Exercise-induced asthma can cause wheezing and shortness of breath. These are the same symptoms that a person may experience if they are out of shape. Because the conditions are so similar, only tests can determine which is present.

Although exercise is a common trigger for people with asthma, people without asthma can also have exercise-induced asthma.

Exercise-induced asthma, or exercise-induced bronchoconstriction (EIB), makes the bronchial tubes spasm during and after exercise. This makes breathing difficult.

So, how can a person tell EIB from being out of shape?

A key difference between the two conditions is that exercise-induced asthma often causes coughing, whereas simply being out of shape is unlikely to do so. The effects of EIB also tend to peak after exercise, while people who are out of shape typically notice that their symptoms rapidly improve after stopping exercise.

Read on to learn more about the difference between EIB and being out of shape. This article also covers diagnosis and treatment.

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Asthma is a chronic respiratory condition that causes inflammation in the airway. Exercise-induced asthma can affect people with and without regular asthma.

Exercise-induced asthma makes the bronchial tubes narrow during physical activity, causing symptoms such as wheezing, coughing, and difficulty breathing.

A 2018 paper estimates that 5–20% of the general population have exercise-induced asthma. This includes people with asthma, individuals without asthma, and those who are very physically fit.

People with asthma are significantly more likely to have EIB. For many individuals with asthma, exercise is a trigger for asthma attacks.

Even very physically fit individuals, including those with and without asthma, can have exercise-induced asthma.

However, for people who are starting a new exercise routine, it can be difficult to tell whether the symptoms are due to a lack of fitness or EIB.

Both conditions can cause shortness of breath and difficulty breathing. However, EIB differs from being out of shape in several important ways:

  • For people with asthma, symptoms tend to get worse when they are around other triggers, such as allergens.
  • In people with EIB, symptoms continue for 10–15 minutes after a workout ends.
  • EIB can cause coughing and wheezing.
  • People with EIB may experience nausea, which is uncommon in those who are just out of shape.

Exercise-induced asthma can be chronic, which means that a person may experience it every time they exercise. For others, it can be infrequent, or it may only occur when they do certain types of exercise, such as running.

The actual symptoms are typically fairly short-lived. They usually happen during exercise and for around 10–15 minutes after stopping.

In rare cases, a person may have a more serious asthma attack that requires emergency treatment. People with asthma should always carry an inhaler for asthma attacks.

A doctor may suspect EIB based on a person’s physical history. For example, if the person’s wheezing and breathlessness persist despite getting fitter, they may have exercise-induced asthma.

Doctors use two tests to diagnose EIB: spirometry and bronchial provocation tests.

Spirometry measures how much air a person can breathe in and out. A doctor usually performs this test shortly after the person exercises to test for breathing difficulties.

Bronchial provocation tests expose the lungs to an asthma trigger, then use spirometry to see how the lungs react.

According to a 2018 review article, exercise-induced asthma is under-diagnosed and frequently misdiagnosed. Many people assume that wheezing, coughing, and breathlessness are normal parts of exercise and either ignore their symptoms or avoid exercise.

It is important to tell a doctor about any symptoms, especially if they persist. The doctor can evaluate the person’s condition, carry out tests, and rule out other potential causes.

Like chronic asthma, exercise-induced asthma can make breathing difficult. It is important to treat EIB as well as have an emergency plan in place for asthma attacks.

People with EIB may need to use a rescue inhaler. After evaluating their condition, a doctor may also prescribe:

  • short-acting beta-2 agonists, or bronchodilators, to help open the airways
  • long-acting beta-2 agonists, which a person can take 30–60 minutes before exercise to prevent symptoms
  • daily asthma medications, such as montelukast

However, competitive athletes should be careful when taking prescription medications. This is because some medications that treat EIB may return a positive test for performance-enhancing drugs (PEDs).

Athletes with exercise-induced asthma who are subject to PED testing should contact a doctor. They may be able to get a therapeutic use exemption, which allows certain medications without violating the rules of their sport.

People with EIB, whether they are competitive athletes or not, can use some strategies to reduce their symptoms during exercise. For example, they can try:

  • warming up slowly
  • avoiding exercising in cold, dry air
  • avoiding allergens when exercising

Although EIB can make exercising difficult, people with the condition do not need to avoid physical activity altogether. Getting regular exercise is important for overall health, and it may reduce symptoms of both asthma and EIB.

Exercise-induced asthma is a common condition that can cause wheezing, difficulty breathing, and coughing. Because its symptoms are similar to those a person may experience when out of shape, it can be difficult to tell the conditions apart.

People with EIB can manage their condition with lifestyle strategies and medications. Despite its challenges, exercise is important for overall health and any asthma symptoms a person has.