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Patient Instructions

Sometimes exercise triggers asthma symptoms. This is called exercise-induced asthma (EIA).

The symptoms of EIA are coughing, wheezing, a feeling of chest tightness, or shortness of breath. Most times, these symptoms start soon after stopping exercising. Some people may have symptoms after they start exercising.

Having asthma symptoms during exercise does not mean a student cannot or should not exercise.

Being able to take part in recess and physical education is important for all children. And children with asthma should not have to sit on the side lines. These tips may keep your child from getting EIA at school.

Read the student's school action plan. Make sure staff know where it is kept. Use the medicines indicated for exercise induced asthma.

Talk with the parent or guardian. Know what to do if a child has an asthma episode.

Teachers, coaches, and gym teachers should know what the symptoms of asthma. Find out what type of activities a student can do, and for how long. Check the school action plan that tells staff how to take care of the child's asthma.

Adapt a running program so a student can still take part in it. The student could:

• Walk the whole distance
• Run part of the distance
• Alternate running and walking

Some types of exercise may trigger asthma symptoms less:

• Swimming is often a good choice. The warm, moist air may keep symptoms away.
• Football, baseball, and other sports that have periods of inactivity are less likely to trigger asthma symptoms.
• Activities that are more intense and sustained, such as long periods of running, basketball, and soccer, are more likely to trigger asthma symptoms.

Dressing for a physical education class and participating at any level is better than being left out or left behind.

School staff should know other asthma triggers. Some of them are:

• Cold or dry air. Breathing through the nose or wearing a scarf or mask over the mouth may help.
• Dirty or polluted air
• Freshly mowed fields or lawns

A student with asthma should warm up before exercising and cool down afterward.

Take your short-acting inhaled beta-agonists (normally called relief and rescue drugs)

• Take 10 to 15 minutes before exercise
• It can help for up to 4 hours.

Long-acting inhaled beta-agonists may help also.

• Use them at least 30 minutes before exercise
• They can last up to 12 hours. Children can take the medicine before school and it will help for the whole day.
• However, these medicines may become less effective if used daily before exercise.

Inhaled cromolyn can also be used prior to exercise, but it is generally not as effective as the other medications for this purpose.

National Asthma Education and Prevention Program Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma. Rockville, MD. National Heart, Lung, and Blood Institute, US Dept of Health and Human Services; 2007. NIH publications 08-4051.

Updated by: Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.