Constantly coughing in the middle of your HIIT class? Read this.

By Alyssa Brown
January 03, 2020
woman running outside
Credit: Getty / Artem Varnitsin

A really challenging workout can leave anyone feeling out of breath during and tired and sore after. But when you're running uphill or cycling hard in a spin class and a coughing fit suddenly strikes, it might be time to see a doctor to learn whether or not you have exercise-induced asthma. Dr. Melanie Carver, of the Asthma and Allergy Foundation of America, answers the most commonly asked questions about exercise-induced asthma below, including how to manage the symptoms and develop an action plan with your doctor so you can continue to enjoy your favorite activities in a way that works best for your body.

What is exercise-induced asthma?

When physical activity triggers airway obstruction or narrowing, it is known as exercise induced bronchoconstriction (EIB), otherwise known as exercise-induced asthma, explains Dr. Carver. "It is very common in people who have asthma—as many as 90% of people with asthma experience asthma symptoms when they are physically active," she notes.

What are the most common symptoms?

"The most common symptoms of EIB are coughing, wheezing, shortness of breath, and chest tightness. Out of these symptoms, coughing is the most common," adds Dr. Carver. These symptoms, which can range from mild to severe, don't usually start at the beginning of exercise—they often begin right in the middle and then worsen about five to 10 minutes after you stop working out.

What triggers might make the condition worse?

Cold, dry air can trigger or exacerbate symptoms, explains Dr. Carver. Your nose helps humidify and warm the air you breathe, but when you exercise, you typically breathe with your mouth open; the cold, dry air can bother airways. The spring season an also worsen the condition: If you exercise outside during a time when pollen counts are high or the air quality is poor, EIB often flares. Another culprit? Respiratory illnesses, like colds, which compromise your airway long before exercise begins.

Can your exercise induced asthma get better or worse over time?

Regardless of whether or not you become and remain in shape, your asthma can change (and worsen) as you age. If you're deconditioned, you may experience more episodes of asthma during exercise—but it is important to know the difference between being out of shape and having EIB, since both can cause shortness of breath.

What treatments are available?

Everyone needs to exercise—even people with asthma. A strong, healthy body is one of your best defenses against disease. With proper prevention and management, you should be able to exercise free of symptoms. Your health care provider may recommend "pre-treating" your lungs with a bronchodilator medicine like albuterol to open up your airways before you start moving. This is the first step on The Asthma and Allergy Foundation of America's seven-step action plan for those attempting to exercise with EIB. As for the rest? Recognize the signs of asthma (and understand its green, yellow, and red zones) so you can stay in the green; check the weather (consider pollen counts and air quality!); carry an inhaler at all times; prepare your body for exercise with fluids and a proper warm-up; watch for signs as you move; and, most importantly, try to enjoy your workout, knowing that you've done all you can for your body.

Is it necessary to stop exercising if it triggers asthma?

If you are having symptoms of asthma, stop your current activity and take your asthma medicines as prescribed, says Dr. Carver. But overall, you should not avoid exercise if you have asthma: You may need to adjust what types of activities you do and when or where you do them. Try swimming, walking, leisure biking, or sports that involve short bursts of physical activity, like volleyball, baseball, and gymnastics—they're better-suited for those with EIB, notes Dr. Carver. The activities that are most likely to trigger EIB are those that occur in dry and cold environments (think skiing, ice hockey, ice skating, and snowboarding) and activities that require constant physical activity, like long distance running and soccer.


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