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Physical exertion is a powerful and frequent trigger of different hypersensitivity events. The all-encompassing term exercise-induced (EI) hypersensitivity syndromes include EI-asthma (EIA), EI-bronchoconstriction (EIB), EI-rhinitis, EI-anaphylaxis and EI-urticaria. These are significant problems for those practicing sports both at a recreational and an elite level. Adequate management depends upon its recognition, which allows a correct diagnosis and proper treatment. The fear of exacerbations often prompts individuals to curtail exercise. However, the evidence for the potential benefit of exercise in asthma and allergic diseases is increasing, with several studies showing improvements in inflammatory, lung function, and even quality-of-life outcomes after a training program. So, physicians should stress the importance of adequate levels of physical activity to patients. EI-urticaria and EI-anaphylaxis are much lesser frequent, but yet with an important impact in performance and quality of life. As recurrences might occur under the same conditions, future exercise-related activities are often curtailed and therefore prompt diagnosis and proper identification of triggers are mandatory.

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