Around one in 10 Australians – 2.7 million people – suffer from asthma, a chronic condition involving inflammation and narrowing of the airways. This can cause breathing difficulties, wheezing, chest tightness and coughing.
Understandably, fear of triggering symptoms often leads to exercise avoidance. Some people avoid it due to a high symptom burden; others have exercise-induced asthma. Even people not in these categories live in fear of exacerbating symptoms, says Dr Sarah Valkenborghs from the University of Newcastle.
But this can be a catch-22. “With avoidance of sport and exercise comes de-conditioning,” says exercise physiologist Bridget Nash from Body Smart Health, adding that physical inactivity can also worsen symptoms. “For anyone with asthma, it is highly recommended to continue regular exercise to avoid this deconditioning cycle.”
All people with asthma should benefit from an exercise program when taking the right precautions, according to the Australian Association for Exercise and Sports Science. Some might even excel – about 7% of Olympians overall and 25% of Olympic swimmers have asthma.
Here are some general recommendations for taking the plunge – but it’s important to first consult with a health professional for individually tailored advice and an asthma management plan.
The move: diaphragmatic breathing
Most research on exercise for asthma has focused on aerobic activities. But Valkenborghs says increasing muscular strength will also deliver a multitude of benefits and is considered relatively safe. “The thing with strength training is you don’t increase your breathing that much at all.”
The most relevant study on strength training for asthma found that diaphragmatic breathing was as effective as aerobic exercise in improving lung function. This involved putting weights on the stomach and breathing deeply from the belly to lift the weight up and down.
“A lot of individuals with asthma take shallow breaths, using the muscles of the neck to expand the lungs rather than taking deep breaths using the diaphragm,” Nash says. She recommends the upper body strengthening exercises lat pulldown or row through to her clients to promote better and deeper breathing.
The class: yoga or pilates
Indoor classes may help avoid potential outdoor triggers such as cold air, pollution and pollen. Yoga or Pilates are good choices, according to Nash. “Slowing down and focusing on good-quality breathing will help make sure we are getting those deep, full breaths in,” she says. “As you start to feel more confident, you can start to incorporate with some moderate-intensity strength training to help with global strength and other co-morbidities.”
Aerobic exercise is highly recommended for improving asthma-related outcomes such as quality of life, asthma control, air flow, lung function and inflammation. When ready to move to more vigorous activities, Valkenborghs says spin and Hiit classes are a good option; or aqua aerobics, which would be ideal for people whose symptoms aren’t triggered by chlorine.
For any aerobic exercise, she says, a 10–15-minute warm-up with low to moderate activity can help prevent sudden irritation to the lungs.
The activity: walking
There are plenty of free activities, of course. Even walking is very beneficial, says Valkenborghs, especially for someone with asthma who wants to embark on an exercise program and is a bit deconditioned or unfit. “It’s low risk for inducing asthma and can prepare the muscles and bones for future high-intensity exercise.”
As physical activity and fitness levels improve, they can start increasing the intensity by progressing to low-level interval training with intermittent walking and jogging, and later building up to a continuous jog or run, stop, run, stop. Cycling is also a good option.
Swimming is ideal, especially at the beach for people triggered by chlorine. The air above the water contains virtually 100% humidity and in warm weather can provide minimal provocation to the lungs.
The hard pass: scuba diving
Scuba diving has long been a definite no-no for people with asthma, says Valkenborghs, although a small percentage of people with well-managed symptoms might get a doctor’s clearance.
Nash says make sure to have your Ventolin when trying a new activity, and seek professional advice on breathing techniques.