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Life Time has partnered with the sports health experts at NYU Langone Health to provide insights into the common health issues that have the potential to prevent you from moving freely and functioning at your best.

Meet the Expert

headshot of Nathanael Horne
  • Nathanael Horne, MD, NYU Langone Health

Q: What is exercise-induced broncho­constriction (EIB), and how can I exercise safely if I suffer from this?

A: “Exercise-induced bronchoconstriction (EIB) is defined as a transient narrowing of the lower airway during and after exercise,” says Nathanael Horne, MD, allergist and sports health expert at NYU Langone. “It can occur with underlying asthma or alone.”

Although the terms EIB and asthma are often used interchangeably, Dr. Horne explains that they are distinct conditions. “Exercise-induced asthma is when exercise is a trigger for underlying asthma — for which there may be other triggers such as an allergy exposure,” he says. “EIB is a standalone syndrome that can affect recreational and competitive athletes alike.”

Common symptoms include broncho­spasm, or airway constriction, that result in coughing, wheezing, and chest tightness with exer­cise. Some people also experience fatigue, abdominal pain, and impaired performance, which can make the condition more difficult to evaluate. These symptoms usually occur during a strenuous workout and peak about five to 10 minutes after exercise. “If exercise is your only trigger of bronchospasms, then you most likely have EIB.”

The exact cause of EIB is still unknown, though there are numerous factors that are being investigated, including environmental elements like air quality, sport-dependent conditions (swimmers and cold-weather athletes, for instance, have been found to be at a higher risk for EIB), and history of prolonged and intense physical exercise over many years. All of these can damage cells in the airway and over time, Dr. Horne says, “this environment can cause inflammation and constriction.”

The condition affects up to 50 percent of endurance athletes, with prevalence appearing to be higher in elite athletes than in the general population. “It is unclear as to why this is — it may be that athletes are more likely to seek treatment and diag­nosis, or perhaps the training itself is a factor,” notes Dr. Horne.

If you suspect you might have EIB, consult with your healthcare provider to properly diagnosis and determine the appropriate protocols for your unique condition.

Meanwhile, Dr. Horne offers these three lifestyle habits that can make a difference in managing EIB, plus five training and performance tips.

Lifestyle Habits

  1. Consider anti-inflammatory supplements like omega-3s. “Research has not definitively shown benefit,” Horne notes, “but omega-3s certainly wouldn’t hurt.”
  2. Wear a face mask, especially when exer­cising in cold conditions. Masks promote humidification and reduce water loss, which may help prevent symptoms.
  3. Enjoy some caffeine. Limited research has shown that it may help alleviate symptoms in some patients with EIB.

Training and Performance Tips

  1. Warm up. Taking the time to ease into a workout can help prepare your airway for the work ahead. While it is not completely protective, Dr. Horne notes that taking the time to warm up has been shown to help about half of people with EIB.
  2. In consultation with your healthcare provider, take prescribed medication such as beta agonists prior to prolonged competitions and hard workouts to reduce symptoms of EIB (medication is likely not necessary for lower intensity endurance workouts).
  3. Exercise in warm environments. In general, exercising in cold, dry air is harder on your airways and can contribute to bronchoconstriction.
  4. Seek out environments with less airborne irritants and allergens (e.g., poorly ventilated pools with high chlorine levels).
  5. Avoid airborne allergens to the degree you can. For patients with pollen allergies, avoid exercise at the height of pollen season outdoors.

The Sports Health experts at NYU Langone have the multi-specialty expertise to provide coordinated, comprehensive care for all types of athletes. As an official healthcare partner, Life Time is able to offer its members exclusive concierge access to NYU Langone’s world-class orthopedic specialists and performance experts, who can help you meet your fitness goals. To schedule an in-person appointment or video visit with a Sports Health expert, visit nyulangone.org/lifetime.

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