7 Tips to Overcome Asthma When You Exercise

If you’re an athlete with asthma, you don’t have to hold back. With proper medication and conditioning, you can participate fully in sports. But in colder months, you should take some special precautions because cold dry air can trigger asthma attacks.

You start your workout and begin to wheeze or cough, feel short of breath or a tightness in your chest, generally peaks within 10 to 15 minutes and resolves by 60 minutes. This happens if you have exercise-induced asthma because your airways are overly sensitive to temperature and humidity.

“Normally, our nasal passages warm and moisten the air we breathe,” says pulmonologist Nirosshan Thiruchelvam, MD. But he says during exercise, we tend to breathe through our mouths, so the air we inhale is colder and drier.

Playing ice hockey or winter sports compounds the problem. An asthma attack causes muscle bands in the airways to react to the cold with spasms, which narrows the airway and causes symptoms. Upper respiratory infections can make asthma worse.

How to relax the airways

Dr. Thiruchelvam says the primary goal is to ensure that you don’t avoid exercise. Here are some practical things you can do if you have exercise-induced asthma:

• Use asthma medications. A short-acting beta-2 agonist (such as albuterol) with two inhalations 15 to 20 minutes before exercise can prevent airway spasms for several hours. A long-acting bronchodilator will work for 12 hours, but generally not recommended as a monotherapy. Long-term inhaled anti-inflammatory medications may also be required to “quiet” the airways.
• Breathe through a scarf. During training or exercise, breathing through a scarf can help to pre-warm the air as you breathe harder.
• Avoid exercising outdoors in frigid temperatures. Find alternate exercise options inside, such as working out at a gym or swimming in an indoor pool.
• Wait until any colds or sickness subside before you exercise. Allow your body to fully recover before exercising, especially when you have a cough or any upper respiratory issues.
• Do 10-minute warm-ups and cool-downs. This can help your airways adjust and is a good habit to form for whenever you exercise.
• Consider playing sports that require short, intermittent bursts of energy. These include football, baseball, wrestling, gymnastics and track. They are easier on the airways than sports that require endurance, such as soccer, long-distance running and basketball.
• Try swimming. A warm, humid environment often makes swimming a good choice for people with exercise-induced asthma. However, sometimes irritants in the air, especially at indoor swimming pools, can aggravate asthma so pay attention to your symptoms. It is also reasonable to reduce chloramines in an indoor pool environment.

Gaining and maintaining good control over exercise-induced asthma often requires teamwork. A primary care sports medicine physician can help you keep your asthma well-controlled, so that exercise is less likely to trigger symptoms.