The Elite Breathless Clinic, the first private service of its kind in the North West, provides tailored multi-disciplinary assessment and treatment for people struggling with breathlessness symptoms during exercise.

What is EIB?

Exercise-induced bronchoconstriction, or EIB, is the preferred term for what was known for years as exercise-induced asthma, and is the most common medical condition in athletes. EIB is the narrowing of the tubes in the lungs during exercise.

The true prevalence of EIB is unknown, but it’s been estimated that up to 70% of elite athletes are affected by the condition. People involved in sports that have challenging environments, such as cold climates, or high aerobic demands are at a greater risk.

However, not all exercise-associated breathlessness is due to EIB. Several other conditions can mimic EIB, including upper airway conditions like exercise-induced laryngeal obstruction (EILO) and dysfunctional breathing.

Symptoms of EIB

In EIB, the airways can become temporarily narrowed during exercise, which can cause wheezing, cough and chest tightness.

The impact of breathlessness symptoms during exercise can range from a reduction in performance to fatigue and, at worst, withdrawal from competitive participation.

Respiratory symptoms alone don’t provide enough information for accurate, targeted treatment as breathlessness symptoms can be multi-factorial, so specific specialised tests are crucial to provide an accurate diagnosis. An early diagnosis for the cause of breathlessness is key as it can prevent impaired performance.


  • Indirect airway challenge test: The International Olympic Committee recommend this as a gold standard for determining EIB in competitive athletes
  • Continuous laryngoscopy during exercise (CLE) test: Consensus guidelines advise this examination of the back of your throat, your voice box (larynx), and vocal cords with a laryngoscope during exercise to assess for EILO.


Treatment can include targeted medication or therapy programmes to gain control of breathing. We deliver comprehensive management packages that allow individuals to recover from breathlessness symptoms and fulfil their competitive goals.

As the Elite Breathlessness Clinic is based at The Manchester Institute of Health and Performance, you not only have access to the best clinicians, but also state-of-the-art equipment for both health and performance in the region, all under-one-roof. The clinic provides a unique infrastructure, which ensures that each and every patient receives assessment, diagnosis and bespoke, goal-orientated treatment within one clinical service.

The Elite Breathlessness Clinic is run by Dr Aashish Vyas, Consultant Chest Physician, who has more than 20 years’ experience treating individuals with complex breathlessness needs.

Meet the team

Dr Aashish Vyas


Specialty General (internal) Medicine, Respiratory Medicine

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