Exercise-Induced Asthma

It is normal to feel out of breath when you exercise, but some people find their asthma symptoms are particularly bad during or after their session. Often wheezing or breathlessness will get worse after the activity finishes, when ordinarily you would expect to feel more, not less, comfortable.

If this is you, there are two possible reasons: it could be that your asthma is poorly controlled and exercise just highlights the problem. Or if you are generally well, but exercise triggers asthma symptoms, then you may have exercise-induced asthma. For some people, exercise is just one of many triggers for their asthma, but for others it is the only time they get symptoms.

During exercise - when you are breathing harder and mostly through your mouth - the air that reaches your lungs is generally colder and drier than normal. This can irritate the airways and cause the tightening, inflammation and mucus secretion that are the basis of asthma symptoms. If you already have a cold or there are other triggers to irritate your airways (for example pollen or pollution), then symptoms might be particularly troublesome.

What can I do to tackle the problem?

There are a number of things you can do to eliminate or reduce asthma associated with exercise.

  • Firstly, take your blue (reliever) inhaler just before you start exercising. Make sure you have it with you when you exercise and take it again if you need to; then wait until you feel better before you start exercising again.
  • Always warm up and warm down thoroughly so that your airways are gradually, not suddenly, prepared for the change.
  • Be prepared to modify your exercise depending on your triggers. So for example you could avoid running on days with high pollen counts, if this is a trigger for you, or when the air is particularly cold, switching to indoor activities on these days might help. Or if pollution triggers symptoms for you, avoid exercising outside near busy roads.

For some people, exercise-induced asthma continues to be a problem despite taking these steps. If this is the case, you may need a different medicine, one that gives longer control over symptoms. You might be prescribed a different inhaler, a long-acting beta agonist (or LABA) or a tablet called montelukast which is taken daily. Speak to your regular doctor for further support in changing your medication if exercise continues to trigger your asthma.

What if my asthma bothers me at other times too?

Nearly everyone whose asthma is poorly controlled will feel worse on exercise. You are asking more of your airways, and if they are already tight and/or inflamed then you will inevitably feel worse. Review your overall control and take a look at your Personal Action Plan (PAP) for advice on what to do. You may need to increase your preventer (eg Clenil), review your inhaler technique and/or add in another inhaler. Your GP or practice nurse will be able to help with this.

Whatever the cause, don’t let asthma put you off exercising - it is important to keep physically active - and as long as you take steps to manage the problem then you should be able take part in whatever exercise you choose.