Yes, You Can Exercise With Asthma

M.A., Health Writer
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You have asthma, but physical activity remains a priority. Good for you, because exercise helps control weight, blood sugar and insulin levels, reduces risk of heart diseases and some cancers, and helps your brain stay sharp. It improves sleep, sexual health, and your chance of living longer. A lifelong allergy sufferer, allergist-immunologist Derrick R. Ward, M.D., of Kansas City Allergy & Asthma Associates, P.A., wants you to stay healthy and keep moving as you manage your asthma. Here's how.


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Get the best help now

You want the best for yourself, so start with a doctor who understands your problem, like Dr. Ward. He's a member of the American Academy of Allergy, Asthma and Immunology, and he has at least two years of special training in the nuances of why you have asthma and how to best control — not cure — it. Allergists use the latest evidence-based treatments to help you keep exercising at your peak. The academy website has a handy search tool to help you locate a professional near you.


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Excel with asthma

It's not unusual for people with asthma to go to the Olympics, says Dr. Ward. Olympians and professional athletes include soccer great David Beckham, track and field superstar Jackie Joyner-Kersee and diver Greg Louganis. About a quarter of winter Olympians, especially cross-country skiers, were found to experience bronchospasms (a common feature of asthma).


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Stay in control

Good asthma control is job one, he says. To assess, he asks:

  • What and how frequent are your symptoms and do they impair your quality of life?
  • Are your medication levels just the right amount?

He then determines diagnostics based upon your history and symptoms. "If exercise is limited by asthma, you're not controlling it well enough," he says. Allergies, chronic sinusitis, sleep apnea and acid reflux — the latter, common with asthma — plus being out of shape, make it harder to control.


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The best general tests

He may recommend:

  1. Asthma Control Test:  Return this online questionnaire to your doctor.
  2. Breathing test or spirometry: Measure the amount and rate of air in and out of lungs.


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The best specific tests

*These next two promote airway constriction for assessment:

  1. Exercise challenge test: Done on a treadmill or stationary bike, it increases breathing rate.
  2. Methacholine challenge test: Used with spirometry, a spray irritates airways, causing narrowing.


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Love your meds

So you're health-conscious, and in addition to working out, you try to eat right. "Of course, you don't want to 'put a lot of medications into your body' if you don't have to," he says. "But you can't have your cake and eat it too. To exercise, you must be able to breathe, so you may have to take medication. I want you to understand that in most situations the benefits far outweigh the risks. Really effective, newer meds allow you to do most things you want to do."


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Understand your inhalers

Don't get confused about bronchodilator inhalers, says Dr. Ward. There are two main types:

  • Short-acting: The most common is albuterol, in several brands, and levalbuterol. Both work fast (about 20 minutes) to ease shortness of breath. They can be used before exercise and combined with other medications.
  • Long-acting: These are used regularly if prescribed. They are long-acting beta2-agonists (LABAs) or long-acting muscarinic antagonists (LAMAs), typically used with an inhaled steroid.


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Be proactive

Dr. Ward says patients can be "afraid" to use their inhalers. They tell him, "I feel like I shouldn't have to use this." Enter patient education: He says it's not going to harm them, and that it's much easier to keep airways open from the beginning, before they become constricted and narrow. "Use it as prescribed, and be proactive, so you can exercise at your peak capacity all the time. Let's go over how it works until you're comfortable and it's not such a big deal."


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Just your type

Allergic asthma is most common, set off by inhaling allergens such as pet dander, pollen, mold or dust mites. Bronchial hyperactivity or hyperresponsiveness means bronchial tubes are more likely to spasm and constrict due to cold air, dry air, smoke and other irritants, such as pool chlorine, and yes, exercise! That's non-allergic asthma. Your allergist will determine what type you have.


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Exercise-induced asthma

Exercise can also spark non-allergic, exercise-induced asthma, especially in teens and young adults. Dr. Ward says this is also called exercise-induced bronchospasm. The Asthma and Allergy Foundation of America says it happens at the beginning of exercise and worsens after finishing. It involves fast, deep breaths, usually through the mouth. Winter sports mean dry, cold air that narrows airways, making conditions worse. Constant-activity sports, like long-distance running or soccer, also cause this.


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Go when you want to go

Even weather changes impact asthma control, and they vary depending on time of year. You may only have an asthma flare-up every couple of years, or much more often, depending upon the climate. "If you've been dealing with this and trying to exercise, and can't deal any more, there's no reason to suffer. Try to come in regularly to discuss these changes, so we can adapt your plan to manage what Mother Nature dishes out."


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Do what you said you would

Once you and your allergist make a plan for your asthma, and you say, "Yes, I understand and will do this," be true to yourself, says Dr. Ward. "If you're uncomfortable or confused, don't follow the plan and then can't exercise, you won't be happy. Let me know any issues now and not six months from now. Being open with me doesn't mean being judged. Tell me what you're actually doing — or not doing — so we can control your asthma. If you fib, your breathing test numbers will tell the truth."