One in five competitive athletes suffers from exercise-induced bronchoconstriction, or EIB:
The numbers are even higher in endurance and winter sports. Puzzlingly, studies have found that athletes with EIB who somehow make it to the Olympics are more likely to medal. What’s so great about wheezing, chest tightness, and breathlessness?
The answer isn’t what you’re thinking. Sure, it’s possible that some athletes get a boost because an EIB diagnosis allows them to use otherwise-banned asthma medications. But there’s a simpler explanation: breathing high volumes of cold or polluted air dries out the airways, leading to an overzealous immune response and potential long-term damage. “It’s well established that high training loads and ventilatory work increase the degree of airway hyper-responsiveness and hence development of asthma and EIB,” explains Morten Hostrup, a sports scientist at the University of Copenhagen and lead author of a new review on EIB in the Scandinavian Journal of Medicine and Science in Sports. In other words, the athletes who train hard enough to podium are more likely to develop EIB as a result.
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Activities with the highest risk involve sustained efforts of at least five minutes, particularly if they take place in cold or polluted air. Cold air doesn’t hold much moisture, so it dries the airways. This affects skiers, runners, and triathletes, among others. Indoor environments like pools and ice rinks are also a problem, because of the chloramines produced by pool water and exhaust from Zambonis.
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Before the 1998 Winter Games, U.S. Olympic Committee physiologists examined Nagano-bound athletes to see whose airways showed abnormal constriction in response to arduous exercise. Almost a quarter of the athletes tested positive, including half the cross-country ski team.
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If you do get an EIB diagnosis, your doctor can prescribe asthma medication, including inhaled corticosteroids like fluticasone and airway dilators like salbutamol. If you’re an elite athlete subject to drug testing, you’ll need to tread carefully, since some of those medications are either banned or restricted to a maximum dosage. Hostrup and his colleagues note that there’s also evidence that fish oils high in omega-3 fatty acids, vitamin C, and even caffeine might help reduce EIB symptoms. And on the non-pharmaceutical side, you can minimize the chance of an attack by doing a thorough warm-up of 20 to 30 minutes, including six to eight 30-second sprints. This can temporarily deplete the inflammatory cells that would otherwise trigger an airway-narrowing attack