Asthma And Physical Activity

What is asthma?

Asthma is an atopic condition. This means that it is caused by an over-reactive response from the immune system (as with allergies) that causes airways to swell, become inflamed, narrow, and fill with mucus. The constricted and clogged airways make it difficult to breathe. 

Asthma attack

Asthma exacerbation is also commonly known as an asthma attack. The word exacerbation means when an existing situation or condition becomes worse. Asthma is often a lifelong condition that many people must learn to live with. There is a range of environmental causes of an asthma exacerbation or attack, and we generally call these ‘triggers’ (usually inhaled or ingested) that cause the immune system to overreact. To ensure asthma is not exacerbated, it is important to identify and then avoid, wherever possible, these triggers.

Symptoms of asthma

Symptoms typically experienced can include:

• Breathlessness
• A whistling sound when breathing is called wheezing
• Chest pain
• Shoulder pain
• Back pain
• Coughing

When the asthma is exacerbated so that it is acute (an asthma attack), other symptoms can include:

• Tightness in the chest
• Difficult breathing
• Increase in heart rate
• Feeling dizzy or drowsy
• Losing consciousness
• Blue lips and fingernails

Cause of asthma vs asthma trigger

There are specific causes or reasons why asthma occurs in some individuals and not others. There is no singular direct cause or reason why some individuals have asthma, but many factors increase the risk of developing asthma, including genetics, bronchiolitis (viral lung infections), cigarette smoke or pollutants during pregnancy, infancy, or childhood.

Once diagnosed, they can learn to live with and manage the disease so that it does not become exacerbated (when symptoms worsen and become severe). To do this, it is necessary to know what ‘triggers’ an attack of exacerbated symptoms. Triggers are caused by things in the environment, such as dust, house mites, pollen, cigarette smoke, and animal fur, amongst other things, although some asthma attacks can be unpredictable. 

Physical activity can be an asthma trigger

Even though it's usually considered a positive thing to exercise as it can help to strengthen the lungs and improve general health, unfortunately for some, it can also be a trigger. This depends on the individual and asthma can be triggered even by mild exercise whereas for others it may only occur when it is intense, strenuous exercise.

There isn’t enough evidence to explain why some people experience exacerbated symptoms when exercising, but one reason might be that when exercising outdoors the air might be cooler and drier which when inhaled can irritate the airways.  This can cause the airways to react by constricting (called bronchoconstriction).  This can cause shortness of breath, coughing, and wheezing, making the chest feel tight. 

Asthma symptoms are usually experienced shortly after exercise has begun and may also be experienced several hours later. Therefore, it is really important to learn how to control asthma with the right prescribed medication. If asthma is well-controlled, there is no reason that exercise should trigger an attack.

How to exercise with asthma

With the correct medication and approach, exercise can still be carried out without triggering an attack. This means not skipping your usual prescribed daily doses of preventative inhalers  (usually taken in the morning and evening). Take a small dose of a reliever inhaler before exercise (to help open the airways) or if you start to experience exacerbated symptoms. It is also helpful to eliminate any potential triggers, for example, try to avoid exercising outdoors when the air is cold and dry or wear a scarf. It is important that the exercise regime includes a warmup and warm-down to give the muscles in the lungs time to adjust.

Benefits of physical activity when you have asthma

It is important to ensure that people with asthma don’t give up exercise because it has several benefits for the lungs and can help with the long-term management of symptoms. Exercise increases heart rate and therefore increases the flow of oxygen not only to the heart and around the body but to the lungs themselves and reduces carbon dioxide levels. The capacity of the lungs will also increase as well stamina and respiratory muscles will strengthen. One study by the British Medical Journal¹ (2015) found that aerobic exercise helps to reduce the hyperresponsiveness of the bronchial airways and so they are less likely to become inflamed and therefore reduce other symptoms.

What to look out for when exercising with asthma

When planning your exercise activity, it is important to look out for other potential triggers such as pollution, pollen, dust, or other potential irritants such as areas where people may be smoking. It is better to exercise in clear open spaces where possible, away from traffic or parks where there is a substantial amount of flora.  

Summary

Providing individuals with asthma follow the prescribed doses of their medication, in particular, the preventer medication, their asthma should be well-controlled, and exercise should not trigger an asthma attack. It is important to remember all the benefits of exercise, which in the longer term, not only improves the health of the lungs and the rest of the body but also strengthens the immune system. A study in the European Respiratory Journal² shows that individuals who have well-controlled asthma not only participated successfully in a ten-week exercise programme but were still exercising at least once per week 3 years later.  They also improved their capacity to exercise, reduced the severity of their symptoms, and improved lung function.