Try using oxygen when exercising.

I broke and fractured my ribs by coughing up stuff too.. Even the nebs and inhalers help loosen the phelm so you will cough more. And exercise will over heat you and cause you to cough. A towel and try doing like your trying to clear your throat to bring up stuff rather than the deep coughs that hurts ya. .. Hugs !

I would bet it is due to violent coughing and hacking. I broke 3 ribs this way, confirmed by a cat scan

I think obviously it is from constant coughing. Sorry I don't know how to help you. I am not having coughing problems and not even using inhalers, just spitting up a little in the AM. Maybe you need to use nebulizer or inhalers at different intervals. ask your Pulmonary Dr. they may suggest some other method. May need x rays to see if there I damage somewhere. good luck and hugs.

You might place a towel where the weakened area is when you hack and cough to keep the abdominal wall from protruding or rupturing DAH