Exercise-induced asthma is a "very much underdiagnosed" malady, Dr. Max Testa told a caller during Saturday's Deseret News/Intermountain Healthcare Hotline.

"Every month we see people who are training, trying to qualify for a marathon or to climb a mountain. They think they're not training properly. It turns out to be exercise-induced asthma."

Testa, a sports medicine specialist at The Orthopedic Specialty Hospital, and Carrie Petteys, an exercise physiologist there, fielded calls that ranged from a woman who has young children with allergies and asthma, but no health insurance, to a 62-year-old woman who has no symptoms while she's exercising, but afterwards feels like she "can't get the air out" of her lungs.

That's pretty typical, Testa said. People who have exercise-induced asthma typically feel it either at the beginning or after they've stopped exercising. The woman said that an inhaler after cleared up the problem, another clear sign that she's suffering exercise-induced asthma.

Increasing the warm-up and cool-down times makes a huge difference, they said.

But it's very important, they told callers, to get an accurate assessment of what's going on, not only to treat it, but also to make sure it's not something else.

A high school coach called about two of his female athletes who are short of breath and miserable during their workouts. The likely culprit is a vocal-fold dysfunction, and Testa and Petteys often refer such cases to a speech therapist.

It's most common for exercise-induced asthma to be a problem exhaling adequately, usually after exercise, Petteys said. Vocal fold dysfunction usually feels like a problem inhaling while you're exercising. That's assuming, of course, the problem isn't one of being badly out of shape, which can be remedied by getting in shape.

It's important to keep exercising — the benefits trump the symptoms, which can be treated. But Testa told one woman, who has several medical problems at the same time, that she should do supervised rehabilitation and gentler exercises to avoid problems. He also recommended gentler exercises that don't make her fight gravity.

The two also said statistics and norms don't always work when analyzing someone. An athlete who is performing poorly by his capability may look pretty good compared to a general population, because his baseline for physical activity is so much higher than the norm.

The hotline tackles a different topic each month on the second Saturday.

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