Your Guide to Exercising With Asthma

Vincent Disabella, DO, with Carl Sherman

Series Editor: Nicholas A. DiNubile, MD

THE PHYSICIAN AND SPORTSMEDICINE - VOL 26 - NO. 6 - JUNE 98

Years ago, everyone thought strenuous physical activity was dangerous if you had asthma, but now we know better. Exercise is not only safe if done properly, it's an integral part of treatment. Regular workouts will make you stronger and more energetic and reduce your risk of heart disease, diabetes, and other health problems. What's more, your asthma is likely to improve. Studies have shown that physically fit people have fewer attacks, need less medication, and lose less time from work or school.

Controlling Symptoms

Chronic asthma control. To make sure asthma doesn't interfere with your ability to exercise, keep it under control. If your doctor has prescribed medications like inhaled corticosteroids for daily use, use them faithfully. Take the necessary steps to control allergies. Visit the doctor on a regular schedule, follow his or her instructions about monitoring your condition at home (using peak flow testing, for example), and be sure to report any problems promptly.

Exercise-induced asthma. Even if your asthma is well-controlled, you may develop coughing, shortness of breath, chest pain, or nausea if you exercise without taking precautions. But several simple steps can prevent this exercise-induced asthma:

Warm up with 10 minutes of stretching or light activity (like walking) before you work out more strenuously.
Avoid exercising in cold, dry air. You'll probably have less trouble in the winter if you work out indoors. If you are active outside, cover your mouth and nose with a scarf or breathing mask to warm the air you breathe.
If your doctor recommends it, prepare for exercise with two puffs of a beta-agonist inhaler 15 minutes before you exercise. This will keep your airways open and prevent symptoms.
After exercise, cool down gradually with 10 to 15 minutes of lighter activity, like walking or stretching.

The Exercise Plan

Exercise specifics. For full benefit, try to exercise for 20 to 30 minutes, four or five times a week, strenuously enough to raise your heart rate to 60% to 85% of maximum. (Your maximum heart rate is roughly equal to 220 minus your age.)

Choose an aerobic activity you find enjoyable; jogging, biking, and swimming are all good. If steady activities like these provoke symptoms despite precautions, substitute sports that involve short bursts of intense activity, like tennis, volleyball, or half-court basketball.

Take it easy. If you develop asthma symptoms during exercise, don't try to push your way through them. Stop what you're doing and take two more puffs from your beta-agonist inhaler. If this doesn't bring relief within 15 to 20 minutes, seek medical help.

For Trouble-Free Workouts

Don't exercise on days when your symptoms are bothersome, such as when you're wheezing or coughing.
Avoid areas where air pollution is high (like near a highway). On days when pollution is worse than normal or the pollen count is particularly high, exercise indoors or not at all.
Vary your routine to keep things interesting. Go in-line skating one day, use an exercise bike another.
Join with others. Exercise is more fun—and harder to skip—when it's a social event.

Remember: This information is not intended as a substitute for medical treatment. Before starting an exercise program, consult a physician.

Dr Disabella is assistant director of primary care sports medicine for Crozer-Keystone Health System in Springfield, Pennsylvania. Mr Sherman is a freelance writer in New York City. Dr DiNubile is an orthopedic surgeon in private practice in Havertown, Pennsylvania, director of Sports Medicine and Wellness at the Crozer-Keystone Healthplex in Springfield, Pennsylvania, and a member of the editorial board of The Physician and Sportsmedicine.

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