Since the first written description of asthma appeared in Homer's "Iliad," scientists have been trying to describe the shortness of breath you feel during exercise to improve treatment for this disease. Early physicians were unable to visualize the physiological processes responsible for the array of medical conditions included under the umbrella term asthma, and were unable to give any differential diagnosis as to the cause and eventual treatment for shortness of breath associated with exercise. Modern doctors know that vocal cord dysfunction, or VCD, is the most common reason for inspiratory stridor, according to the website Peak Performance.
Inspiratory Wheezing and Stridor
In 2003, the U.S. Olympic Committee published results of a study of 370 athletes that found 5 percent of the athletes experienced inspiratory stridor, or IS, which resolved itself within five minutes of onset. Fifty-three percent of these athletes with IS also experienced exercise-induced bronchospasms. This report also found that misdiagnosis of IS as exercise-induced bronchospasms is common and suggests your physician use diagnostic tools to help differentiate IS from other types of asthma.
Cause of IS
During normal respiration during exercise, your vocal cords move apart to allow air to pass freely. If you have VCD, your vocal cords move closer together instead of farther apart. The vocal cords obstruct your glottis, the part of your airway that leads to your larynx. The obstruction leads to a feeling of breathlessness and audible wheezing sound, known as stridor. It is this stridor, especially when you experience it as a result of exercise, that leads doctors into a misdiagnosis of exercise-induced asthma.
Difference Between IS and Asthma
The primary difference between IS because of VCD and asthma is whether you wheeze when you inhale or when you exhale. You will wheeze upon exhalation with asthma, whereas you will experience stridor when you inhale if you have IS due to VCD. Additionally, the wheezing associated with exercise-induced asthma has a lower pitch than the stridor associated with VCD. Moreover, the wheeze emanates from the asthmatic patient's chest, and your doctor is more likely to hear your stridor coming from your neck and vocal cords when you are suffering inspiratory wheezing associated with VCD.
Causes and Treatment
Treatment addresses the way your vocal cords close during exercise. Vocal cord dysfunction is a viscous cycle where pressure across your glottis causes your vocal cords to even more. Anxiety may initiate this cycle, causing you to grow even more anxious as your breathing difficulty increases. Your doctor may recommend speech therapy and confidence building to reduce performance anxiety. Breathing techniques such as conscious control over laryngeal function, pressure threshold inspiratory muscle training, diaphragmatic breathing and relaxed throat techniques are helpful.
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