Exercise-Induced Asthma in Kids and Young Athletes

Your child coughs every time they run laps, needs to stop sooner than teammates, or complains that their chest feels tight after practice. These are classic signs of exercise-induced bronchoconstriction (EIB), often called exercise-induced asthma. It is common, very treatable, and should not keep a child off the field.

What happens in exercise-induced asthma

During hard exercise, children breathe faster and through the mouth, pulling in air that is cooler and drier than usual. In sensitive airways, that drying and cooling triggers the muscles around the airways to tighten. Cold winter air, dry indoor rinks, high pollen days, and poor air quality make it more likely.

Common signs

• Coughing during or right after running, especially in cold air
• Wheezing, chest tightness, or feeling unable to take a deep breath
• Symptoms that peak about 5 to 10 minutes after stopping and ease within an hour
• Getting tired much faster than peers, or avoiding activities they used to enjoy
• In younger children: stomachaches, irritability, or simply stopping play

How it is diagnosed

Your pediatrician starts with a detailed history and exam. Breathing tests (spirometry) measure how well air moves out of the lungs, sometimes before and after a dose of quick-relief medicine. If the diagnosis is still unclear, an exercise challenge test with a pulmonary specialist can confirm it. Testing matters: AAP News reports that among otherwise healthy children who get short of breath with exercise, EIB is actually found in only about 8% to 23%. Other causes, such as vocal cord dysfunction or simply being out of condition, are treated differently.

Treatment and prevention

• Quick-relief inhaler before exercise. A prescribed inhaler, used with a spacer 10 to 15 minutes before activity, prevents symptoms for most children. Your pediatrician will tell you exactly how and when to use it.
• Daily controller medicine if symptoms happen often, the pre-exercise inhaler is not enough, or your child also has symptoms at rest or at night.
• A real warm-up. 10 to 15 minutes of gradually increasing activity can reduce symptoms for an hour or more afterward.
• Cover the nose and mouth with a scarf or neck gaiter in cold weather.
• Control allergies and check air quality alerts on high-pollen or smoky days.
• A written asthma action plan shared with coaches, the athletic trainer, and the school nurse. New Jersey law allows students to carry and self-administer asthma inhalers at school with the required authorization from a parent and physician.

Before the season starts

A sports physical is a good time to bring up breathing symptoms. We can review your child's asthma action plan, check inhaler technique, and complete school and NJSIAA forms in one visit. Children already diagnosed with asthma should have their plan reviewed at least once a year through our asthma management program.