Asthma is one of the most common chronic conditions in Australia. While traditionally, asthma is managed by education around avoiding flare-ups and certain prescription medications, exercise can play a significant role in helping manage the condition.
What is Asthma?
Asthma is a chronic disease that affects the airways. Once inflamed, the airways can become narrow leading people with asthma to experience symptoms such as wheezing, coughing, shortness of breath and difficulties in breathing.
There are different types of asthmas, based on what triggers a person's asthma and caused inflammation of the airways. You can find more information here.
Who gets Asthma and how common is it?
There are approximately 2.7 million Australians estimated to have asthma. That's 1 in 9 of us.
Although asthma can affect anyone at any age, research shows that in children under the age of 14, it is more common among boys than girls. Meanwhile, in adults aged over 25, it's more common in women than men.
How is Asthma managed?
Asthma is firstly managed by avoiding the specific triggers that lead to asthma symptoms. This could be anything from dust or pollen, to chemicals or perfumes. Each person with asthma will be aware of their specific trigger and should avoid being exposed to it as much as possible.
Secondly, a doctor may prescribe certain puffers to help manage a person's asthma. The puffers can be either preventers or relievers. A person with asthma should speak to their doctor about what is right for their asthma management.
If you don't have one, you speak to your doctor about your Asthma Action plan.
In terms of diet, there are certain foods which may be good for asthma management, including fruits (such as apples and bananas), leafy vegetables (especially those high in magnesium) and foods containing vitamins A and D. Whereas, foods which can lead to increased asthma symptoms include foods containing sulphites (such as wine and dried fruits), and processed foods containing artificial flavours and preservatives.
What's the role of exercise in asthma management?
Regular planned physical activity (aka exercise) can help people with asthma better manage their condition. There are 3 main benefits of exercise for people with Asthma:
Improved aerobic capacity – which means your heart and lungs become more efficient in their functions. You'll notice that as you improve your fitness, the same physical task (such as climbing stairs or carrying groceries) will feel much easier than before. And because your body is more efficient in the way it uses oxygen, it actually needs less of it to perform the same task. Which then means, you're less likely to have an exercise-induced attack.
Improved strength – this means you're able to lift heavier weights. This makes it much easier to lift the things you are lifting as part of your day to day routine, including the bag of groceries or a young child.
Reduced medication use (potentially) - Exercise may also reduce your need for medication. Exercise performed slowly and gently can induce a refractory period which prevents an asthma attack for a period of time subsequent to it. This means if you perform a thorough warm-up prior to exercise, you are less likely to suffer an attack during the exercise session.
What type of exercise is best for asthma?
In general, people with well-controlled asthma can safely participate in any type of exercise and physical activities such as walking, swimming, hiking or going to the gym. There are with a few exceptions to this (e.g. scuba diving). But as an exercise physiologist, I tend to focus mainly on two types of exercise: aerobic exercise to improve cardiovascular fitness and resistance/ strength training to improve strength.
How to exercise with asthma?
Prior to commencing any new exercise program, it is a good idea to speak to your doctor and exercise physiologist to make sure the program is safe for you. Also, make sure to follow your asthma action plan to further reduce any risk of unwanted flare-ups.
Warm-up – As mentioned before, a thorough warm-up can induce a refractory period which prevents an asthma attack during exercise. Start slowly with low impact and repetitive movements such as walking or bike riding. You may slowly increase the intensity and speed of the movements. Aim for at least 10 minutes for a thorough warm-up.
Aerobic exercise – After your warm-up, perform a simple aerobic exercise. This may be going for a gentle walk at a pace and duration that's comfortable for you or going for a bike ride. It's important to keep it at a low intensity which you can gauge by what we call the talk test. If you are feeling a little puffed but are able to hold a conversation, then you're at the right speed. You might also want to try swimming as a way of doing aerobic exercise. Swimming is low impact exercise which can help improve your breathing and lung capacity.
Resistance training – Resistance training is a great way to improve your strength. This can include bodyweight exercises like standing up and sitting down or doing push-ups. Or, you may perform certain exercises using dumbbells or resistance bands such as lifting, pushing or pulling. Aim to start with a few exercises as tolerated and begin with 10 repetitions and 2 sets for each exercise. You can slowly progress your program to include more and more strengthening exercises.
Cool-down and stretches – It's important to always end with a cool down. You can do this by performing the same routine as your warm-up. And you can further include some general stretches such as the seated hamstring stretch or the standing calf stretch.
When is it not safe to exercise with asthma?
Exercise is like medicine. While it has many benefits for people with Asthma, it's important to understand that a certain exercise may not always be suitable for you.
For those who have a peak flow meter at home, a value of less than 75% of your normal value suggests that exercise is not recommended. For those who don't have this, it's important to listen to your body. The biggest thing to remember, if you don't feel like exercising, don't exercise. If you're experiencing asthmatic symptoms and finding it hard to breathe, doing exercise will further increase your body's demand for oxygen which can lead to a drop in oxygen saturation levels in your blood.
Also, I often tell my clients that not having their puffer with them is a reason to not exercise. This is particularly important as exercise can induce an asthma attack which is managed using your reliever puffer.
If you're somebody living with well-controlled asthma, there is no reason why you cannot participate in regular physical activity and exercise. Doing regular exercise can help you to get fitter and stronger and even better manage your asthma. As long as you follow your asthma action plan, use your puffers as directed and take things slow when it comes to exercise, exercise is a safe and healthy way to manage your asthma.
If you're looking to speak to someone about getting started with exercise, you should find your local exercise physiologist and give them a call.
Start exercise - If you're someone living with asthma and have been avoiding exercise or physical activity due to the fear of worsening symptoms, you can rest easy knowing that the right exercise will not make your asthma worse. Start slowly and build your way up!
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Get in touch - If you have a specific question, or would like to go through these steps with a clinician, contact us.
ABOUT THE AUTHOR
Hassan Qureshi is the founder and owner of Holistic Exercise Physiology. He believes educating and communicating good science to the wider public is not only important but is the responsibility of every clinician. For this reason he started the Holistic blog.
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