Athletes with asthma compete at the highest level of virtually every sport; at least 17 percent of athletes who competed in recent Olympics–including many gold medal winners–have a history of asthma.
Asthma is an inflammation of the passageways of the lungs. Because of abnormally high sensitivity to triggers such as cold air, dust mites, tobacco smoke, pollen, animal dander or other irritants in the environment, these airways start to contract, causing coughing, wheezing, shortness of breath and tightness in the chest. During an asthma attack, the person seems to be choking for air. It’s a frightening experience that can be life threatening if ignored.
For about 80 to 90 percent of persons with chronic asthma, exercise is one of the factors that can precipitate an attack. In addition, many individuals who never have asthma any other time get symptoms when they exercise.
Doctors are not sure why exercise brings on asthma attacks, but it may be related to the inhaling of colder and drier air with rapid mouth breathing. Muscles that surround the airways are sensitive to changes in temperature and humidity, and they react by narrowing the passageways.
In addition to coughing or wheezing, symptoms such as shortness of breath, cramps, stomach pain or headaches may come on 10 to 20 minutes after the start of exercise or 5 to 10 minutes after it’s over. In some cases, the effect may be delayed for four to eight hours. Those who don’t have chronic asthma may attribute these symptoms to “being out of shape.”
Ignoring these signs can be dangerous, but there’s no reason to let anxiety about asthma stop you–or your child–from being physically active. Regular exercise has health benefits for everyone, and it may even make the asthma easier to control over the long term.
If you’re bothered by exercise-induced symptoms–and even top-level athletes frequently are–it’s important to see a doctor who can confirm a diagnosis and offer comprehensive treatment and an action plan for managing problems during exercise.
Exercising with Asthma
If you’re already involved in a sport or activity, there’s no reason to stop what you’re doing. As numerous top-level athletes have proven, it’s possible to manage your asthma without compromising your play. If you’re choosing a new activity, on the other hand, some are better than others for a person with asthma.
Because of the warm, humid environment just above the water, swimming is usually considered the ideal activity for a person with asthma. Some individuals, however, are sensitive to the chlorine in swimming pools.
Tennis, golf, baseball and volleyball are also good because they involve short bursts of activity followed by rest periods. Walking is relatively unlikely to trigger symptoms, but endurance activities such as running, biking and cross-country or downhill skiing have risks, particularly during winter when cold, moist air is inhaled.
Whatever activity you choose, there are strategies for managing your asthma:
-Keep your asthma under control and talk to your doctor any time you feel your control is slipping.
-Devote at least 10 minutes for warming up and 10 minutes for cooling down. This may be a bit more than others need, but it allows the bronchial tubes to adjust and reduces the likelihood you will have an attack shortly after starting exercise.
-Drink plenty of fluids.
-If you experience breathing or other problems while exercising, don’t try to work through them. Stop immediately, rest and use your bronchodilator.
-Following your doctor’s advice, make preventive use of long-acting and/or short-term bronchodilators and other medications.
-Avoid exercising in cold, dry air or in smoggy conditions. Sometimes a mask or scarf can help.
-Air pollution and a high pollen count also increase the risk of exercise-induced asthma. Move your exercise indoors, if possible, when the air quality outside is bad.
No Excuse To Avoid Activity
Studies show, unfortunately, that children with asthma are less likely to be physically active than those without the disease.
A study of inner city Head Start children using motion sensor wrist watches found that children with a history of wheezing or a diagnosis of asthma were significantly less active than other children. And a United Kingdom study found that children at a clinic for asthma were less likely to engage in physical activity and more likely to be obese than a comparison group of children with other medical conditions. Both the children and their parents reported that their asthma was a barrier to physical activity and participation in sports.
In this study, as in others, asthma patients who were physically active had better mental health and fewer long-term medical problems than others.
When you have asthma, getting fit can be a slow, gradual process, but the benefits are worth it. With increased fitness, it’s possible to do more physical activity before becoming breathless.
One recent review of 13 studies found that exercise had no effect on the total number of days that subjects experienced wheezing. It did, however, increase oxygen intake by about 20 percent–improving the transfer of air in and out of the lungs.
Weight control is another important issue. With less weight to carry, exercise becomes easier, reducing the patient’s anxiety and raising his or her confidence. Physical activity becomes easier and more rewarding. There’s also evidence that aerobic fitness reduces the overall severity of asthma symptoms.
Elite athletes who have succeeded in spite of their asthma have demonstrated that the disease need not be a limiting factor. Other asthma patients should get the message early: it’s possible to get fit and stay fit–with all the health benefits that follow–despite your asthma.
Tana N Kaefer, PharmD
