Asthma is an increasingly common lung disease in the U.S. People who have asthma have inflamed and highly irritable airways. When the airways are exposed to irritants, they narrow, making breathing more difficult. Signs of asthma include wheezing, coughing, chest tightness and difficulty breathing, especially at night and early in the morning. Common irritants include tobacco smoke, air pollution, viral infection and allergens like dust mites and cat dander. Vigorous exercise also can act like an irritant by triggering airway spasm and narrowing. This is referred to as exercise-induced asthma.
The ABCs of Exercise-induced Asthma
About five to 10 minutes into a strenuous soccer game you start to cough and feel short of breath. You tell yourself that you’re out of shape and recommit to your resolution to participate in vigorous cardiovascular exercise at least three days per week. But then, the next time and the time after that the same feelings of difficulty breathing set in. You finally go visit your doctor, who tells you that you have asthma. But this only happens with exercise, you say.
If that’s the case, you’re one of 5 to 10% of people with asthma who only experience symptoms with exercise. On the other hand, 90% of people with asthma have exercise-induced symptoms. Exercise-induced asthma attacks may start during exercise or shortly after exercise. These episodes tend to be shorter than attacks with other triggers.
Many people with asthma avoid exercise, thinking it will do more harm than good. The truth is that people with asthma can experience the same benefits from exercise as everyone else. And with the proper precautions, the risks are significantly lessened.
Exercising With Asthma
First, have a thorough medical evaluation and obtain your doctor’s permission before beginning an exercise program. Your doctor will probably prescribe you a medicine to help keep your airways open during exercise. For example, you may be instructed to take albuterol, a short-acting inhaled bronchodilator, 15 minutes before exercise to prevent symptoms for up to about four hours.
Once you receive clearance from your doctor, consider the following exercise guidelines:
- Always have medication nearby for use in the event of an asthma attack. Be aware of early signs of an asthma attack, such as shortness of breath and coughing.
- Take extra time (aim for 15 minutes) to warm up before exercising. This helps the airway retain a more normal size.
- Prolong your cool-down. The second most likely time to experience an exercise-induced asthma attack is in the five to 10 minutes after exercise. By gradually decreasing intensity, you reduce your risk.
- Be aware of your exercise environment. Avoid exposure to other asthma triggers such as pollen and pollution when exercising. A warm and humid environment (like that in a pool) reduces exposure of the lungs to cool, dry air—the suspected cause of exercise-induced asthma.
- Consider exercising at the lower end of your target heart-rate range and incorporating intervals for high-intensity training to minimize your risk of an asthma attack. Choose exercises least likely to trigger an attack, such as pool swimming and walking.
- Maintain adequate hydration. This will decrease mucous accumulation in the airways, thus reducing risk for an asthma attack or a future infection like bronchitis or pneumonia.
- Maximize air exchange with diaphragmatic breathing. Inhale deeply through your nose and exhale through your mouth. With each inhalation you should see or feel your belly rise.
- Rest when necessary and listen to what your body is telling you.
Keep Your Options Open
Asthma does not equate to an inactive life. In fact, six-time Olympic gold medalist Jackie Joyner–Kersee achieved the highest levels of athletic success despite having asthma. As long as you and your physician are comfortable with your level of activity, nothing should keep you from doing the activities that keep you happy and healthy. An ACE-certified Advanced Health & Fitness Specialist can help you design the program that’s just right for you if you need help getting started.
American Academy of Asthma, Allergy, & Immunology