Once you have a secure diagnosis of EIA , you can use inhalers to hel� �revent the airway inflammation and smooth muscle constriction . The inhalers you are given will vary depending on your medical history , symptoms , result of your objective test and how often you train . The main purpose of the inhaler therapy is prevention , therefore , your inhaler therapy should include a strategy to reduce airway inflammation and not be to rely on salbutamol when you feel symptomatic on the bike . Other strategies that may also reduce EIA severity include diets high in fish oils �omega �� , avoidance of triggers such as training indoors when it ’ s cold and dry outside , avoid training in areas with high pollution and conducting a vigorous warm-up 30 minutes before training or races .
If it isn ’ t asthma , what else could it be ?
Exercise respiratory symptoms , as discussed above , are not exclusive to EIA . So feeling tight chested and a bit whee�y during training or a com�etition does not confirm or exclude a diagnosis of EIA . In 2004 , 20 percent of the British Olympic team were found to have an incorrect diagnosis of EIA and this was also the case for 50 percent of English-based professional football players in 2009 . This point highlights the importance of completing an objective test for EIA before the diagnosis is made .
An important but often overlooked cause of breathing di�culties can be a dysfunctional breathing ���� �attern and / or narrowing around the voice box , which can occur during exercise and is called exercise-induced laryngeal obstruction ( EILO ), which is when the upper breathing passages become narrowed or blocked , making it hard to breathe ( see table 1 ).
S�ecialised tests are re�uired to differentiate between EIA and these other potential causes . If dysfunctional breathing ( DB ) is suspected , then a personalised breathing programme comprising breathing techniques , posture and inspiratory muscle training has been found to be beneficial . �f voice box closure is suspected ( i . e . EILO ), then breathing training and the use of certain medications can make a massive impact . In severe cases , it is possible to perform an operation to reduce the obstruction .
Practical steps to manage breathing problems on the bike
One thing is certain , breathing problems can cause a significant limitation to cycling performance and increase the
Exercise-Induced Asthma
Can limit exercise performance but narrowing of the airways typically occurs �ve to ten minutes a�er e�ercise
Wheeze on breathing out �all in lung function post e�ercise Sound is primarily from the chest �ymptoms relieved a�er inhalation of reliever inhaler
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likelihood of picking up respiratory tract infections , if untreated . Follow these practical steps to take care of symptoms .
1 . If you experience symptoms such as wheezing , a tight chest , coughing and difficulty in breathing during or following training or competition , get these checked out at your GP or specialist respiratory clinic .
2 . Make sure you have an objective test to see if you have EIA . This can include measuring your lung function before and after a hard piece of exercise or you can use a surrogate for exercise such has a hyperventilation challenge known as Eucapnic Voluntary Hyperpnoea ( EVH ).
3 . If a diagnosis of EIA is made , make sure you use your inhalers as instructed . This means taking a preventative inhaler on a daily basis regardless of symptoms .
4 . If you think you may have EILO ( see table 1 ) then this asthma treatment is likely to be ineffective and you need to speak with your doctor and highlight this problem so they can help with a referral .
5 . Breathing training may help reduce symptoms of DB and EILO . To ensure your breathing training is effective you should contact a specialised respiratory therapist or physiologist .
6 . It is possible to have EIA and EILO . Once your EIA therapy is optimised and you are still experiencing inspiratory symptoms during high intensity cycling , it may be worth investigating whether you are also experiencing EILO and / or DB .
��ercise�Induced �aryn�eal ��strucuon
�ccurs during intense e�ercise and resolves within �ve minutes of stopping e�ercise
Wheeze on breathing in �o fall in lung function post e�ercise Sound originates in the neck �ymptoms remain a�er inhalation of reliever inhaler