You've bundled up in your cold-weather gear and mustered the determination to head outside for an invigorating winter run. You feel great at first, but a few minutes into your route, you need to stop to catch your breath. After a few stops and starts, it's suddenly almost impossible to breathe. Other vigorous outdoor activities—such as hiking, biking and skiing—can also cause this. What gives?
A little huffing and puffing is normal during a strenuous workout—but when the symptoms go beyond standard shortness of breath and into more severe, painful territory, an underlying condition may be the cause.
Exercise-induced bronchospasm (EIB) is a disorder that makes it difficult to breathe during or after intense aerobic exertion, such as when you run or bike. Don’t worry, it doesn't mean you're out of shape—in fact, many elite athletes and winter Olympians suffer from the condition.
While wheezing and shortness of breath are the telltale signs, other EIB symptoms may include coughing, chest tightness, fatigue and general weakness. In most cases, a doctor will diagnose EIB by evaluating the strength of the patient's breathing before and after exercising, and again after using an inhaler.
EIB and Asthma: What's the Difference?
EIB is often confused with asthma, but they're not the same. People who suffer from EIB don't have inflammation in the lungs and don't experience wheezing outside of exercise. Although having asthma makes someone much more prone to EIB, it's not a prerequisite.
"Unlike most people who have asthma and get exercise-induced symptoms, these individuals don't have true asthma, but when they exercise, they experience the symptoms of asthma," Timothy J. Craig, M.D., told WebMD.
What Causes EIB?
The primary trigger isn't necessarily the coldness of the air, but the lack of moisture. As the dry winter air enters the airway, the bronchial tubes tighten. This bronchoconstriction, or bronchospasm, narrows the airway and makes it difficult to breathe. The effects are usually noticed within the first few minutes of activity. Some experts also believe that bronchitis can cause EIB, as the airway is already swollen and inflamed when the dry air hits.
Exercising with EIB
If you suffer from EIB, that's not a reason to give up on exercise. You can still participate in safe, comfortable workouts when you take the right precautions:
- Don't skip the warm up. A pre-workout warm-up is always beneficial, but particularly for those who experience EIB. A 2012 study published in the Medicine & Science in Sports & Exercise found that EIB symptoms were effectively managed by high-intensity intervals during warm-ups. Short bursts of exercise don't seem to trigger the same airway constrictions as a steady, sustained effort. If you're heading out for a winter run, start with a few short, fast bursts followed by slow jogging or walking, gradually increasing the running periods.
- Steer clear of smog. Pollutants in the air can irritate the airway and make you more prone to EIB. If you tend to wheeze more on a certain running route that has heavy exhaust fumes, seek out a less-trafficked road with fewer irritants.
- Cover your mouth. Comfortable winter workouts start with the right gear. Wearing a ski mask will help warm up the air before you breathe it in. Although they can be pricey, heat exchange masks can significantly reduce the amount of cold air exposure.
- Seek medical treatment. For many, EIB can be managed with the right medications. Bronchodilators can help relax the muscles in the airway to promote easier breathing. Other medications, such as an inhaler of a beta2 agonist or albuterol, have shown to be effective in preventing swelling and inflammation. Talk to your doctor for recommendations.
- Work out inside. If you've tried other remedies but still struggle to breathe in the cold, consider moving your workouts into a temperature-controlled environment until temperatures rebound. When exercising at the gym, in a Spinning class or an indoor pool, the humid, warm air will be easier on your airway.
Other Causes of Winter Wheezing
Other conditions can trigger similar symptoms and are often mistaken for EIB, such as:
- Colds and allergies can cause breathing problems and make you more susceptible to EIB.
- Tightness in the chest and shortness of breath can indicate a possible heart condition. If these symptoms persist, see a doctor.
- Most people's vocal cords move to allow for more airflow during exercise. For those with vocal cord obstruction, also known as exercise-induced laryngeal obstruction, the vocal cords block the airway during physical activity.
- Ever have a nagging cough after you've finished a run? If it doesn't come with wheezing, it could be caused by thirst or dehydration, which can cause dryness or irritation in the throat and lead to coughing.
- Grass, pollen, dust and other allergens can irritate the throat and cause coughing.
By warming up properly, wearing protective gear, moderating your exercise environment and using doctor-prescribed medication, EIB can be managed enough to allow for wonderful winter workouts.
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