Open Access article published in the Journal of Sports Medicine April 2nd 2014.


Respiratory disorders in endurance athletes – how much do they really have to endure?


“Respiratory disorders are often a cause of morbidity in top level endurance athletes, more often compromising their performance and rarely being a cause of death… Both bronchospasm and the onset of interstitial edema induced by exercise cannot be considered pathological per se, but are more likely findings that occur in several healthy subjects once physical exhaustion during exertion has been reached. Consequently, we get a vision of the respiratory system perfectly tailored to meet the body’s metabolic demands under normal conditions but which is limited when challenged by strenuous exercise, in particular when it happens in an unfavorable environment.”

The prevalence and incidence of exercise-induced respiratory disorders in athletes

“In sports requiring strenuous endurance training, athletes are obliged to inspire large volumes of air, and for this reason an increased risk of developing EIA/EIB (Exercise-Induced Asthma/Exercise-Induced Bronchoconstriction) may be expected. This risk is further increased if athletes are exposed to cold air.”

Conclusion and future direction

“With the state of current knowledge, cardiac problems are not the only cause of morbidity and mortality among endurance athletes. For this reason, the above mentioned meaningful evidence of respiratory disorders in endurance athletes deserves to be widespread knowledge both in the scientific and in the athletic international community. As a matter of fact, paying attention to the concept that the respiratory system may show a pathophysiological limitation to endurance performance and sometimes be a cause of illness or even death is definitely the first step…”

…“In conclusion, taking up the question of the title of this report, we can say that every endurance athlete has their own limit in endurance training that once passed will produce all the possible respiratory disorders previously described. The question is precisely to understand if there is a limit in terms of intensity and/or in terms of duration in years to endurance training, before respiratory disorders can appear, and if we can apply any preventive strategies. To be an endurance champion, this inevitably means accepting all the labors of strong training but also enduring all possible health problems caused by the same.”