Breathing hard is a normal part of exercise, but sometimes it can be tricky to distinguish between a healthy response to exertion and an abnormal one. People often ask about asthma when they seem more out of breath than friends and teammates. Here are some factors to consider.
Fitness Is One Indicator
First, a quick review of the basics: Anytime we push our bodies, we increase our demand for oxygen. To meet this increased demand, our heart rate and respiratory rate speed up. The more conditioned we are, the more exertion it takes to trigger that cardiovascular response. In other words, a fit athlete can do more without getting out of breath than an unfit peer. An athlete who misses preseason conditioning will feel more winded when practice starts than a teammate with a head start on fitness.
Exercise-induced bronchospasm (EIB) is an abnormal response to stresses in the lungs. The bronchi, the large, branched passages in the lungs, are lined with a mucosal surface (a bit like the lining in the mouth or nose) and ringed with muscle. Breathing harder, especially in cold, dry air, changes the temperature and moisture content of the airways. For some people, especially those with asthma, the sudden shifts cause swelling in the lining of the bronchi and spasm of the rings of muscle around them. This response, bronchospasm, makes breathing feel tight and difficult.
Coughing Is a Telltale Clue
Distinguishing between breathing hard and a hard time breathing hinges mainly on timing and cough. Struggling athletes who are just pushing their bodies will generally feel fine after stopping for a few minutes. Someone suffering from EIB will usually continue to feel worse for 20 to 30 minutes after stopping and will cough throughout this period. The so-called “locker room cough” can indicate that the airway is hyper-responsive.
So, what is an athlete with EIB to do? The general approach to EIB is to warm up, get in shape, and maybe medicate. Rapid changes in respiratory rate and temperature are so irritating to the lungs that even sled dogs experience EIB. Start any workout, especially on a cold, dry day, with a gradual warm-up to allow the airway to adjust to its new demands. Training smartly to get in shape promotes healthy body weight and allows people to do more without breathing hard, effectively raising the threshold for bronchospasm to occur. Lastly, sometimes medication is indicated. Often patients with EIB are teens who have largely outgrown their childhood asthma, only to need their inhalers again when they start participating in athletics.
Don’t give up on exercise if it leaves you panting. It’s important to talk to your pediatrician about any breathing problems to achieve optimal health and peak performance.
Share your experience with EIB! Pose a question or two!
Dr. Suzanne Condron is a board-certified pediatrician at Kelsey-Seybold Clinic – Fort Bend Medical and Diagnostic Center whose clinical interests include obesity, nutrition, allergies, asthma, childhood development, literacy, infectious diseases and preventive medicine.