Don’t Let Asthma Slow You Down

Donna Wolf, PhD, is a clinical research coordinator with UVA’s Division of Pediatric Respiratory Medicine, where she conducts clinical trials that test asthma treatments in children and adults. Wolf is also a clinical exercise physiologist. She wrote this post for us about asthma and exercise.

Asthma is a chronic condition that affects the respiratory system, primarily the airways. It can cause symptoms that range from minor coughing and wheezing to life-threatening attacks; however, asthma is not a reason to avoid exercise.

For many asthma sufferers, physical exertion and vigorous exercise can trigger asthma symptoms. But lack of exercise is not good for anyone, especially patients with asthma who should avoid gaining weight and need the benefits of exercise on breathing. With the right treatment, you can enjoy physical activity while still controlling your asthma.

What is Exercise-Induced Airways Narrowing?

Exercise-induced airways narrowing (EIB) is a narrowing of the airways in response to vigorous activity that disrupts the normally smooth flow of air from the lungs. According to the American Academy of Allergy, Asthma and Immunology (AAAI), most people with chronic asthma have symptoms when they exercise. Others experience EIB even though they do not have persistent asthma symptoms at other times.

Symptoms of EIB include coughing, chest tightness, wheezing and shortness of breath. They generally flare up after 5 to 10 minutes of vigorous outdoors exercise.

Is It Safe to be Physically Active if I Have Asthma?

One of the goals of asthma treatment is to help you maintain a normal and healthy lifestyle, which includes being physically active.

Following an asthma action plan by taking medications as prescribed by your doctor, avoiding your asthma triggers and monitoring your symptoms and lung function will help you achieve this goal. If exercise triggers your asthma symptoms, you can eliminate or reduce it with planning and preventive medications.

The days of protecting and preventing individuals with asthma from taking part in organized sports are essentially a thing of the past, thanks to the overall successful management of the condition through medications and breathing aids, including inhalers.

Physicians want their asthma patients to get active, especially in asthma-friendly activities like:

• Swimming
• Bicycling
• Golf
• Walking
• Weightlifting

Why are these good choices if you want to be physically active?

• They let you control how hard and fast you breathe.
• They let you breathe through your nose at all times.
• They don’t dry out your airways.
• They mix short, intense activities with long endurance workouts.
• You can do them in a controlled environment (for example, a gym with air that’s not too cold or dry).
• Usually you do them with other people, who can help you if you have an attack.

Getting regular physical activity can improve your breathing and lead to fewer asthma attacks. Just remember to follow these tips.

What Should I Do to Control My Asthma When I Am Physically Active?

• Talk to your healthcare provider about using a pre-exercise asthma inhaler (inhaled bronchodilator) about 10 minutes before becoming physically active. Usually this is an inhaler like albuterol. (Tablet medications that block the actions of chemicals called leukotrienes released with exercise can be used in combination with albuterol or taken before albuterol. In special cases, asthma patients who participate in prolonged activity need to take a long-acting bronchodilator instead of albuterol.)
• Ease into it. Start out a new exercise program slowly and work your way up to being able to do 30 minutes most days of the week.
• Perform 5-10 minutes of warm-up exercises and maintain an appropriate cool-down period of 5-10 minutes after exercise. (The first episode of EIB on a given day is usually the worst one.)
• If the weather is cold, exercise indoors or wear a mask or scarf over your nose and mouth.
• If you have allergy-induced asthma, avoid exercising outdoors when pollen counts are high and when there is high air pollution.
• Restrict physical activity when you have a viral infection, like a cold.
• Conduct physical activity at a level that is appropriate for you.

What If I Have an Asthma Attack While Exercising?

If you begin to experience asthma symptoms during exercise, stop and repeat your pre-exercise inhaled medication (like albuterol). If your symptoms completely go away, you may restart the exercise. If your symptoms return, stop the activity, repeat your quick relief medication and call your healthcare provider for further advice.

Communication With Your Healthcare Provider Is Key

With proper diagnosis and the most effective treatment, you should be able to enjoy the benefits of exercise without experiencing asthma symptoms.

To feel your best, do the right things to control your asthma. And listen to your healthcare providers — they’re on your team!

Find out more about asthma and allergy treatment at UVA.