Exercise in the cold can induce asthma

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Q: My daughter has "exercise asthma." Is that the same thing as asthma?

A: It's the time of the year when cold-weather sports are underway. As we get closer to winter, the cold air may scare away the summer exercise crowd, but activities such as curling, hockey, skating and skiing can be fun and great for fitness. However, what happens if motivation is not the issue, but breathing in cold air is very uncomfortable? For some individuals, this is the time of year when exercise-induced asthma becomes a problem.

What is exercise-induced asthma?

Exercise-induced asthma is a condition where you have difficulty getting the air out of your lungs during or following vigorous exercise. The condition is a transient (not permanent) one where the resistance in your airways increases. Approximately three to 10 per cent of the general population suffers from exercise-induced asthma.

Exercise-induced asthma vs. asthma

There is a difference between these two conditions. You can have exercise-induced asthma without having asthma. While 90 per cent of those with asthma also have exercise-induced asthma, their condition is affected by many other things other than exercise.

Symptoms to watch for

Common symptoms include coughing, wheezing, shortness of breath or chest discomfort with exercise. These may occur in the period immediately after exercise, as well. These symptoms are often worse in cold, dry environments. This is why many individuals notice their symptoms more in the winter or during winter sports. The teenage years are often when exercise-induced asthma becomes noticeable. Denial of symptoms is common in young people because of embarrassment, peer pressure or fear of losing their place on a sport team. Some children may complain of not being able to keep up with their peers in sports. Symptoms usually improve within 20 to 60 minutes of exercise. Symptoms can also be made worse by cigarette smoke, colds and allergies.

Making a diagnosis

It is difficult to diagnose exercise-induced asthma on the basis of a physical examination because the exam is usually normal when the individual sees their physician. This makes the history of the problem very important. There are special lung tests that can be ordered by your physician. These are best done just before, during and after exercise to look for any sign of difficulty you're having with getting the air out of your lungs. When the tests are done without you doing any exercise, they are often normal.

How to treat and prepare for exercise

There are special inhalers and pill-form medications that are very important and helpful in treating exercise-induced asthma. Discuss these with your physician. It is also important that you do at least 15 minutes of warm-up at low intensity followed by a 15-minute rest before you do your actual exercise session. Many individuals will experience an improvement in their symptoms by doing this warm-up program. A gradual cool-down can also reduce post-exercise symptoms. Breathing warm, humid air may also improve symptoms and wearing a facemask can help accomplish this. Occasionally, extreme cold weather and respiratory-tract infections may lead to a cancellation of your workout. Otherwise, once your exercise-induced asthma is treated successfully, there are no physical restrictions. Enjoy the winter air and all your favourite activities.

Dr. Maureen Kennedy MD, CCFP, FCFP, Dip. Sport Med., is a sport and exercise medicine physician at the Sport MB-Sport Medicine Centre and the Reh-Fit Centre in Winnipeg.

Republished from the Winnipeg Free Press print edition November 5, 2012 D1