People with asthma have inflamed airways. Because of this constant inflammation, the airways are quick to respond to anything that irritates them. Although this varies from person to person, triggers such as colds and flu, cigarette smoke and cold air can make the airways narrower by tightening the surrounding muscles.

Exercise is also a common trigger. When the symptoms of asthma (coughing, wheezing, chest tightness or breathlessness) follow exercise, this is called exercise-induced-asthma (EIA).

Unfortunately many people with asthma may give up sports as a result, however EIA does not have to mean the end of exercising. It can often be effectively treated, so that most people with asthma can take up or continue with almost any sort of exercise. In fact, many people with asthma have become Olympic medallists. GAA star and captain of the winning Tyrone All-Ireland football team, Peter Canavan has asthma.

How to recognise Exercise Induce Asthma (EIA)
It may be difficult to tell the difference between normal breathlessness after exertion and EIA. We all get ‘puffed’ by exercise, however if someone is wheezing, coughing or their chest tightens, they should ask their doctor if this could be caused by asthma.

The symptoms may be most obvious within a minute of stopping exercise, get worse over a few minutes and last for up to half an hour.

Both adult and child asthma can be triggered by exercise, even when it is otherwise well-controlled. In fact, in some people symptoms after exercising are their only signs of asthma. They may not cough or wheeze at any other time.

There are times when EIA is more likely to develop because the airways are more irritable, such as during the pollen season or after having a cold. At these times, even short, mild activities may trigger an attack. The chances of wheezing also increases on cold, dry days.

The causes of EIA
A major cause seems to be the temperature and moisture content of the air. Indoor swimming for example does not appear to cause EIA as often as running and other forms of outdoor exercise. This is because indoor pools are warm and moist. In contrast, on a frosty day for example, the air outside is cold and dry.

It is important to ask your doctor about exercise-induced wheezing if you have not been diagnosed with asthma. This may be the first clue that you have the condition. For those who do have asthma, wheezing as a result of exercise may point to poor control of the condition and medication may need to be changed/increased.

How doctors spot EIA
Often the knowledge that particular symptoms appear after exercise is all that a doctor needs to diagnose EIA. However this diagnosis may be confirmed by carrying out a peak flow measurement of the lungs. This is a type of breathing test. If the measurement drops after six minutes of exercise, a diagnosis of EIA is more than likely correct.

The doctor may then suggest that the patient takes a few puffs of a reliever inhaler and the peak flow reading will be checked again after a couple of minutes.

Conquering EIA
The best way of preventing symptoms of EIA is by taking medicine before exercising. Cutting back on exercise should not be necessary in most cases. The doctor may advise two puffs from a reliever inhaler before exercising – usually the reliever is only used when asthma symptoms appear.

One of the most important things to do when trying to prevent the symptoms of EIA is a warm up. Everyone should warm up 15 – 30 minutes before an exercise session, but this is particularly important for people with asthma.

Stretching and short runs of 10–20 seconds, with 20–30 second recoveries, are recommended.

In some cases, improvement in fitness levels, especially aerobic fitness, can reduce the severity of EIA. Many people with asthma report that the condition was least troublesome when they were physically fit.

The use of medicines in sport
The inhaled steroids used to treat asthma are called corticosteroids. These are not to be confused with anabolic steroids, which are banned substances used by some athletes to improve their performance.

Sporting regulatory agencies allow most inhaled asthma medicines to be taken. However, serious athletes need to check out the regulations about this for their own individual situations.

Helpful tips
If the medicines are not helping sufficiently, it is worth remembering that:
Wheezing is usually worse on cold, dry days
Long spells of exercise are more likely to induce asthma than short bursts
Exercising with either the arms or the legs is less likely to trigger an attack than exercising with both arms and legs together.

For more information, contact the Asthma Society of Ireland on freephone, 1850 44 54 64.

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