Exercise is good for everyone. Regular exercise is an important part of a healthy lifestyle. But it is also a common trigger for asthma. In general, it’s a good idea to try to avoid asthma triggers. However, exercise has many health benefits, and it shouldn’t be avoided.
Exercise-Induced Asthma – What Is It?
Most people who have poorly controlled asthma will have symptoms with exercise. However, some people may have asthma symptoms that are only brought on by exercise. This form of asthma is called exercise-induced asthma, or EIA. Common symptoms of asthma that can occur with exercise are coughing, wheezing, shortness of breath, chest pain or tightness, tiredness, and difficulty keeping up with others.
Asthma symptoms can occur during vigorous activity, but usually start five to ten minutes after stopping the activity. Sometimes symptoms can return hours later. Whether exercise brings on asthma symptoms may depend on how long you are active, how intense the activity is, and the environment where you exercise. Very intense sports, such as swimming, soccer, and long-distance running, are most likely to cause asthma symptoms, but they do not always need to be avoided since the symptoms can usually be controlled.
Asthma symptoms can occur during vigorous activity, but usually start five to ten minutes after stopping the activity.
Asthma symptoms may also occur with exposure to triggers in the environment where exercise is taking place. For example, a person may breathe comfortably indoors on a basketball court, but will have asthma symptoms when running in a grassy field or ice skating in cold weather. Triggers that can be a problem include outside temperature, humidity, air pollution, pollen or molds in the air, and chemical fumes, including those found at some ice rinks and pools. The triggers that affect you may be different from triggers that affect someone else.
How to Prevent Asthma Problems with Exercise
To stay active with asthma, or to become more active, these steps can help: 1) identify your exercise-induced asthma triggers, 2) take your pre-treatment asthma medicine, 3) warm up before exercise, and 4) end with a cool-down exercise.
Identifying your exercise-induced asthma triggers If cold air triggers your asthma, you can try wearing a scarf or cold-weather mask over your nose and mouth to warm the air. Try to breathe through your nose when exercising. If you have allergies to any molds or pollens, check mold or pollen counts and avoid outdoor activity when the counts are very high.
2. Talk with your doctor before starting an exercise program to be sure you are healthy and your exercise plan is right for you.
3. Do a gradual warm-up before exercise and a cool-down after exercising.
4. Ask about the use of asthma medicines to help prevent breathing problems while exercising.
5. Check the environment for asthma triggers before exercising.
6. If you smoke, talk to your doctor about how to quit, and set a quit date.
Air pollution can also trigger asthma. Usually air pollution levels are highest during midday or in the afternoon. Ozone is a common outdoor air pollutant in the summer months. When the levels are high, you should avoid outdoor activities. Check the Air Quality Index updates in your local newspaper, television, or radio weather reports. Air quality information for many U.S. cities is also available on the Environmental Protection Agency’s air quality forecast website, AirNow.gov.
Pre-treatment asthma medicines There are several kinds of medicine you can take before exercise to prevent asthma symptoms. Both bronchodilator and anti-inflammatory medicines can be used.
• Bronchodilators are medicines that open your airways by relaxing the muscles around your breathing tubes. There are two types of bronchodilators: short-acting and long-acting. Both types are used to prevent asthma symptoms. Short-acting bronchodilators include albuterol and levalbuterol. You should take your short-acting bronchodilator fifteen to thirty minutes before starting to exercise. It will not last longer than two to four hours. Even if you take your short-acting bronchodilator before you exercise, you can use it again as a reliever medicine if you have symptoms during or after exercise.
• Anti-inflammatory medicines are medicines that are used to prevent swelling in your breathing tubes. These include both corticosteroids (such as beclomethasone, budesonide, flunisolide, fluticasone, mometasone, and triamcinalone) and non-steroid medicines (such as montelukast and zifarlukast). Anti-inflammatory medicines are usually taken on a regular schedule to control your asthma. They are called controller medicines. You may not notice any immediate improvement when you use these medicines. They can take time to work. If you have regular asthma symptoms (more than twice a week during the day or twice a month at night), you should talk to your doctor about using a controller medicine.
Warming up and cooling down Spending five to ten minutes warming up before exercising can help to prevent asthma symptoms during exercise. A simple warm-up exercise can be to begin walking slowly and increase your speed. You could also do jumping jacks, starting with moving your arms only and then adding your legs. Slowly cooling down for five to ten minutes after exercising can help prevent asthma symptoms that might start after exercise. Your cool-down activity can be walking or stretching.
What to Do If Symptoms Occur with Exercise
Even if you use your bronchodilator medicine before exercise, asthma symptoms can occur during exercise. If they do occur, you should slow down your exercising. If symptoms continue to get worse, you may need to use your quick-relief medicine (albuterol, for example). Even if you took this medicine before exercising, it’s OK to take it again to relieve your symptoms. If you feel your breathing is limiting your ability to exercise, tell your doctor.
If you’re overweight or haven’t been getting regular exercise, you may be out of shape or in poor physical condition. Poor conditioning can make you feel out of breath when you exercise, and this breathlessness can often be confused with asthma symptoms. Your doctor can help you decide whether your symptoms are due to asthma or to poor conditioning.
It takes time and effort to build physical fitness and get in good shape. Make a plan to get in good condition gradually. When your asthma is well controlled, you shouldn’t be limited in physical activity. By working with your doctor, you can make a plan that will allow you to feel good and take part in normal activities, including exercise.
Reprinted with permission from the ATS Patient Information Series handout Asthma and Exercise, © American Thoracic Society, thoracic.org
This article was originally published in Coping® with Allergies & Asthma magazine, Spring/Summer 2017.