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Medical Author:

Dennis Lee, MD

Dennis Lee, MD

Dr. Lee was born in Shanghai, China, and received his college and medical training in the United States. He is fluent in English and three Chinese dialects. He graduated with chemistry departmental honors from Harvey Mudd College. He was appointed president of AOA society at UCLA School of Medicine. He underwent internal medicine residency and gastroenterology fellowship training at Cedars Sinai Medical Center.

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Medical Author:

George Schiffman, MD, FCCP

George Schiffman, MD, FCCP

Dr. Schiffman received his B.S. degree with High Honors in biology from Hobart College in 1976. He then moved to Chicago where he studied biochemistry at the University of Illinois, Chicago Circle. He attended Rush Medical College where he received his M.D. degree in 1982 and was elected to the Alpha Omega Alpha Medical Honor Society. He completed his Internal Medicine internship and residency at the University of California, Irvine.

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Medical Editor:

Jay W. Marks, MD

Jay W. Marks, MD

Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

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Medical Editor:

William C. Shiel Jr., MD, FACP, FACR

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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In this Article

• Unusual symptoms of asthma
• Can a cough without wheezing be due to asthma?
• Nocturnal asthma
• Masqueraders of asthma
• Cardiac asthma
• Other bronchial conditions
• Vocal cord dysfunction (VCD)
• Other hypersensitivity reactions
• Exercise and sports
• Exercise induced asthma (EIA)
• What causes exercise induced asthma?
• What sports are best suited for exercise induced asthma? What sports are not?
• Ways to prevent and treat exercise induced asthma
• Conditions that may worsen asthma
• Gastroesophageal reflex disease
• The allergic rhinitis-asthma connection
• Sinusitis and asthma
• Air pollution
• Food allergy
• Asthma Complexities At A Glance
• Find a local Asthma & Allergy Specialist in your town
• Asthma Complexities Index

Environmental allergens, pollutants, or irritants inhaled during exercise may help trigger the symptoms. Prolonged, strenuous exercises without rest periods and exercising in cool, dry conditions can also bring on exercise-induced asthma. There are two theories to explain why this occurs.

1. Rapid breathing during exercise does not allow inspired air to be warmed and humidified by the nose. This cold, dry air cools the bronchial tubes, causing the muscles around the bronchial tubes to constrict (producing bronchospasm). After exercise, the bronchial tubes warm up. In asthma patients, warming up of the bronchial tubes causes the bronchial tubes to swell and become inflamed. This might explain why asthma occurs after exercise. This may be similar to what happens when previously cold fingers are warmed and they become red and swollen.



2. The second theory involves the loss of humidity surrounding the cells lining the bronchial tubes during rapid breathing. This drying induces the mast cells (cells that contain chemicals that can trigger asthma and other allergic reactions) to release their chemicals, causing bronchospasm and inflammation.

Swimming is one of the best exercises for those with exercise-induced asthma. Breathing the usually warm, humid air prevents cooling and drying of the airways. Sports that involve short bursts of exertion interspersed with rest periods are preferable. Tennis, golf, baseball, and volleyball are among the sports meeting this description. The resting periods allow the airways to recover, which usually prevents the onset of exercise-induced asthma.

Rapid breathing of cold, dry air is a potent stimulus of bronchospasm in asthmatic patients. Therefore, outdoor winter sports, such as skiing, may be the most problematic. It is best to choose a sport that does not require continuous vigorous outdoor exercise such as running, bicycling, or cross-country skiing.