For anyone who’s been diagnosed with asthma, exercising might seem risky. The condition, according to sports and exercise medicine consultant Dr Rebecca Robinson, is a chronic ‘inflammatory condition that affects the lungs’ airways and can make you feel like your chest is tightening or you’re short of breath’.
Exercise can be a symptom trigger since ‘you breathe in colder and drier air than normal as you tend to breathe through your mouth rather than your nose during exercise, while your nose warms up the air we breathe in’. This cold, dry air ‘causes your airways to get even narrower’ which is what sets your symptoms off. You’re also more exposed to other asthma triggers like pollution, pollen and dust during exercise. Not fun.
What’s more, while the causes of asthma are unknown, some of you might suffer with exercise-induced asthma, better known as ‘exercised-induced bronchoconstriction (EIB)’. This is when your airways get tighter with strenuous exercise.
All in all, whether you’ve got asthma or EIB, it’s understandable if you’re hesitant to exercise – several studies have shown this is the case for many - but that could be where you’re going wrong. Research proves that exercise could actually improve asthma symptoms.
The most recent was published in 2021 by the University of East Anglia. Upon reviewing 25 different studies on exercise for asthma, it showed that ‘interventions designed to promote physical activity in adults with asthma, such as exercising in group sessions and setting goals, helped decrease asthma symptoms and improve quality of life’. Plus, three-time London marathon winner Paula Radcliffe has EIB - if that’s not proof asthma shouldn’t stop you from exercising, we don’t know what is. Here’s everything you need to know about how to exercise with asthma, safely.
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How can exercise help asthma?
To caveat, while exercise could contribute to easing asthma symptoms, this should complement any asthma medication or inhalers you may have been advised to use by a GP or healthcare professional. Once that’s under wraps, Dr Robinson cites several ways that exercise can help asthma.
- It improves lung capacity. ‘Your lungs will get used to consuming oxygen, so your body won’t have to work so hard to regulate your breathing during exercise.’
- It increases endurance. ‘Your airways will build up a tolerance to the exertion from exercise, so it won’t seem so hard over time.’
- It reduces inflammation. ‘Exercise reduces inflammatory proteins in your airways, so your lungs won’t feel so tight during exercise.’
- It strengthens your muscles. ‘You won’t feel so tired during workouts as you build strength, so your breathing won’t be so heavy.’
- It supports your immune system. According to Asthma UK, colds and viruses are a trigger for over 80% of people with asthma, and a solid immune system will help prevent this.
- It releases feel good chemicals in your brain. Studies show that stress can trigger asthma since it activates the parasympathetic nervous system, which leads to an inflammatory response in the body. Serotonin and dopamine from exercise can counteract this.
What are the best forms of exercise for asthma?
A review in the Strength and Conditioning Journal looked at the benefits of various different types of exercise for asthma, including resistance training. It found that people with asthma or EIB reacted to resistance training in the same way that non-asthmatics did, without any complications, providing you stick to low weights and high reps, training two or three times per week.
The weights or resistance level should equate to a five or six out of 10 for perceived exertion, and you should look to do two or four sets of 10-15 reps per set of exercises, with three-four minutes of rest between sets. The biggest reward you'll reap by doing this is muscle strengthening. In turn, you won't find exercise as strenuous after a while, so your lungs won't work so hard and you won't feel so breathless or tight in the chest.
Walking is underrated. Fact. One study found that adults who by walking just three times a week for 12 weeks had better asthma control and fitness levels than those who didn’t, since it improves lung capacity. They walked for 30 minutes at a time with a 5-minute warm up and cool down, and the walks were a moderate to brisk intensity – aim to stay at 60-75% of your max heart-rate.
Dr Robinson is a big proponent of yoga for asthma since it helps to teach you to control your breathing. In fact, a study published in 2016 proved so. Combining the results of 15 trials from around the world involving more than 1,000 asthma sufferers, it showed that the breathing exercises and postures in yoga relax the muscles in the airways and help to expand the chest. The calming effects of yoga may also reduce the chance of asthma attack. Go figure.
You’re not alone if you think doing HIIT with asthma is the last thing you should do, but last year, a study showed that it could actually be more effective for improving dyspnea in asthmatics (the level of chest tightness and difficulty of breathing), than continuous training (training without intervals, like a 30-minute cycle), since HIIT forces your lungs to work overtime and improve capacity, while allowing them to recover with each rest interval. Over 12 weeks, 32 asthmatics – split into a group who did continuous training and a group who did HIIT – did two 40-minute sessions of each type per week. When the 12 weeks were up, the HIIT group showed an improvement in asthma clinical control and dyspnea, while the continuous group didn’t.
Dr Robinson explains that swimming is often more tolerable by those with asthma as it promotes good breathing control as you settle into a rhythm with each stroke, and because you’re breathing in humid and warm air. The horizontal position means that any mucus that may have accumulated at the bottom of your lungs that could be exacerbating symptoms might also loosen.
Disclaimer: Dr Robinson warns that chlorine from swimming pools could be a trigger, since it may irritate your airways. If you’re not a regular swimmer, try a 10-minute swim and see how you go.
Types of exercise you might want to avoid with asthma
Before we go any further, know that these are simply exercise forms that may pose more of a health risk than others for asthmatics, but if you’ve got your asthma under control, they may well be totally fine.
Dr Robinson tells us that ‘the pressure from swimming underwater in scuba diving may cause your airways to narrow further, so it would be wise to seek medical advice before attempting it if you have asthma’. One study in 2016 showed this to be particularly true for those with EIB, emotion or cold-induced asthma, all of which are factors in play with scuba diving.
How regularly should you exercise with asthma?
According to Professional Andrew Wilson, who led the research published by the University of East Anglia this year, 150 minutes is the goal.
He said: ‘Being physically active is widely recommended for people with asthma. Doing more than 150 minutes a week of moderate to vigorous physical activity has extensive benefits including improved lung function and asthma control.’
Dr Robinson adds that three-five days of workouts would be a good split, with 30-50 minutes per workout to make a total of 150.
Tips for exercising with asthma
There are a few general pointers to keep in mind, too. Take note.
The Strength and Conditioning Journal’s review found that warming up and cooling down for 10-15 minutes each, rather than suddenly stopping or starting exercise, means your airways will gradually rewarm and you’ll be less likely to exacerbate any symptoms.
When starting out, exercise indoors to avoid any potential environmental triggers such as pollen or pollution. Then, once you feel confident enough and you’ve strengthened your lungs over time, you can try an outdoor workout.
Dr Robinson explains: ‘It might be that suddenly breathing in cold air, not having good breathing control or not using the right medication could be the main issue. Once you’ve identified this, you’ll be able to exercise more regularly and efficiently, without any setbacks.’
‘Remember that feeling breathless can make you even more anxious,’ says Dr Robinson. ‘So slow down, focus on each breath and take control.’ And always take breaks – continuous exercise could be too hard on your lungs.
When to avoid exercise with asthma
Dr Robinson says you should always seek medical advice before implementing any form of exercise if:
- You’ve had a recent asthma attack
- You’ve had a recent respiratory infection
- You have brittle or severe asthma
You can find more information on exercise for asthma via Asthma UK.
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