Exercise-Induced Laryngeal Obstruction (EILO)

Exercise-induced laryngeal obstruction (EILO), also commonly referred to as vocal cord dysfunction or paradoxical vocal fold motion, is a condition in which the larynx — your voice box — narrows or closes during exercise, restricting airflow and creating a sensation of breathing restriction. Unlike asthma, EILO affects the upper airway and typically resolves within minutes of stopping exercise.

The key differences are where and how the restriction happens. EILO makes it hard to breathe in — you feel like you can't get air. Asthma makes it hard to breathe out, causing wheezing and chest tightness. EILO also resolves rapidly once you stop exercising, while asthma often persists or worsens. Most importantly, rescue inhalers don't help EILO because it's not a lower airway condition. It is important to know that you can have both EILO and asthma.

Yes. EILO responds well to speech therapy and functional breathing retraining. It does not typically respond to inhalers or medication. Treatment focuses on restoring control of the airway during exercise. Most athletes see meaningful improvement within a few weeks of consistent practice.

The gold standard for EILO diagnosis is continuous laryngoscopy during exercise (CLE), which uses a small camera to observe the larynx during peak exertion. At Functional Airway Lab, we begin with a thorough clinical assessment of your symptoms, history, and breathing mechanics, and can guide you toward formal diagnostic testing if needed.

EILO affects 5–8% of adolescents and is significantly more common in athletes.

Many parents and athletes are surprised when speech therapy is recommended, especially if their child communicates well. Speech-language pathologists evaluate and treat a wide range of skills related to breathing, swallowing, feeding, voice, airway function, and communication. Therefore, we are specially trained in the anatomy and function of the larynx and airway and uniquely positioned to treat EILO.