more likely to happen when you exercise in cold, dry air, or when there is a sudden change in temperature or humidity.

Breathing through the mouth, which does not warm and humidify the air like the nose, can make symptoms worse.


How is EIB diagnosed?

It is important that people with EIB or EIB with asthma see an allergist to be diagnosed and treated early to help prevent damage to the lungs. When EIB is the only symptom of asthma, it may be hard to diagnose, since coughing or shortness of breath during exercise may have many causes.  See an allergist when:

  • Breathing difficulties are interfering with daily activities
  • Breathing problems are decreasing quality of life
  • Warning signs of asthma are present, including:

–       shortness of breath;

–       wheezing or coughing, especially at night or after exercise;

–       tightness in the chest; or

–       frequent attacks of breathlessness, despite previous diagnosis and treatment for asthma.

Tips & Treatments to Prevent

or Reduce EIB Symptoms

  • Warm up at least 10 minutes before exercise.
  • Breathe through your nose – it warms and humidifies the air.
  • Use a face mask or scarf when in cold weather.
  • Limit exercise if you have a viral infection, such as a cold, or when the air temperature is cold.
  • Cool down after exercise.
  • If you have EIB with asthma and allergies, avoid exercising outside when pollen counts are high or around pets if these are allergy triggers.
  • If you are an elite athlete with EIB alone, cross training and some restriction of activities (e.g. limiting training to 20 hours per week) may be recommended.
  • Consider walking, hiking, golf, baseball, football, gymnastics, swimming and shorter track and field events, which are less likely to trigger the condition than endurance sports such as running, biking, soccer and basketball.
  • Even if your symptoms are mild, seek treatment to prevent damage to your lungs.
  • See an allergist to discuss controlling EIB with prescribed medications. Quick-relief medications are used to open the lungs’ airways shortly before exercise. A short-acting inhaler – or bronchodilator –is carried at all times when exercising to stop symptoms when they start. Long-acting medications and inhaled corticosteroids are taken twice daily and can provide 12-hour control.

If you are experiencing breathing difficulties during or after exercise, make an appointment with Dr. Ulrike Ziegner, MD, PhD to discuss your symptoms.

Download Dr.Z's Guide To Allergy Freedom
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