Understanding Exercise Induced Laryngeal Obstruction (EILO)

Have you ever felt like your throat was “closing” during exercise? Maybe you noticed noisy breathing, tightness in the throat, or sudden difficulty getting air in while running or training hard. Many people assume these symptoms are caused by asthma, but for some individuals the issue may actually be something called Exercise Induced Laryngeal Obstruction (EILO).

EILO is increasingly recognized in athletes, active individuals, and teenagers, yet it is often misunderstood or misdiagnosed. The good news is that with proper assessment and treatment, many people can significantly improve their symptoms.

What Is EILO?

Exercise Induced Laryngeal Obstruction occurs when structures around the larynx (voice box) temporarily narrow during exercise, making it harder for air to move into the lungs.

Normally, the airway should open wider as exercise intensity increases to allow more airflow. In EILO, parts of the larynx instead move inward at higher breathing rates, partially obstructing airflow.

This obstruction most commonly happens during inhalation and can create a sensation of:

• Throat tightness
• Difficulty breathing in
• Noisy breathing or wheezing
• Choking sensations
• Sudden shortness of breath during intense exercise

Symptoms often improve quickly once exercise stops.

EILO vs Asthma

EILO is frequently mistaken for asthma because both conditions can cause breathing difficulties during exercise. However, they are quite different.

Asthma involves narrowing of the lower airways in the lungs and typically causes more difficulty breathing out. Symptoms may continue after exercise and often respond to inhalers.

EILO affects the upper airway at the level of the throat and usually causes more difficulty breathing in. Symptoms often come on rapidly during intense exercise and settle relatively quickly with rest.

Some people can also have both asthma and EILO at the same time. Learn more about Asthma symptoms, causes and treatments here.

Common Symptoms of EILO

Symptoms may include:

• Tightness in the throat or upper chest
• Inspiratory stridor (high-pitched noisy breathing)
• Feeling unable to get enough air in
• Panic or anxiety during exercise
• Sudden breathing restriction during high intensity activity
• Voice changes during exercise
• Reduced athletic performance

Many people describe feeling as though they “hit a wall” during exercise despite being physically fit.

What Causes EILO?

EILO is usually multi-factorial, meaning several contributing factors may be involved. These can include:

• High breathing demands during exercise
• Increased tension in the neck, throat, or jaw
• Inefficient breathing patterns
• Stress or anxiety
• Poor breathing coordination
• Nasal obstruction or mouth breathing
• Reflux or airway irritation

For some athletes, symptoms may worsen during competition or high-pressure situations.

Physiotherapy and Breathing Retraining for EILO

Physiotherapy can play an important role in managing EILO. Treatment often focuses on improving breathing efficiency, reducing unnecessary tension, and helping the airway remain more open during exercise.

Breathing Pattern Retraining

Many people with EILO benefit from learning:

• Nasal breathing strategies
• Diaphragmatic breathing
• Better breathing rhythm and control
• Reduced upper chest and neck tension

Improving breathing efficiency can reduce the workload on the airway during exercise. Learn more about how to retrain your breathing pattern.

Laryngeal Control Techniques

Specific exercises may help improve awareness and control of the muscles around the throat and larynx.

People are often taught strategies to:

• Relax throat tension
• Maintain a more open airway
• Recover breathing more quickly during symptom flare-ups

Exercise Exposure and Confidence Building

Because EILO symptoms can feel frightening, some individuals begin avoiding exercise altogether. Gradual return to exercise with breathing strategies can help rebuild confidence and performance.

Can EILO Improve?

Yes! Many people experience significant improvement with proper education, breathing retraining, and individualized treatment. Learning to recognize early symptoms and respond with appropriate breathing strategies can make exercise feel safer and more manageable.

Final Thoughts

Exercise Induced Laryngeal Obstruction is a real and treatable condition that affects the upper airway during exercise. If you experience throat tightness, noisy breathing, or sudden breathing restriction during activity, especially if asthma treatments have not fully helped, EILO may be worth exploring.

At Move Authentically Physiotherapy, we assess breathing patterns and help individuals improve breathing efficiency, diaphragm function, and exercise tolerance. If you are in Kingston and struggling with exercise-related breathing symptoms, our physiotherapists trained in Breathing Pattern Disorder assessment and treatment may be able to help. Book with us today to start taking control of your breathing.