Exercise-Induced Bronchospasm

A bronchospam is a condition that is commonly caused by exercise, in which the muscles around the bronchioles (airways to the lungs) tighten, causing the airway to constrict. Exercise-induced brochospams are usually associated with short periods of vigorous activity. Many people who experience an exercise-induced bronchospam may not notice at the time of the event; however, the athlete may later experience symptoms that negatively affect training and performance.

SYMPTOMS

  • High-pitched sounds with breathing (wheezing).

  • Coughing.

  • Increased work of breathing (dyspnea).

  • Rapid breathing (hyperventilation).

  • Chest pain.

  • Symptoms occurring 4 to 6 hours after exercise is completed (late-phase reaction).

CAUSES

It is not know why certain individuals experience bronchospasms. Respiratory specialists currently think that the cool or dry air breathed in may cause damage the lining of the bronchioles, which elicits and inflammatory response. The inflammation causes the airways to narrow and symptoms then occur.

RISK INCREASES WITH:

  • Viral infections.

  • Exercise in cold air.

  • Exercise in dry conditions.

  • Poor physical fitness.

  • High-intensity exercise.

  • No warm-up before play.

  • Frequent exposure to substances that produce allergic reactions (allergens).

PREVENTION

  • Improve conditioning.

  • Treat allergies.

  • Breathe warm air (cover mouth and nose with a towel or scarf).

  • Warm up for an appropriate period of time before physical activity.

  • Gradually decrease intensity (warm down ) for an appropriate period of time after physical activity.

PROGNOSIS

Most people with exercise-induced asthma respond well to medication. Patients are typically prescribed an inhaler to treat bronchospams. However, if symptoms persist despite treatment and continue to affect performance, individuals may need to consider avoiding activities that produce symptoms.

RELATED COMPLICATIONS

  • Decreased athletic performance.

  • Inability to condition as well as expected.

  • Side effects from medications.

TREATMENT

  • Maintain physical fitness.

  • Run with a scarf or towel over your mouth in cold, dry air.

  • Complete at least 10 minutes of warm up before high-intensity exercise.

  • Warm down after play.

  • Treat allergies.

MEDICATION

  • The usual initial medication is an albuterol inhaler, which expands the constricted bronchioles.

  • The second-line medication is inhaled corticosteroids, which reduce inflammation in the airway.

  • Alternative medications included sodium cromoglycate and nedocromil inhalers.

  • Long-acting medications such as salmeterol can also be used as second-line medications.

ACTIVITY

If medications are able to treat the offending symptoms, then no activity modification is required. If you know you will be training or competing in cold or dry climates take extra precaution to prevent symptoms.

DIET

No specific diet is recommended.

SEEK MEDICAL CARE IF:

  • Greater than normal fatigue with exercise.

  • Greater than normal difficulty breathing occurs with exercise.

  • Increased wheezing with exercise.

  • You appear to be breathing harder and faster than expected with training.

  • Allergies appear to be uncontrollable.

  • You experience chest pain with exercise.