Asthma is a lung disease that affects more than 19.2 million Americans adults every year, and comes with often debilitating symptoms of bronchial constriction, shortness of breath, chest tightness, wheezing and coughing. (1) Some asthmatics may avoid exercising for fear of worsening symptoms, but studies show that people with asthma have better health outcomes and improved symptoms if they exercise. (2) Here we explore the best forms of exercise for those with asthma and offer some safety tips on how to exercise safely with asthma.
Best Exercise for Asthmatics
The best exercise for asthmatics will differ depending on the severity of the disease and the ability to control triggers. However, the following may be supportive of asthma, with some caveats:
- Swimming: Studies show that exercise in water tends to induce less restrictive bronchoconstriction than other exercises for asthmatics. (3) This may have to do with the high degree of moisture in the air and the horizontal posture of the body while swimming. Chlorinated pools can, however, aggravate some asthmatics, and the “diving reflex" may trigger a bronchoconstriction in some asthmatics. (4) Each asthmatic should consult with their doctor or care team to determine if swimming is right for them.
- Walking, yoga, and biking: While there are not many individual studies on all forms of exercise related to asthma, a 2012 study in the Journal of Complementary and Alternative Medicine (5) found that yoga improved quality of life in women with mild-to-moderate asthma, decreasing parasympathetic responses. Other possible forms of exercise for asthmatics include biking—and stationary bikes may be a good solution for those who prefer to exercise indoors—and walking, so long as allergic triggers are under control. (6)
- Sports: In general, research suggests that medium-risk sports are best for asthmatics, those with a short duration of physical effort, and lower levels of ventilation. They recommend team sports. (7)
Recognizing and Avoiding Triggers
In order to exercise safely, asthmatics can learn to identify and manage their asthma triggers, and either modify their behavior so as not to exercise during trigger conditions, or medicate appropriately before and after such exercise. Common triggers include:
- allergen load
- extreme cold air
- exposure to chemicals (including chlorine)
- strenuous exercise too close to a recent viral respiratory tract infection (8)
Once an asthmatic knows their triggers, the American Lung Association recommends some strategies to gain the benefits of exercising without triggering symptoms, which include: (8)
- Warm up before exercise and cool down after
- Breathe through the nose
- Avoid exercising in extreme weather and high pollen counts or cover your nose when doing so
- Carry a rescue inhaler
Exercise Induced Asthma
In general, exercise is good for asthmatics, however, there is a condition known as exercise-induced asthma (EIA), resulting from exercise, which can happen to anyone, even those who don't have asthma. Its symptoms of bronchoconstriction, coughing, wheezing and chest tightness, mimic the symptoms of traditional asthma. (7)
Research finds that EIA may be caused when air cools in the airways after warming up from exercise, which triggers a parasympathetic nerve stimulation that causes bronchoconstriction through the vagal nerve. (7) Whether one only has EIA or experiences existing asthma symptoms during exercise, most cases can be managed with medications to allow for people to exercise regularly. (7)
Overall, people with asthma should not feel that they have to give up exercise, but rather speak with their health care provider to come up with a plan for the right kind of exercise, under the right conditions, for them.