What should I do if I experience shortness of breath during sports practice?

What to Do If You Experience Shortness of Breath During Sports Practice

If you're experiencing shortness of breath during sports practice, you should first assess whether you can hold a normal conversation during exercise—if you cannot talk comfortably, you're exercising too intensely and need to slow down immediately. 1

Understanding Normal vs. Abnormal Breathlessness

Your breathing rate and depth should increase during exercise, but it should never be uncomfortable. 1 Here are key warning signs that indicate you need medical evaluation:

• You cannot hold a conversation during your activity without difficulty breathing 1
• Wheezing develops during or after exercise 1
• Recovery takes longer than 5 minutes after stopping exercise 1
• You feel faint or dizzy during exercise 1
• You experience chest discomfort of any kind during activity 1

Immediate Actions to Take

During Practice

• Slow down immediately if you cannot speak comfortably—this is your body's signal that the intensity is too high 1
• Stop exercising if you develop wheezing, chest discomfort, or feel faint 1
• Allow adequate recovery time—you should feel normal within 5 minutes of stopping 1

Hydration Strategy

Adequate fluid intake is essential before, during, and after each exercise session, particularly in hot weather when excessive fluid loss occurs. 1 However, it's important to understand that while proper hydration supports overall exercise performance, increasing fluids alone will not resolve exercise-induced breathing problems if an underlying condition exists. 1

When to Seek Medical Evaluation

You must obtain medical consultation before continuing exercise if shortness of breath persists, as this could indicate several conditions requiring proper diagnosis. 1 The American Academy of Allergy, Asthma, and Immunology emphasizes that objective testing with spirometry and exercise challenge is necessary for accurate diagnosis—symptoms alone are insufficient. 2, 3

Common Causes Requiring Medical Assessment

Your healthcare provider should evaluate for:

• Exercise-induced bronchoconstriction (EIB)—the most common pathologic cause in young adults, which requires specific testing to diagnose 2, 3
• Exercise-induced laryngeal dysfunction (EILD)—can mimic asthma but requires different treatment 1, 2, 3
• Poor physical conditioning—the most common reason for exercise dyspnea in children and young people, which requires no medication 3, 4
• Cardiac conditions—must be ruled out if chest pain accompanies breathlessness 1, 2

Important Pitfalls to Avoid

Do not assume you have asthma based on symptoms alone—this leads to unnecessary medication use and missed diagnoses. 2, 3, 4 Many athletes with exercise-related breathing problems have conditions that don't respond to asthma medications, such as dysfunctional breathing patterns or simply reaching their physiological limit. 4, 5

Do not start using asthma inhalers without proper testing, as studies show that 58-70% of athletes with breathing problems during exercise were using asthma medication, but only a small fraction actually had asthma or benefited from the treatment. 5

Practical Exercise Modifications

While awaiting medical evaluation, the American Heart Association recommends these adjustments: 1

• Use the "talk test"—maintain an intensity where ordinary conversation is comfortable 1
• Extend your warm-up period with low-level activities and stretching 1
• Include a proper cool-down—never stop exercise abruptly, as this can cause faintness 1
• Exercise in appropriate conditions—avoid extreme heat and humidity when possible 1
• Wear proper, breathable clothing—never use rubberized or non-porous materials 1

Next Steps

Schedule an appointment with your healthcare provider for spirometry and appropriate exercise testing to determine the actual cause of your symptoms. 2, 3 This objective testing is essential because treatment varies dramatically depending on whether you have EIB, EILD, deconditioning, or another condition. 2, 3, 5

If diagnosed with exercise-induced bronchoconstriction, your doctor may prescribe a short-acting bronchodilator (like albuterol) to use 15-30 minutes before exercise. 3, 6 However, this should only be used after proper diagnosis, not as a trial-and-error approach. 2, 3