Get Better. Faster.
Exercise Asthma Testing and
Laryngoscopy for Vocal Cord Dysfunction
All elite athletes involved in endurance sports should undergo
testing to exclude the presence of Exercise Induced Asthma.
Clin J Sport Med. May 2004; 134 - 138.
Dr. Silberman specializes in the work-up and treatment of exercise related breathing
complaints, such as exercise induced asthma, exercise-induced laryngeal obstruction
(E-ILO), vocal cord dysfunction (VCD) or paradoxical vocal fold motion (PVFM).  He
has diagnosed and treated elite, collegiate, high school, and recreational athletes who had
previously been seen by pulmonologists and allergists.  He has diagnosed Epstein Barr
Virus (EBV) or "mono", anemia, and heart disease in athletes with breathing problems
diagnosed as "asthma".  

Clinical symptoms and questionnaires may guide the diagnosis  of asthma but have been
found to be only a mediocre guide, often underdiagnosing and overdiagnosing exercise
induced asthma (EIA) or exercised induced bronchospasm (EIB).   Symptoms of
exercise induced asthma or EIB are often 1. Expiratory, 2. Peak after exercise, 3. Peak
3-15 minutes after exercise (Roksund OD).

If your symptoms are 1. Inspiratory, often with coarse or high pitched inspiratory stridor,
2. Peak at peak exercise, and 3. Stop 1 to 5 minutes after exercise then you may suffer
from exercise-induced laryngeal obstruction (E-ILO) formerly called vocal cord
dysfunction (VCD).  The Continuous Laryngoscopy Test (CLE) is a method that allows
for continuous documentation of your laryngeal airway using a laryngoscope, a small
video camera placed into the back of your throat that allows visualization of your airway
during exercise (Roksund OD 2006, J. Tod Olin 2014).

An exercise challenge test, otherwise known as spirometry or pulmonary function test,
can be performed in the
NJ Sports Medicine Performance Center.  A VO2 max test
is usually required to reach effort to bring on asthma.  If office testing is negative, Dr.
Silberman may test your performance in the field or with pre- and post- bronchodilator
medication inhalation.  If symptoms and/or findings are compatible with E-ILO or you fail
treatment with asthma medication, then the Continuous Laryngscopy Test will be
performed with a flexible laryngoscope visualizing your vocal folds and airway during

If you are a cyclist, Dr. Silberman may test you out on the roads you ride on.
If you are a swimmer, Dr. Silberman can perform pulmonary function tests at your pool.
If you are a skater, Dr. Silberman can perform pulmonary function tests you at your rink.

You will not achieve peak potential if you have untreated asthma.

Untreated asthma is a serious health risk

Link to World Anti-Doping Agency Medical Information to Support the Decisions of
TUE (Therapeutic Use Exemptions) Committees - also called TUE Physician Guidelines
- on Asthma.
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