Exercise

Exercising regularly makes you feel good and is great for your body in lots of ways;

helps the heart, bones and digestive system to stay healthy
keeps unwanted weight off
releases endorphins, making you feel happy and energised
reduces stress
helps you sleep

As we grow older, we need to keep using our bodies to get the best out of them. Staying active keeps our joints working, helps the speed of our reflexes and keeps us strong. Studies have shown that people who keep exercising through their middle years stay healthier than people who don't.

You don't have to spend hours in the gym to get fit. As fitness guru Rosemary Conley, who's had asthma all her life, says: 'Go gently at first, but even a five minute walk three times a day will make a real difference. Walk to the shops, use the stairs more, mow the lawn - anything!'

Being active can help your asthma

Eight out of ten people with asthma aren't doing enough exercise, often because they're worried it will trigger their symptoms. But actually exercise can help your asthma, so don't let it hold you back! If your condition is stopping you from exercising see your GP or asthma nurse. They'll be able to check your medicines and help you find ways to get more active.

Exercise can help you:

improve your lung capacity, which will help you to manage your asthma better when you exercise
cope better with everyday chores such as cleaning and shopping, as you'll have more stamina
worry less about your asthma, and give you the confidence to manage your condition.

Getting started

Before you exercise

If you're worried about starting to exercise, have a chat with your GP or asthma nurse first. They'll be able to help you find the best type of exercise for you. Get them to check that your asthma is under control (this means you should rarely have symptoms).
Your GP might refer you to a physiotherapist who can write you an exercise programme.
If you have asthma symptoms when you exercise (cough, wheeze, shortness of breath or a tight chest), your doctor may suggest you take one to two puffs of your reliever inhaler before starting the activity.
If you take preventer medicines, take them as prescribed by your doctor or nurse, even when you're feeling well.

When exercising

If exercise continues to trigger your asthma it probably means that your asthma isn't as well-cotrolled as it could be so see your doctor or asthma nurse as soon as possible to see if things can be improved.
Make sure anyone you're exercising with knows you have asthma, and knows what to do if you have an asthma attack. Carry an Asthma Attack Card , which shows the simple steps to take in an asthma attack.
Always have your reliever inhaler (usually blue) with you.
If you have asthma symptoms when you exercise, stop, take your reliever inhaler and wait five minutes for your symptoms to go before starting again.
Wait at least 90 minutes after eating before you exercise.
Take some water with you.
Wear suitable loose fitting clothing, such as jogging bottoms and a t-shirt.
If cold air triggers your asthma, don't exercise outside when it's really chilly.
If pollen is a trigger, don't exercise outside the when the pollen count is very high.

Tips on getting going

Gradually build up your exercise. If you haven't been exercising at all, start with trying to do 5 minutes a day, and when this becomes easy move up to 10 minutes, gradually building up to at least 30 minutes a day.
Always warm up before doing moderate to vigorous exercise and cool down afterwards. So over 15 minutes you might start at a slow walk, increasing to a regular pace, going up to a fast walk and then a jog. Then when you finish exercising, don't just suddenly stop but gradually cool down, slowly lowering your heart rate and blood pressure.
Try to include some stretches at the end to help with your flexibility and the range of movement in your joints.

What are the symptoms to look out for when you are active?

When you exercise it's normal for your heart to beat faster and your breathing to be quicker. If you're doing vigorous activity you'll feel out of breath, hot and sweaty.

Make sure you can tell the difference between feeling out of breath through exercising, which is normal, and the symptoms of asthma. Then you can stop and take your reliever if you need to. Ask your doctor or nurse about what symptoms to look out for.

Remember, exercise won't harm your lungs. When you feel short of breath, it's a sign that your body is working harder. If you control your breathing you'll be able to keep going for longer.

When exercising it's normal if:

you're breathing faster and harder
your heart is beating faster
you're feeling hot and sweaty
you're looking flushed.

Stop exercising if you:

start coughing/wheezing
are gasping for air/very short of breath/can't get enough air
feel tightness in the chest
have trouble speaking in short sentences
younger children may complain that their chest or tummy hurts.

You're having an asthma attack if any of these happen:

your reliever inhaler doesn't help
your symptoms are getting worse (cough, breathlessness, wheeze or tight chest)
you're too breathless to speak
cyanosis (a blue tinge on the skin or lips). This is a sign of lack of oxygen in the blood and means you need urgent medical attention.

Click here for information on what to do in an asthma attack

If exercise triggers your asthma

Exercise can be a trigger for asthma. This can happen to anybody with asthma: children or adults, people who play sports or elite athletes.

How does exercise trigger asthma?

It's not known exactly how exercise triggers asthma. When people exercise they breathe faster. This makes it more difficult for the nose and upper airways to warm up and add moisture to the air breathed in, so the air is drier and colder than usual. It's thought that this cold, dry air in the airways triggers the symptoms of asthma.

Managing exercise-triggered asthma

Asthma shouldn't stop you doing any type of exercise as long as you:

see your doctor regularly
keep your asthma well controlled
take the right medicine
slowly build up the amount of exercise you do and the level of intensity, starting with gentle exercise before trying more vigourous activities.

Factors that may trigger asthma when exercising include:

continuous physical activity
long distance and cross country running (as this often talks place outside in cold air and without breaks)
high intensity exercise
low physical fitness
cold, dry air
recent respiratory infection
some adventure sports or outdoor activities may bring on asthma symptoms. This is more likely to be related to emotional or environmental factors associated with the activity, e.g. excitement, anxiety, stress, weather, pollen count, altitude.
fitness tests
dusty equipment
chlorine in swimming pools.

Activities less likely to trigger asthma

Activities that require short bursts of energy alternated with slower paced exercise are less likely to trigger asthma. These include:

team games such as football, hockey, netball and volleyball

badminton or table tennis, as they are slower than tennis or squash

field games, like cricket or rounders
swimming, as the warm humid air is less likely to trigger asthma, but chlorine used in pools or cold pools may be a trigger for some people
yoga, Pilates or t'ai chi, provide a workout for both your body and mind. Postures are performed in harmony with breathing techniques. Some people find that breathing techniques are helpful for their asthma. However, don't stop taking your normal asthma medicines unless your doctor or asthma nurse advises you to.
low-moderate intensity exercise, e.g. walking, cycling, yoga.

Asthma that only comes on with exercise

Some people find that they have symtoms of asthma only when they exercise and not at any other time. This is unusual and affects only a small number of people. It is sometimes called exercise-induced asthma.

What would the symptoms be?

The symptoms are the same and include coughing, wheezing, chest tightness and difficulty in breathing. Symptoms usually begin after exercise and worsen about 15 minutes after exercise stops.

If you think you have asthma that comes on only when you exercise let your GP or asthma nurse know. To help you manage your asthma they may ask you to record some peak flow readings during and after exercise.

Asthma brought on by exercise is still treated the same, usually with preventer and reliever inhalers. The good news is that many top athletes have asthma and are still able to complete at a very high level.

Adult

How much physical activity should I do?

If your asthma is under control, and you rarely have any symptoms, you should be able to do any sport or exercise you enjoy.

Try to be active every day. If you spend half an hour a day doing moderate exercise, over the week you'll reach the recommended amount of two and half hours. If you're doing more vigorous activities, aim for 75 minutes a week (such as two classes of high intensity circuits or aerobics).

Try to also do at least two sessions of muscle-strengthening activities a week. Remember these can be things around the house like gardening, or using weights.

If this sounds like a bit too much for you, you can break it down into 10-minute blocks, so you might do a brisk 10-minute walk to work, 10 minutes at lunch time and 10 minutes back home in the evening.

I don't have time to exercise

If time is an issue, try to incorporate some physical activity into your daily life by doing things that increase your heart rate. You could try:

walking briskly - try to get out in your lunch hour, avoid using the car for short journeys or get off the bus a few stops earlier
gardening - digging, mowing the lawn
taking the dog for a walk (if dogs don't trigger your asthma)
playing in the garden or park with your children/grandchildren
climbing the stairs instead of taking the lift or escalator
vacuuming

Even light activity is better for you than none at all. So try to spend a bit more of your time getting active and a bit less sitting watching TV, reading or listening to music.

Starting an exercise programme

Think about what kinds of exercise you like doing, as there's no point starting an activity you don't enjoy. Ask yourself:

What have I enjoyed in the past?
What do I do at the moment that I enjoy?
Would I prefer a group activity or to exercise alone? Finding an exercise buddy might help you with motivation.
What time of day would be best? When do I feel like I have the energy? When can I fit it in? Try to make it part of your regular routine, so it becomes a habit.
What do I want to achieve? Setting a goal gives you something to work towards. Keep an exercise diary to track your progress and see what you've achieved.

Children and Young People

Evidence shows that exercise is good for everyone, including children and young people with asthma. Don't let asthma hold you back - speak to your GP or asthma nurse if you're finding physical activities difficult.

How much exercise should I do?

Try to do at least an hour of exercise every day, which should be a mix of moderate-intensity aerobic activity, such as fast walking, and vigorous-intensity aerobic activity, such as running.

On three days a week, these activities should involve muscle-strengthening activities, such as gymnastics, rope climbing, sit-ups, climbing frames, and bone-strengthening activities, such as running. Many vigorous-intensity aerobic activities do both muscle and bone strengthening. These include running, skipping, gymnastics, martial arts and football.

Information for parents

How can I support my child to be more active?

Asthma shouldn't stop your child from living an active life. Many successful athletes have asthma, such as Paula Radcliffe and David Beckham. If your child finds one activity difficult, try another one. If you try lots of different things you can find out what activity they like best and what they can cope with. This will also help your child learn about their asthma, what triggers it and how to manage it.

You could try being active as a family. If exercising is fun and feels safe your child will enjoy it more and feel more confident about having an active life.

What activities should they do?

Find activities your child enjoys. The best activities for people with asthma are those that are in short bursts of intense activity followed by less intense activity such as: rollerblading, skateboarding, football, hockey, netball, volleyball, badminton, short tennis, tag, gymnastics, swimming.

PE/school

To get the most out of school, your child should be able to take part fully. Encourage them to get involved in PE and after school clubs, but at their own pace and within their own limitations.

Tell teachers your child has asthma, so that they understand the condition and how to manage it. They can help your child to remember to warm up and cool down, as well as to have their reliever inhalers when they play sport.
At school your child needs to keep their inhaler with them or close to hand at all times. If they're too young to keep their inhaler on them, it should be kept within easy reach.
Make sure they take their medicines as prescribed and attend their asthma reviews with their GP or asthma nurse.
Get your child an asthma action plan and ask their asthma nurse to help you fill it in, so they can learn to manage their own condition.
Complete an asthma school card this provides information for your child's school on their triggers and symptoms, and what to do in an asthma attack.
Tell the school about any recent asthma attacks or if anything has changed. Make sure your child's asthma action plan or school asthma card is up to date.
Ask about the school's asthma policy (or medical conditions policy). Find out where they store the inhalers, and what training staff have received on how to help a child with asthma symptoms. Ask the school to inform you of any times when your child has asthma symptoms and needs to use their reliever inhaler.

What else can I do to encourage my child to be more active?

Encourage your child to be physically active throughout the day, not just by playing sports, but through playing outside with friends, games such as tag, dancing or roller skating are great exercise!
Help your child to find out what exercise they can do and what they like. It's no good trying to get them to do a sport they hate or are not very good at.
Make activities fun - if they do them with their friends they'll enjoy them more.
Encourage your child to spend less time sitting down (watching TV or playing computer games).
If possible, get your child to walk or cycle to school or the shops.
Praise and reward them for being active. Be positive about their achievements.
Above all, remember that exercise should also be fun - for your child and for you!

Exercise-induced asthma

Exercise is a common trigger for asthma. It can affect anybody with asthma – children or adults, recreational sports players or elite athletes.

What are the symptoms of exercise-induced asthma?

Symptoms include coughing, wheezing, chest tightness and difficulty in breathing. Symptoms usually begin after exercise and worsen about 15 minutes after exercise stops. Research shows that if exercise is attempted again within three hours the symptoms are less severe.

Why can exercise trigger asthma?

It is not known exactly how exercise triggers asthma. When people exercise they breathe faster. This makes it more difficult for the nose and upper airways to warm and add moisture to the air breathed in, resulting in the air being drier and colder than usual. It is thought that this cold, dry air in the airways triggers the symptoms of exercise-induced asthma.

Diagnosing exercise-induced asthma

To help to diagnose exercise-induced asthma, your doctor may ask about your medical history and take peak flow tests. If the diagnosis is difficult to make or symptoms are having a large impact on life, other breathing tests performed in a hospital may be recommended, including an exercise test.

Managing exercise-induced asthma

Certain types of sport are more likely to trigger asthma:

Long-distance or cross-country running are particularly strong triggers because they are undertaken outside in cold air without short breaks.
Team sports such as football or hockey are less likely to cause asthma symptoms as they are played in brief bursts with short breaks in between.
Swimming is an excellent form of exercise for people with asthma. The warm humid air in the swimming pool is less likely to trigger symptoms of asthma.

However, swimming in cold water or heavily chlorinated pools may trigger asthma.

Yoga is a good type of exercise for people with asthma as it relaxes the body and may help with breathing.

Asthma should not stop you doing any type of exercise as long as you:

consult your doctor regularly
keep your asthma well controlled
take the correct medicine
work up to your sport gradually.

There are several steps that can be taken to help to reduce the symptoms of exercise-induced asthma. These should be used with any prescribed medicines.

Warm up and down.
Avoid the cold air. It may help to cover the nose and mouth with a scarf in the cold.
Stay fit. Good aerobic fitness can help to reduce exercise-induced asthma

Special situations

At school

Full participation in PE and sport at school should be possible for all but the children most severely affected by asthma. Make sure that your child’s teacher knows they have asthma. Teachers can help children to remember to warm up, warm down and bring their reliever inhalers with them when they play sport.

Competitive sport

None of the inhaled medicines commonly used for managing asthma are banned in competitive sports. However, their use may be restricted. If you play sport competitively you have to inform your sport’s governing body about any asthma medicines you are taking and register them. They will also be able to provide you with details on which substances are banned.

Adventure sports

People with asthma may need to take special care when doing adventure sports. It is important that you contact your doctor before undertaking these activities. Always tell the instructor you have asthma and ensure that your reliever is easily accessible. You should mention your asthma on medical insurance, fitness declaration and medical waiver forms.

Scuba-diving

In recent years medical opinion has recognised that people with controlled asthma symptoms can take part in scuba-diving. However, if you have asthma you may have greater problems when scuba-diving because of the triggers to which you are exposed when you dive (cold air, exercise, stress, emotion).

Regulations on scuba-diving by people with asthma vary between countries. It is important that you check the regulations of a particular country before you plan to dive, as some do not allow anyone with asthma to scuba-dive. The British Sub-Aqua Club suggests that those with mild, controlled asthma may dive provided that:

you do not have asthma that is triggered by cold, exercise, stress or emotion
your asthma is well controlled
you have not needed to use a reliever inhaler or had any asthma symptoms in the previous 48 hours
your peak flow must be within 10% of your best value for at least 48 hours before diving.

You may also be asked to undertake an exercise test.

Football & Asthma

This factfile is to help you support children and young people with asthma to help them achieve their full potential. Many coaches and youth club organisers are concerned about working with children with asthma as they are worried about the effects of asthma medicines and the risk of an asthma attack. By following these simple steps you will enable any child with asthma to participate as much as they are able and give them the confidence that they are being looked after by an informed professional.

The main worry for children and young people with asthma playing football is the effect of cold air as this may cause the muscles around the airways to tighten, making breathing more difficult. To minimise the effect of cold air ensure that everyone is warmed up thoroughly and that they have taken their inhaler beforehand.

Top tips to manage your asthma while playing football

If football makes a child’s asthma worse always ensure that they use their reliever inhaler (usually blue) immediately before they warm up.
Always start your session with warm up exercises.
Try to avoid the things that trigger their asthma (eg, smoke, pollen).
Ensure that the child always has their reliever (blue) inhaler with them.
If they have asthma symptoms when they are playing, ensure they stop, take their reliever inhaler and wait five minutes or until they feel better before starting again.
If a child has to sit out for five minutes try to involve them as much as possible for example by getting them to take notes on the match or training or getting them to do some ball work (if they are feeling well enough to do so).
Always end your session with warm down exercises.
Make sure you know which children have asthma.
Ensure the children all have an asthma attack card with them. This is especially important while playing football and is a reminder for the child and those around them about what to do if they are experiencing severe asthma symptoms.

Swimming & asthma

This factfile is for you to help you support children and young people with asthma to help them achieve their full potential. Many coaches and youth club organizers are concerned about working with children with asthma as they are worried about the effects of asthma medicines and the risk of an asthma attack. By following these simple steps you will enable any child with asthma to participate as much as they are able and give them the confidence that they are being looked after by an informed professional.

Swimming is usually an excellent form of exercise for children and young people with asthma. The warm humid air in the pool is less likely to trigger symptoms of asthma. However, this is not the case for everyone and chlorine and swimming in cold water can trigger some people’s asthma. To minimise the effect of cold air ensure that everyone is warmed up thoroughly and that they have taken their inhaler beforehand.

Top tips to manage your asthma while swimming

If swimming makes a child’s asthma worse always ensure that they use their reliever (blue) inhaler immediately before they warm up.
Always start your session with warm up exercises.
Try to avoid the things that trigger their asthma before swimming (eg, smoke, pollen).
Ensure that the child always has their reliever (blue) inhaler with them by the side of the pool.
If they have asthma symptoms when they are swimming, ensure they stop, take their reliever inhaler and wait five minutes or until they feel better before starting again.
If a child has to sit out for five minutes try to involve them as much as possible for example by getting them to call encouragement, be in charge of a stopwatch or to look at other people’s techniques and take notes (if they are feeling well enough to do so).
Always end your session with warm down exercises.
Make sure you know which children have asthma.
Ensure the children all have an asthma attack card with them by the pool. This is especially important while swimming and is a reminder for the child and those around them about what to do if they are experiencing severe asthma symptoms.

What to do in an asthma attack

Give the child their reliever inhaler (usually blue), immediately
Encourage the child to sit up and ensure that any tight clothing is loosened
If there is no immediate improvement during an attack, continue to give the child one puff of their reliever inhaler every minute for five minutes or until symptoms improve. If their symptoms do not improve in five minutes – or if you are in doubt – call 999 or a doctor urgently. The child should continue to take one puff of reliever every minute until help arrives.

If a child is having any problems during a swimming session always let their parents know as they may need to visit their doctor or asthma nurse for an asthma review.

You are here