Exercising with Asthma
Asthma is one of the most common respiratory disorders. It affects about 22 million Americans. Asthma is a chronic inflammatory disorder of the airways. It causes episodes of difficulty breathing, wheezing, shortness of breath, chest tightness, and coughing. These episodes vary in severity and duration. Most occur at night and early morning.
For some people, aerobic exercise may trigger an asthma attack. They react by avoiding exercise. As a result, their fitness gets worse, and symptoms may occur with even lower levels of physical activity. Exercise can help control the frequency and severity of these asthma episodes, however. Through proper treatment and precautions, you can learn how to control your asthma as you become more active. With the right medicine, most people with asthma should be able to exercise with minimal problems or restrictions.
While the reasons are unclear, mounting evidence suggests obesity increases the risk for asthma. If you are overweight, becoming more active will help you lose body weight as well as help your asthma. The key is to choose activities that you enjoy. Making exercise a normal part of your life also can have a major positive impact on your overall health.
What types of activities are best? Try one of these (listed from the least to most likely to trigger an attack): swimming, walking, cycling, jogging, and running.
In general, high-intensity exercise will cause more problems than longer durations. Also, cold, dry air is more likely to trigger an attack than warm, moist air. So try to breathe through your nose at rest and during light exercise.
As you become more fit, you will be less breathless during the same amount of exercise. Research also indicates that exercise reduces airway swelling and lowers the severity and frequency of symptoms. This results in fewer emergency department visits and fewer symptoms of anxiety and depression. Overall, your quality of life will improve.
How much exercise do you need? The most health benefit comes when inactive people become moderately active. Try to work up to 150 minutes of brisk walking a week. Making exercise a regular part of your life can have a major impact on your health.
Just starting out? Begin with aerobic exercise. Over time, add resistance workouts. People with asthma on prolonged oral corticosteroid treatment may experience some muscle wasting. This causes reduced strength, especially in the lower limbs. If this is the case, then you may need to start with strength training. Despite which type you begin with, aim to do both. This will bring even more benefits for your overall health and fitness.
- Talk with your doctor before you start an exercise program. Ask about any changes to your medications or concerns in becoming more active.
- Take all medicines prescribed by your doctor. You might need short-acting bronchodilators to treat symptoms before and after exercise.
- If you are having symptoms, don’t exercise until they improve. You need normal airway function to exercise.
- If exercise aggravates your symptoms, stop immediately and contact your doctor. You may need more intensive medical treatment.
- Consider air quality when choosing outdoor exercise. If the Air Quality Index (AQI) is in the moderate to unhealthy range (> 50), consider indoor exercise.
- Plan to exercise when you’re least likely to have an attack. Mid- to late-morning often is best.
- Warm up and cool down to reduce possible symptoms.
- Make a long-term commitment to your program for improved health. It might take up to six weeks to get useful results.
- Adjust your workouts for variations in weather and changes in your symptoms. •
- Start slowly. Just 10 minutes of walking each day is enough.
- Take as many breaks as you need.
- Increase the intensity and duration of your workouts over time. Focus more on duration.
- Start by exercising on your own. Begin walking or another form of activity that you can integrate into your daily routine.
- Invite others to join you. Exercising together is more fun and increases the chance you will continue. Dogs also make great walking partners!
- Look for programs available in your community. Consider contacting an appropriately credentialed exercise professional* to help you. All you really need, though, is a good pair of shoes to get started walking.
- Use a pedometer or other activity tracker to monitor your progress. Slowly work toward a goal, like maybe 10,000 steps per day.
Aerobic Exercise Programs
The American College of Sports Medicine and the Centers for Disease Control and Prevention recommend at least 150 minutes per week of moderate-intensity aerobic activity, 75 minutes of vigorous aerobic activity, or a combination of both for adults. They also suggest twice-a-week muscle strengthening. Follow the FITT principle to design and implement a safe, effective, and enjoyable program. F = frequency, I = intensity, T = time, and T = type (Pescatello et al., 2013).
- Frequency – Be active on most days of the week but at least three to four days. Work up to five days a week.
- Intensity – Exercise at a moderate level. Use the “talk test” to help you monitor. For example, even though you may notice a slight rise in your heart rate and breathing, you should be able to carry on a conversation while walking at a moderate pace. As you walk faster, you will begin to breathe faster and have difficulty talking. At that point, you’ve achieved moderate intensity or “somewhat hard.” Vigorous exercise causes a large rise in heart rate and breathing. At this intensity it would become difficult to talk. Most people would rate this as “hard to very hard.”
- Time – Exercise 30-60 minutes per day. You can do it all at once or break it up into a few sessions of at least 10 minutes each.
- Type – Do rhythmic exercises using the large muscle groups. Try brisk walking, cycling, and swimming. Choose activities you enjoy and will do regularly in your new, more active lifestyle. Add variety depending on the day or the season to keep your program more enjoyable.
Aerobic Exercise Cautions
- Avoid exercising at the coldest times of the day (early morning or evening). Also, don’t exercise when pollution or allergens are at their highest. Instead, exercise indoors. Watch out for irritants such as smoke or allergens there, too.
- Warm up for 10 minutes before you exercise. This can reduce the duration and severity of an attack during and after exercise.
- Cool down for 10 minutes after your exercise.
- If you have been inactive for a long time, start with short sessions (10 to 15 minutes). Add five minutes to each session, increasing every two to four weeks. Gradually build up to being active at least 30 minutes a day for most days of the week.
- Drink plenty of fluids before, during, and after exercise.
- Don’t exercise at an intensity that is too high for you. Doing so might provoke an attack and temporarily prevent exercising. It also increases the risk of injury.
Resistance Exercise Programs
Evidence suggests that moderate-intensity resistance training also improves your ability to function and promotes good health. Follow the FITT principal when creating a resistance exercise program, too.
- Frequency – Do resistance training at least two days per week. Plan a day of rest between sessions.
- Intensity – Exercise at a moderate level. If you can lift a weight 10 to 15 times, you’ve achieved moderate intensity. You get to high intensity when you can lift a weight only eight to ten times. Remember, you aren’t training to be a weight lifter. Your goal is to improve your strength and muscle endurance so your daily activities will be less stressful.
- Time – This will depend on the number of exercises you do.
- Type – Exercise all major muscle groups using either free weights or a machine. There is no difference between the two methods. Don’t belong to a gym or health club? No problem. You can do the same exercises at home using lighter weights, resistance bands, or your body weight as the resistance, like push-ups or sit-ups.
Resistance Exercise Cautions
- Avoid holding your breath when lifting. This can cause large changes in blood pressure. That change may increase the risk of passing out or developing abnormal heart rhythms.
- If you have joint problems or other health problems, do only one set for all major muscle groups. Start with 10 to 15 repetitions. Build up to 15 to 20 repetitions before you add another set.
Design your exercise program for maximum benefit and minimum risk to your health and physical condition. Consider reaching out to an appropriately credentialed exercise professional* to work with you and your doctor. Together, you can establish realistic goals and design a safe, effective, and enjoyable program.
For more information, e-mail [email protected]
*A listing of exercise professionals can be found at www.usreps.org and EIM Credentialed professionals can be found through the ACSM ProFinder (http://bit.ly/1Mq6ldN).