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13 September 2001

Asthma and exercise

Exercise-induced-asthma (EIA) usually occurs after about six to ten minutes of exercise and may interfere with the continuation of the sport. But this shouldn’t stop your child from being physically active.

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In many asthmatics, particularly children, breathlessness and wheezing is brought on by exercise. This is referred to as exercise-induced-asthma (EIA).

EIA usually occurs after about six to ten minutes of exercise and may interfere with the continuation of the sport. But this shouldn’t stop your child from being physically active. Asthmatic children should be encouraged to join in for their general good health, although they may need to use a bronchodilator before exercise.

No one is certain why exercise sets off asthma, although experts believe asthmatics wheeze when they exercise because faster, deeper breathing dries out the airways and triggers a spasm. Breathing through the nose instead of the mouth causes less wheezing. Exercising in cold, dry weather is more like to cause wheezing, while swimming is especially good for asthmatics because the air in swimming pools is warm and damp.

We answer some common questions
What can I do to improve my exercise tolerance?
Use the recommended medication to help prevent chest tightness. Stay active. The fitter you are, the better you’ll be able to manage your asthma.

I’m asthmatic but I want to start exercising. Where should I start?
Consult your physician before embarking on any exercise programme. Choose an asthma-friendly sport, start out slowly, take your time getting fit and include your friends. This will help prevent injuries and will keep up your enthusiasm for the activity.

My child has asthma. What exercise do you recommend?
Encourage your child to swim or, if you don’t have access to a pool, short burst types of exercise, like sprinting, are better than cross-country or long distance running. As an adult asthmatic, take up sports that are mildly aerobic such as walking, golf, bowls and swimming.

What do I do once exercise-related coughing or wheezing has started?
Use a reliever bronchodilator. Sodium cromoglycate, theophyllines and inhaled steroids won’t relieve symptoms once they’ve started.

Asthma friendly sports
Asthma-friendly sports fulfill a number of requirements. When weighing up which sport to begin ask the following questions:

When participating in this sport are you able to control your breathing rate and depth?
Can you breath through your nose?
Does it promote coughing, air trapping, or airway drying?
Are you able to rest and drink fluid whenever you need to?
Does it include a mixture of short high-energy bursts with low energy endurance activities?
Does it involve other people who are able to watch out for your safety?

Swimming is the most asthma-friendly sport of all but other sports include:

  • cycling;
  • canoeing;
  • fishing;
  • sailing;
  • walking.

What about scuba diving?
Traditionally it’s been an absolute no-no for asthmatics to even consider scuba diving. But at a recent Undersea and Hyperbaric Medical Society Workshop, it was decided that asthma should no longer be considered the absolute contradiction to diving that it was previously thought to be.

If your asthma is well controlled, exploring the deep blue may become a reality. However there are some asthmatics who would be at too great a risk to consider diving. These include:

  • Exercise or cold-induced asthmatics;
  • Asthmatics requiring chronic medication;
  • Mild to moderate asthmatics with normal screening spirometry can be considered if FEVI/FVC ration is above 85% of predicted;
  • Although you may be excited about exploring the ocean depths, use your common sense. To safeguard you and your diving buddies’ safety, if you’ve had an attack, don’t dive until your airway function has returned to normal.

Did you know?
A study of the 1984 American Olympic team proved that with proper management, asthma need not hinder peak performance in mature athletes: The 67 Olympians with EIA – 11 % of the team – won 41 medals, 15 of them gold.

Peak performance
If you suffer from exercise-induced-asthma (EIA), using a metered dose inhaler will help you stay on top form.

To get the most out of your medication, however, you need to maximise the amount of medication that gets deep into your lungs. Contrary to popular perception, this means holding the inhaler opening a couple of centimetres away from your month and not closing your lips around the mouthpiece. This will allow bigger drops from the inhaler to break up into smaller drops that are more likely to penetrate the narrow branches of your lungs.

Press down on the inhaler to release a puff as you start to breathe in slowly. Inhale the medication for three to five seconds, then hold your breath for up to ten seconds.

As an alternative, use a spacer device – a small plastic container, which make the asthma pump easier for babies and children to use. Ask your doctor how to use your inhaler correctly and make sure you know how often you should use the medication.

 
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