August 30, 2023 — Asthma is a sneaky enemy.
One moment you are enjoying a walk or a bike ride. You are breathing easily and your symptoms are under control.
The next moment you feel things changing. It may start with coughing. Or labored, wheezing breaths. Or tightness in your chest and lungs. They’re all telltale signs of one asthma attack.
“Asthma may seem under control until a person starts exercising,” says Maureen George, PhD, professor of nursing at Columbia University and spokesperson for the Asthma and Allergy Foundation of America.
But that doesn’t mean exercise should be avoided, she said.
In fact, exercise is one of the best ways to do that Reduce asthma symptoms. Research from the past two decades has shown that physical activity can help improve lung function and increase the quality of life for someone with asthma.
As their condition improves, asthmatics report better sleep, less stress, improved weight management and more days without symptoms. In some cases, they can reduce their medication doses.
Exercise reduces inflammatory cytokines – small protein molecules that help cells communicate – and increases anti-inflammatory cytokines, according to a study. Review 2023 from researchers in Great Britain. That could help calm chronic airway inflammation, easing asthma symptoms.
A few simple guidelines can help you reap these benefits while staying safe.
Make sure the first steps are not the last steps
For someone new to exercise, there is only one way to start: gently.
The Global Initiative for Asthma recommends biweekly cardio and strength training.
“You always start low and slow,” says Spencer Nadolsky, DO, a certified obesity and lipid specialist and medical director of Sequence, a comprehensive weight management program.
“Low” means light loads in the weight room. ‘Slow’ means short, easy walks.
Many are “put through the wringer” at the start, which discourages them from continuing, Nadolsky says. “They hurt too much and it felt more like a punishment.”
An even bigger concern is triggering an asthma attack. Take measures to reduce the risk. Make sure you have your rescue inhaler with you and stay on top of your medications, Nadolsky says.
“A healthcare provider should be consulted” before starting a new activity or increasing a program, or when asthma interferes with an exercise, George say.
If you exercise outdoors, you should be aware of the air qualityespecially at a time when smoke and particles from a forest fires in Canada can cause asthma symptoms in people thousands of miles away.
The harder you work, the higher you “ventilation”, which means you’re bringing more air into your lungs, and potentially more allergens and pollutants.
Temperature and humidity also become risky in extreme conditions. Cold, dry air can dry out and narrow the airways, making it difficult to breathe.
How to choose the best type of exercise
Step one: Be realistic. People with asthma often have that less effort capacity than those who don’t – understandable if shortness of breath is your default.
Second, give yourself plenty of time to warm up. A solid warm-up routine – especially one with a mix of lower and higher intensity exercises – can help prevent exercise-induced asthma (bronchoconstriction), a narrowing of the airways during strenuous physical activity that causes shortness of breath and wheezing.
For example, if you warm up on a treadmill or stationary bike, you can combine a few short bursts of faster running or cycling, with a few minutes of recovery at a slower pace in between.
You can also expand that concept into a full-fledged workout.
High-intensity interval training (HIIT) is a promising option for people with asthma. a 2021 study showed that three 20-minute interval training sessions per week significantly improved performance asthma control.
“The benefit of HIIT is that ventilation can recover intermittently,” says Carley O’Neill, PhD, an exercise scientist at Acadia University in Nova Scotia and lead author of the study.
That’s a major difference from conventional cardio, where the constant effort can evaporate water from the lungs faster than your body can replenish it. “Dehydration of the airways can cause exercise-induced asthma in some cases,” says O’Neill.
HIIT, on the other hand, allows your airways to recover and rehydrate between workouts.
Another recent study found that people with asthma who did HIIT workouts had fewer breathing problems and felt less fatigued, compared to a similar group who did cardio training at a constant pace. (Both types of cardio led to similar improvements in aerobic fitness.)
You can also choose other types of intermittent – or stop-and-go – exercises. For example, strength training requires relatively short periods of effort, with adequate rest in between.
The only choice you don’t want to make
While there are many good exercise options for someone with asthma, he says there is one clearly bad choice George: “Avoid exercise.”
Being inactive puts you at greater risk of obesity and all the health problems that come with it. And as your fitness declines, it becomes much more difficult to exercise when you need or want to.
Any choice is better than that one.