Exercise-induced laryngeal obstruction in athletes: what is it?

Exercise-induced laryngeal obstruction (EILO) is a cause of exertional breathlessness in athletes. It occurs when the vocal folds or surrounding structures narrow or close, typically during periods of high-intensity exercise. This can lead to shortness of breath, reduced ability to participate in exercise, and symptoms such as throat tightness, noisy breathing on inhalation (stridor), coughing, and changes in vocal quality.

Why does exercise-induced laryngeal obstruction occur?

During intense exercise, our breaths become bigger and faster, and are often taken through our mouth. These bigger, shallower breaths often fill only the upper 50% of our lungs and inhibit diaphragm engagement. As this occurs, carbon dioxide levels rise, and sensory signals in our airways increase. In some individuals, the nervous system perceives these changes as a threat and reflexively narrows the larynx as a means of protection.

Who experiences exercise-induced laryngeal obstruction?

EILO typically occurs in adolescents and young adults. It is more common among female athletes, specifically in high-achieving or elite athletes. EILO often occurs in athletes with breathing pattern disorders or asthma. It can also co-exist more frequently in individuals with perfectionistic, high-performing tendencies.

How do you treat exercise-induced laryngeal obstruction in athletes?

At FLO2, our treatment is individualized and focuses on:

• Developing a more efficient breathing pattern, focusing on the engagement of the diaphragm
• Reducing unnecessary tension through the upper chest, throat, and neck
• Practicing and adapting to nasal breathing to aid in reducing upper airway resistance
• Making lifestyle adjustments that support better airway health and lower irritation and sensitivity of the larynx

When should you seek help?

We strongly recommend seeking a consultation with FLO2 when:

• Your symptoms occur during high-intensity exercise
• Your symptoms do not improve with the use of an inhaler or medication
• You experience throat tightness or noisy inhalation
• Your performance suffers due to your breathing despite strong physical fitness
• You avoid pushing yourself or avoid participation in your sport due to the fear of your breathing condition