Exercise is an important part of a healthy lifestyle; but sometimes, in those who suffer from asthma, exercise may present some challenges.
Exercise can often be a common trigger of asthma symptoms, especially in children. Asthmatics may tend to exercise less than they should; however, with proper management and control, having asthma should not stop your children from participating in sports or other physical activities.
Regular physical activity is one of the best things you can do for both your health and your overall well-being. As long as you and your physician are comfortable with your level of activity, nothing should keep you from doing the activities that keep you happy and healthy.
Why does exercise sometimes trigger symptoms in asthmatics?
One of the main reasons that exercise triggers asthma symptoms is the cool, dry air that is inhaled during exercise. Children tend to breathe quickly, shallowly and through the mouth when they exercise or play vigorously.
The air is actually warmed up when it passes through the nose, and when this process is skipped, cool, dry air reaches the lungs instead. This air causes narrowing of the airways in the lungs, blocking the airflow and making it harder for your child to breathe, thus producing asthma-like symptoms.
What are some of these symptoms?
Some of the obvious symptoms include wheezing, tightness/pain in the chest, coughing, and/or prolonged shortness of breath. The symptoms of exercise-induced asthma generally begin within five to 20 minutes after the start of exercise, or five to 10 minutes after brief exercise has stopped.
Some of the less obvious symptoms include fatigue, low energy levels, slight dizziness, and inability to run without stopping.
It is important to note that there's a difference between someone with exercise-induced asthma and someone who's generally out of shape. People who are overweight and not used to exercise can catch their breath within minutes, whereas it takes much longer for someone with exercise-induced asthma to recover.
Controlling asthma through medications
Your healthcare professional should have given you written information about the medications you are taking to manage your asthma. You should know each of the following about all of your medications.
- How much you should take.
- When, how often, and for how long you should take each medication.
- What each medication is supposed to do.
- Possible side effects.
- What you should do if your asthma medication makes you feel bad.
- When you should seek help.
- How to get help.
Should my asthmatic son be allowed to play any type of sport then?
Asthma should not be used as an excuse to avoid all types of physical activity. In fact, it is just as important for asthmatic children to get all the exercise that they need, as it is for other children. Successful asthma management would be able to prevent any asthmatic symptoms that may occur during exercise, such as cough or chest tightness.
There are also some kinds of exercises/sports that are better for asthmatics, including swimming; short-burst types of exercise, eg treadmill running, cycling, walking. These activities not only provide them with a good, year-round exercise option, but can also help relax the body and improve breathing techniques. Yoga exercises, for example, can help you child's lungs work better and enhance airflow during asthma attacks.
Are some kinds of exercise better than others?
Yes. Swimming in general is better than outdoor running. Generally, if the air breathed in is cold and dry, your asthma will be worse. The asthma will improve if the air is warm and moist instead. This explains why swimming generally causes less asthma than outdoor running.
Can my child still take part in endurance sports if he/she truly enjoys them?
It is possible for your child to take part in endurance sports if he/she truly enjoys them. Endurance sports such as cycling or long-distance running, as well as those that require extended energy output, for example, football, may be more challenging for asthmatic children.
However, with proper control and management of their asthma, i.e. taking preventive measures or precautions, children can participate in any sport without many complications.
Preventing an asthma attack
What are some of the preventive measures or precautions that can be taken to manage asthma attacks at all times?
In general, asthma may vary from mild to moderate, to severe. It is essential that you recognise which category your child falls into, but all asthmatics should follow a basic five-step treatment plan to avoid serious consequences/complications.
Step 1: Identify and control asthma triggers, eg allergens and irritants (pollen, dust mites).
Step 2: Anticipate and prevent asthma flare-ups.
Step 3: Take medications as prescribed.
Step 4: Control flare-ups by following your paediatrician's step-by-step plan.
Step 5: Learn more about asthma, new medications, and treatments.
How can you prevent your child from developing an asthma attack during exercise?
Besides ensuring that your child follows the preventive measures mentioned above, he/she could also take some precautions before playing any sport or exercising.
Warming up beforehand usually prevents the chest from tightening, and warm-ups could consist simply of five to 10 minutes of stretching. A prolonged period of low-level aerobic activity will help prepare your body for higher-intensity exercise.
Your child should also take rescue medicine as closely before starting as possible, and remember to always breathe through the nose.
Cooling down after any physical activity will help slow the change of air temperature in the lungs too. Extending your cool-down session can help prevent the asthma attacks that occur immediately following an exercise session. A warm bath or shower may also help.
Avoid exercising in polluted environments, or in cold or dry air. Pay attention to the air quality and temperature in the place you're planning to exercise.
In the event of an attack
What happens if your child suffers an attack during physical activity?
Using reliever medication would help in easing symptoms, and your child should be able to continue his sport. However, if the symptoms persist, please follow these useful tips:
> Stop what you're doing.
> Follow your specified asthma action plan. If you do not have a plan, take four separate puffs of your blue reliever medication. If appropriate, this medication is best taken one puff at a time via a spacer, with four breaths taken from the spacer after each puff of medication.
> Wait four minutes.
> Only return to exercise or activity if you are free of symptoms.
> If the symptoms do not go away, or if they return while he's exercising, use your blue reliever as before. Do not return to any exercise or activity for the rest of the day and see your doctor.
In short, most ailments and conditions, including asthma, usually do not stop an individual from practising a normal lifestyle. By controlling and managing the asthma well, your child should be able to do everything any child could do.
Also, parental influence can play a very important role in how your asthmatic child reacts towards physical activity. Encourage fitness and normal physical activity and don't let him feel afraid of pursuing the activities that he enjoys!
Dr Norzila Mohamed Zainudin is a consultant paediatrician and paediatric respiratory physician. This article is courtesy of Positive Parenting Asthma Campaign Programme by the Malaysian Paediatric Association and is supported by an educational grant from GlaxoSmithKline. The opinions expressed in the article are the view of the author. The information provided is for educational and communication purposes only and it should not be construed as personal medical advice. Information published in this article is not intended to replace, supplant or augment a consultation with a health professional regarding the reader's own medical care.