Asthma is a sneaky foe.
a professor of nursing at Columbia University and a spokesperson for the Asthma and Allergy Foundation of America.
But that doesn’t mean exercise should be avoided, she said.
Exercise, in fact, is one of the best ways to reduce asthma symptoms. Research over the past 2 decades has shown that physical activity can help improve lung function and boost quality of life for someone with asthma.
As their fitness improves, asthma patients report better sleep, reduced stress, improved weight control, and more days without symptoms. In some cases, they’re able to cut down their medication doses.
Exercise reduces inflammatory cytokines and increases anti-inflammatory cytokines, according to a 2023 review by researchers in the United Kingdom. That could help calm chronic airway inflammation, easing symptoms of asthma.
A few simple guidelines can help patients reap those benefits while staying safe.
Make sure the first steps aren’t the last steps
For someone who’s new to exercise, there’s only one way to begin: Carefully.
The Global Initiative for Asthma recommends twice-weekly cardio and strength training.
“You always start low and slow,” said Spencer Nadolsky, DO, a board-certified obesity and lipid specialist and medical director of Sequence, a comprehensive weight management program.
“Low” means light loads in the weight room. “Slow” means short, easy walks.
Many have been put “through the wringer” when starting out, discouraging them from continuing, Dr. Nadolsky said. “They were too sore, and it felt more like punishment.”
An even bigger concern is triggering an asthma attack. Patients should take steps to lower the risk by carrying their rescue inhalers and keeping up on medications, he added.
“A health care professional should be consulted” before the start of a new activity or ramping up a program, or anytime asthma interferes with a workout, Dr. George said.
Those who exercise outside need to be aware of the air quality, especially at a time when smoke and particulates from a wildfires in Canada can trigger asthma symptoms in people thousands of miles away.
The harder one works, the higher one’s “ventilation” – taking more air into the lungs, and potentially more allergens and pollutants.
Temperature and humidity also become risky at the extremes. Cold, dry air can dehydrate and constrict the airways, making it hard to breathe.
How to choose the best type of exercise
Step 1: Be realistic. People with asthma often have less exercise capacity than those who don’t – understandable when shortness of breath is the default setting.
Second, allow for plenty of time to warm up. A solid warm-up routine – particularly one with a mix of lower- and higher-intensity exercises – may help prevent exercise-induced bronchoconstriction causing shortness of breath and wheezing.
For example, warming up on a treadmill or exercise bike could be mixed with a few short bursts of faster running or cycling, with a couple of minutes of recovery at a slower pace in between.
That concept can be expanded into a full-blown workout.
High-intensity interval training (HIIT) is a promising option for people with asthma. A 2021 study showed that three 20-minute interval workouts per week significantly improved asthma control.
“The benefit of HIIT is that ventilation is able to recover intermittently,” said Carley O’Neill, PhD, an exercise scientist at Acadia University in Nova Scotia and the study’s lead author.
That’s a key difference from conventional cardio, where the constant exertion can evaporate water from the lungs faster than your body can replenish it. “Dehydrating of the airways can, in some, trigger exercise-induced asthma,” Dr. O’Neill said.
HIIT, conversely, allows the airways to recover and rehydrate between exercise bouts.
Another recent study found that people with asthma who did HIIT workouts had fewer breathing problems and felt less fatigued, compared with a matched group who did cardio training at a constant pace. (Both types of cardio led to similar improvements in aerobic fitness.)
Individuals can choose other types of intermittent exercise as well. Strength training, for example, requires relatively short periods of exertion, with plenty of rest in between.