From the Guidelines
To reduce the likelihood of exercise-induced bronchospasm in a runner, a proper warm-up with 10-15 minutes of light aerobic activity followed by gradual intensity increases is essential, as it triggers a "refractory period" where airways become less reactive, and breathing through the nose rather than mouth helps warm and humidify inhaled air, reducing airway irritation. Several non-medication strategies can help reduce exercise-induced bronchospasm (EIB) in runners.
Key Strategies to Reduce EIB
- Proper warm-up is essential, with 10-15 minutes of light aerobic activity followed by gradual intensity increases to trigger a "refractory period" where airways become less reactive 1.
- Breathing through the nose rather than mouth helps warm and humidify inhaled air, reducing airway irritation.
- Training in warmer, more humid environments is beneficial as cold, dry air is a common EIB trigger.
- Wearing a face mask or scarf in cold weather can help warm inhaled air.
- Maintaining good overall asthma control through regular medical management is crucial.
- Proper hydration helps maintain airway moisture, while avoiding known triggers like high pollen days or areas with air pollution can prevent episodes.
- Interval training may be better tolerated than continuous high-intensity exercise. These approaches work by reducing airway cooling and drying, decreasing irritant exposure, and promoting better airway function during exercise, allowing runners to manage EIB effectively without relying solely on medications. According to the study published in the Journal of Allergy and Clinical Immunology 1, nonpharmacologic therapy is recommended by using pre-exercise warm-up to prevent EIB and partially reduce the severity of EIB.
From the FDA Drug Label
Albuterol sulfate inhalation solution is indicated for the relief of bronchospasm in patients 2 years of age and older with reversible obstructive airway disease and acute attacks of bronchospasm. The FDA drug label does not answer the question.
From the Research
Non-Pharmacologic Treatments for Exercise-Induced Bronchospasm
Besides medication, several non-pharmacologic treatments can help reduce the likelihood of exercise-induced bronchospasm in a runner. These include:
- Physical conditioning 2
- Incorporating a warm-up before exercise 2, 3
- Cooling down after exercise 2
- Performing nasal breathing instead of mouth breathing 2
- Avoiding cold weather or using a face mask to warm and humidify inhaled air 2, 3
- Modifying dietary intake 2
Specific Strategies for Runners
Some specific strategies that may be helpful for runners include:
- Performing a low or variable intensity warm-up before beginning running 2
- Breathing through the nose instead of the mouth while running 2
- Using a heat exchanger or facemask when running in cold weather to warm and humidify the air 2, 3
- Avoiding shortening the cooldown period at the end of the run, as this can help prevent bronchospasm 2
Importance of Diagnosis and Treatment
It is essential to note that exercise-induced bronchospasm (EIB) is a common condition that can be prevalent in elite-level athletes, and diagnostic testing should be used when possible 4. The mainstay of treatment remains the use of short-acting β-adrenergic agonists, but non-pharmacologic treatments can also play a crucial role in managing the condition 2, 4, 3.