EILO - it's not just in your head (or your lungs!)

It’s the end of a workout.

You’re breathless - more than you feel you should be.

Your throat feels tight, your breathing turns noisy and it’s just hard to get air in.

You’ve been told it might be asthma but the inhalers don’t help...

If this sounds familiar then it could be Exercise-Induced Laryngeal Obstruction (EILO) - and it’s more common than people realise.

What is EILO?

EILO is when your voice box (larynx) narrows during intense exercise, making it harder to breathe in. It can be extremely frightening and is all too often misdiagnosed as exercise induced asthma (EIA), also known as exercise-induced bronchoconstriction (EIB). In reality, EILO doesn’t respond to asthma medication because it’s a mechanical issue concerning the upper airway and how the delicate structures in the throat move, rather than a narrowing of the smaller airways lower down in the lungs.

EILO usually shows up in sporty individuals, especially teens and young adults. It can also be common in those who are exposed to intense environments such as chorine in swimming pools, or cold dry environments such as in ice hockey. If you’ve ever heard someone gasp or wheeze loudly on the pitch, or watched them grasp their throat, but recover relatively quickly after stopping, EILO might be the reason.

• Tightness in the throat or chest

• Breathlessness

• A loud, high-pitched noise when breathing in 

• Coughing or gagging

• Feeling panicked because you can’t get air in, or a deep breath

The good news is that symptoms usually settle quickly once you stop are your heart rate and breathing rate slow down. The tricky part is getting the right diagnosis - many people are incorrectly treated for asthma for years.

It all starts with your breathing pattern

We find that people with EILO often breathe inefficiently, even at rest. They tend to breathe high into the chest, use their neck and shoulders too much, and breathe too fast and/or through the mouth. This can make the structures in the throat around the voice box very unhappy to the point where they don’t move out the way on the breath in to allow air to flow freely down the trachea and in to the lungs. Instead, these structures fold inwards, creating a physical restriction to the airflow. The body’s posture, muscle tension and breathing habits also influence EILO. 

Getting the right diagnosis

The gold standard for diagnosing EILO is something called a CLE test. This is the Continuous Laryngoscopy during Exercise test where a tiny camera is passed up your nose and down the top of your throat. It is positioned just above your voice box so the examiner can watch how your throat behaves while you’re exercising on a treadmill or bike. It might sound intense, but it’s quick and incredibly helpful for getting a clear answer.

How we treat it

At Air Physiotherapy, we take a full-body approach to EILO and breathing pattern problems. It’s not just about your throat. It’s about how you breathe, how you move and how you manage your breathing during every phase of exercise.

Here’s what treatment might include:

• Breathing retraining: We help you shift from shallow, chest-based breathing to a slower, more relaxed diaphragm-led pattern. This often begins in static positions before moving.

• Posture work: We look at how your posture might be affecting your airway and guide you on how to move better especially during your chosen sport.

• Laryngeal control: We teach techniques (with help from speech and language therapists) to keep your vocal cords open during intense activity as well as thinking about looking after your larygnx.

• Stress and pacing strategies: Because panic and overexertion can make symptoms worse, we also help you understand when to ease off and how to stay calm under pressure to control your symptoms in these early days of resolution. 

  
  

What can you expect in terms of results?

With the right rehab from the right experts, most people notice a significant improvement in their symptoms within weeks. They feel more in control, perform better in sport and stop relying on inhalers that weren't the right treatment for the condition in the first place.

It’s not a quick fix - but it is treatable.

Book in for a Breathing MOT

If you’ve been told it’s asthma but nothing works, a Breathing MOT will help establish whether EILO could be the real issue.

If your symptoms come on fast, are worse with intense exercise and go away quickly when you stop then these are all signs that EILO may be at play. And if your breathing just feels off all the time, your pattern might need attention too.

When you book an MOT with us we look at the whole picture - not just your lungs. Breathing better starts with understanding how your body moves, how your throat responds and how your mind plays a role too.

If that sounds like what you need, book in today https://air-physiotherapy.carebit.co/patients/bookings/new