Out of shape, or exercise-induced asthma?

The shortness of breath, wheezing, chest tightness or coughing that some athletes experience during physical activity often turns out to be exercise-induced asthma.

An Ohio State University Wexner Medical Center study of Ohio State athletes found that about 40 percent of them had exercise-induced asthma. Most of them didn’t know they had it or weren’t receiving treatment for it.

Studies of Olympic athletes found that between 20 and 50 percent of them had exercise-induced asthma. Many of these athletes also didn’t know they had the condition.

The symptoms are easily mistaken for simply being out of shape. Some athletes may even think the symptoms are normal physical responses to exertion.

But exercise-induced asthma, or exercised-induced bronchospasm, is a condition for which treatment exists. Getting properly tested and diagnosed can improve your athletic performance and quality of life.

What’s the difference between asthma and exercise-induced asthma?

The symptoms of both conditions are the same: chest tightness, shortness of breath, wheezing, fatigue or episodes of coughing.

In asthma sufferers, these symptoms have many triggers, such as allergens, weather or temperature changes, and irritants like smoke, fumes and pollution.

When symptoms are triggered by exercise, it’s called exercise-induced asthma.

You can be diagnosed with exercise-induced asthma without a diagnosis of asthma — about 10 percent of the general population experiences asthma symptoms only during exercise, without having underlying asthma.

How do I find out if I have exercise-induced asthma?

It can be difficult for you to perceive the difference between being out of shape and having asthma. That’s why specialized tests can help — doctors can diagnose you and find out if medication can help.

If you’re experiencing chest tightness, shortness of breath, wheezing or episodes of coughing during or right after exercise, your doctor can determine the underlying cause.

At the Ohio State Wexner Medical Center, our doctors begin with a comprehensive medical history and physical exam, followed by a baseline lung function test while your body is at rest.

If you have asthma, this test usually will reveal it.

To check specifically for exercise-induced asthma, tests may include specialized pulmonary function testing, electrocardiography, echocardiography, allergy testing or vocal cord tests, depending on your individual symptoms and history.

The Ohio State Asthma Center also offers a rapid breathing test called Eucapnic Voluntary Hyperventilation (EVH).  This is the International Olympic Committee’s preferred method for diagnosing exercise-induced asthma.

Results of these tests are immediate, and your doctor can share with you his or her thoughts on treatment and how to safely exercise.

What treatments exist?

The gold standard of exercised-induced asthma treatment is a prescription albuterol inhaler. You can carry it with you and use it about 15 to 20 minutes before exercise to prevent asthma symptoms. It’s an effective treatment for about 80 percent of exercise-induced asthma cases.

Alternative treatments include montelukast sodium (Singulair) and other types of inhalers.

What else can I do to prevent symptoms or attacks?

Depending on your triggers, you can keep an eye on the levels of allergens in the air (Pollen.com) and levels of air pollution and ozone (AirNow.gov), which vary each day.

Choosing to exercise indoors on these high-allergen or high-pollution days could prevent asthma symptoms.

Cold air can provoke asthma symptoms, too. So if you need to be outside when it’s below freezing, wearing a mask or scarf can help cut down on the temperature’s effects on your respiratory system.

Warming up well before competing in sports can also reduce the risk of asthma symptoms developing during competition, in addition to reducing your risk of injury.

Most important: If you’re diagnosed with exercise-induced asthma and prescribed an inhaler, that inhaler should be with you at all times so that you have immediate access.

If you have an asthma attack and panic because you don’t have your inhaler handy, the stress of the situation can make your breathing even worse.