Exercising With Asthma

From a reader:
As a fitness enthusiast, I read your column all the time. My query isn't about me but about my surrogate brother. He wants to lose weight but exercising is proving to be a challenge because he developed asthma or what appears to be an asthma-like condition. What exercises can you recommend for him? He used to train with weights in our home gym as well as use our non-motorized treadmill but lately, it's been hard for him. Thank you in advance for your help.

It sounds contradictory that something that is good for you can also be bad for you. If you have asthma, exercise is beneficial because it makes it easier to perform normal daily activities with less shortness of breath. However, exercise can also bring on an asthma attack known as "exercise-induced asthma" with the resultant chest tightness, wheezing and breathlessness. This can be both discouraging and confusing if you are an asthmatic and you want to get fit. Well, here's something to encourage you. The May issue of Sports Medicine Digest reports that at the summer Olympic games, 67 of the 597 U.S. athletes were diagnosed with exercise-induced asthma. These 67 athletes competed in 29 events and won 41 medals - including 15 gold medals!

Exercise-induced asthma.
Doctors used to think that "exercise-induced asthma" was a totally different kind of asthma. Now they believe it is just one aspect of the disease. In people with mild asthma, physical exertion may be the only thing that sets off an attack. For people with more severe asthma, exercise is one among the many other factors that can trigger an attack.

No single solution.
Asthma specialist Robert Lemanske, Jr., MD, of the University of Wisconsin stresses that there is no single solution for exercise-induced asthma. What works for one person may not work for another. He says that you cannot completely block the exercise-induced asthma response but you can lessen it so you can still reap the benefits of exercise.

Medication.
Many asthmatics can prevent their asthma attacks from happening during exercise by lengthening the warm-up period or lowering exercise intensity but others have no choice but to use short-acting inhaled medication minutes before exercise or long-term asthma medications. Your doctor is the best person who would know what kind of medication you need to be able to exercise comfortably and safely.

Choose your exercise carefully.
According to James Rimmer, Ph.D., in an article about exercising with disabilities (May IDEA Today), the activities known to cause the most problems for people with asthma are high-impact aerobics and start-stop activities, such as racquetball and basketball, which cause the breathing rate to increase rapidly. Rimmer says that anaerobic activities like weight lifting and stretching exercises are generally safe for most people with asthma.

Low to moderate intensity swimming is usually a recommended exercise activity because the warm moist air prevents the air passageways from drying out and triggering an attack.

Exercise guidelines.

  • Here are exercise guidelines from such organizations as the American Council on Exercise and the American College of Sports Medicine. Find out which tip works best for you.
  • A person with asthma should always consult their doctor before starting an exercise program.
  • You should have a bronchodilating inhaler with you at all times. This means it should be by your side and not inside your gym bag inside your locker. Use it at the first sign of wheezing.
  • Start exercising with a low intensity. Increase intensity gradually over a long period. The more intense the exercise, the more likely it is that you will get an asthma attack. I remember a teenage client who would continuously get asthma attacks while exercising because she insisted on using an eight-inch bench during step aerobics. After shifting to a six-inch bench, her attacks were more or less cut in half. We convinced her to switch to a four-inch bench and she never had another attack.
  • Reduce the intensity of your exercise immediately should asthma symptoms occur.
  • If you should have an asthma attack that is not relieved by your medication, immediately seek medical attention.
  • Using your inhaler a few minutes before starting exercise may reduce the possibility of an asthma attack while you exercise.
  • Drink plenty of fluids before and during exercise.
  • Interval-type of workouts may be better for people with a more severe type of asthma. Try doing intervals of one or two minutes of very low intensity exercise alternating with a rest period of 30 to 60 seconds. As you get fitter, lengthen the exercise periods gradually and shorten the rest periods.
  • Asthmatics need warm-up and cool-down periods that are longer than normal (longer than 10 minutes). Doctors believe that one of the reasons for exercise-induced asthma is the rapid loss of heat and moisture from the lungs. A longer warm-up period allows the air passageways to adapt gradually.
  • Be aware that you may experience more asthmatic symptoms when exercising during periods of high pollen count, heavy air pollution, and high or low temperature.
  • When exercising in cold weather, breathing through a scarf or mask may prevent asthma attacks because the mask helps keep inhaled air warm and moist.
  • Don't exercise during periods of active asthma attacks. Exercise only when your asthma is stabilized.
  • Rest as often as you want to if you start to experience breathing difficulties. Don't resume exercising until you are breathing normally.

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