Updated on March 18, 2025.
Staying active has many health benefits. For some people, however, working out triggers a type of breathing difficulty called exercise-induced asthma. Up to 90 percent of people with asthma have this condition, according to the American College of Allergy, Asthma, and Immunology. People without asthma may develop the issue, as well.
Learning how to manage and treat exercise-induced asthma can set the stage for a lifetime of physical activity at all levels. Here’s what to know.
Symptoms and triggers
Signs of exercise-induced asthma (also known as exercise-induced bronchoconstriction or EIB) include coughing, wheezing, shortness of breath, and chest tightness during or after exercise. Some people also experience stomach pain and a sore throat. These symptoms typically start a few minutes after you begin exercising and peak 10 to 15 minutes after you stop. They’ll often fade 20 to 30 minutes later, and then stop altogether by 60 minutes.
Exercise-induced asthma occurs most often during longer periods of exercise and endurance sports like soccer or basketball. It’s especially triggered by breathing in dry air, which tends to be cold air. The condition can also be triggered by indoor chemicals, such as new carpeting, cleaners, perfumes, and even the chlorine in pool areas and outdoor air pollution.
Diagnosing exercise-indudced asthma
To diagnose exercise-induced asthma, your first step is to make an appointment with a healthcare provider (HCP), such as an allergist. The HCP will review your personal and family medical history and your physical activity routines. They will often do a spirometry test, too. This is a lung function test that measures the flow of air in and out of the lungs while you breathe into a tube.
To confirm a diagnosis, the spirometry test may be done in different scenarios to see how your lungs respond, such as:
- Before and after an inhaled lung medication
- Before, during, and after exercise on a treadmill or exercise bike
This workup with your HCP can help rule out other conditions and determine if your symptoms are brought on by exercise alone, or if they're related to air triggers and exercise or underlying asthma (diagnosed or undiagnosed).
Treatment and prevention medications
While symptoms usually go away in an hour, most HCPs recommend taking medicine, both for prevention and treatment of exercise-induced asthma.
Some medications work quickly and are taken just before exercise. Beta2-agonists (bronchodilators) are short-acting inhaled medications that may be taken 15 to 30 minutes before vigorous exercise to prevent symptoms for about two to four hours. Examples include albuterol (ProAir HFA, Proventil-HFA, Ventolin HFA) and levalbuterol (Xopenex HFA). These medications are not for everyday use as it may reduce their effectiveness.
The underlying cause of your asthma will help determine which long-term control medications could also offer help.
- Inhaled corticosteroids are common daily medications that reduce narrowing and inflammation in the bronchial tubes. They begin working for long-term control after about two to four weeks of regular use.
- Combination inhalers include a corticosteroid and a long-acting beta2-agonist. They are taken up to an hour before exercise and work for about 10 to 12 hours to prevent symptoms.
- Leukotriene receptor inhibitors also treat exercise-induced asthma symptoms. This medication is a pill taken once daily or at least two hours before exercise to help prevent symptoms.
If you’re prescribed medication, ask your HCP when and how often you should use it.
Prevention and self-care tips
In addition to medications that may be prescribed, some simple self-care strategies can help prevent an asthma attack while exercising:
- Warm up for at least 10 minutes before physical activity.
- Cover your mouth and nose in cold, dry weather.
- Try to breathe in through your nose when exercising, as this warms the air.
- Change your exercise routine to avoid triggers like indoor chemicals or outdoor air pollution. For example, avoid exercising outdoors if you have seasonal allergies (including fall allergies).
- End your workout by cooling down slowly.
When to get medical help for symptoms
Short-acting bronchodilator medications taken just before exercise work well for treating or preventing exercise-induced asthma symptoms. If your symptoms don’t improve with these medications, let your HCP know.
For those with asthma, exercise-induced symptoms often mean that asthma is not under control. Make an appointment with your HCP to talk about how to better manage your asthma, whether that means increasing your dose or trying a different medication.
Together, you can adjust your treatment plan to ensure you breathe easy and fully enjoy staying active.
