“I re-learnt how to exercise safely after my adult asthma diagnosis“

With 1 in 12 people in the UK being treated for asthma, it’s clear that loads of us need to find a way to move while protecting our respiratory health. Writer Orla McAndrew explores the anxieties around exercising with asthma and how to overcome them.

Not everyone who has asthma has lived with it since childhood. I didn’t – my diagnosis came at the beginning of the pandemic, just as the noise about a dangerous new respiratory disease was reaching a crescendo. In that new reality, I found myself joining the 5.4 million people in the UK who live with asthma.

Like so many people at the time, I wanted to move and exercise safely but was confronted with the fact that I now had extra precautions to take. How are you supposed to exercise safely when you have asthma, particularly when you’re still getting to grips with the condition? Rather than go it alone, I roped in personal trainers and healthcare professionals to help find a strategy for getting stronger with asthma.

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While researching the best ways to exercise with asthma, I realised that I didn’t have the best understanding of what asthma actually is. So, I spoke to Dr Andy Whittamore, a GP and lead clinician for Asthma UK and the British Lung Foundation who explained that: “Asthma is caused by an inflammation in the airways that can come and go. When it’s there, it causes symptoms such as coughing, restlessness, wheezing, feeling tightness in the chest.” He also noted that every person has different triggers for their asthma; allergies such as pollen or pet hair can cause a reaction, while others may find that hormonal changes spark flare-ups.

A similar-but-different condition is “exercise-induced bronchoconstriction”. This is where the airways tighten and become narrower in response to exercise alone. Dr Lafina Diamandis, GP, lifestyle doctor and founder of Deia Health, explains that while asthma is a chronic condition that can be set off by several different triggers, exercise-induced bronchoconstriction has been observed in both asthmatics and non-asthmatics. The two share almost identical symptoms but may be treated differently so it’s important to get diagnosed. If you find that vigorous exercise leaves you struggling to breathe, it’s important to get checked out so that you’re able to receive the proper treatment.

Why is exercise challenging for asthmatics?

A sweaty HIIT class can be challenging at the best of times but living with asthma means having to work out alongside the omnipresent threat of breathlessness. While most people might expect to feel breathless after a session, I’ve got to work out whether I’m having an attack or not. It’s not just the fact that rapid breathing can be confusing; the heavier and faster we breathe, the bigger the risk of inhaling something that could trigger symptoms.

“When you exercise, you tend to breathe faster and use more air,” Dr Whittamore explains, “so you tend to breathe through your mouth. Therefore, all those things in the air, whether it’s the fact it’s cold or very moist, there’s pollen or irritants in the air, that goes directly into your lungs – and your lungs struggle more as a result.” While some activities are likely to cause a “normal” level of breathlessness, signs that you may have triggered your asthma include: “Feeling abnormally short of breath – like you are unable to get enough air in, coughing a lot, wheezing, a sensation of tightness in the chest, or any symptoms that do not resolve after resting.”

If, like me, you were diagnosed with asthma when you already had an exercise regime in place, learning these signs can be tricky. Your best bet is to rest if you start to cough, wheeze or feel tightness, and to have your reliever to hand at all times.

Beginning your fitness journey

One of the hardest things about starting a new exercise routine is finding the motivation to keep going. For me, asthma quickly became just another reason to put off trying something new. But exercise can have an extra beneficial effect for asthmatics, according to Dr Diamandis: ‘There is evidence (to suggest) that by keeping the mind and body healthy through exercise, we can reduce the risk of asthma flares caused by triggers such as stress or infection.”

It’s still important, however, to build up your stamina and confidence gradually – pushing yourself too hard too early can do more harm than good. Dr Whittamore advises starting with “something very, very simple and manageable, and building on your confidence and fitness from there.” That might be something like creating a simple bodyweight circuit of five moves to do every other day, or having a go at something like Couch to 5k. “Learning your triggers and how to overcome them with mindset work and practical skills,” can be an invaluable tool, explains fellow asthmatic and PT at Embrace Life UK, Samantha Thomas.

Because asthma is different for everyone, there’s no such thing as a “best exercise” for asthma. Dr Whittamore points out that in theory, “any exercise can be good for people with asthma”, but equally, “any exercise might potentially be harmful.”

Annie Williams is a PT at OriGym Centre of Excellence who is experienced in helping people with asthma exercise effectively and safely. She’s found that people with asthma “require an extended warm-up, as it can often take longer for their heart rate and breathing patterns to become more relaxed and controlled.” Annie, like Dr Whittamore, recommends starting with lighter weights and smaller movements, which “allows for thorough assessment and then adaptation as necessary.”

In terms of specific exercises, Annie recommends interval training in short two-minute bursts. Interval training involves working out for short amounts of time, followed by periods of rest; as such, it’s a safe way to push yourself in a controlled way. Annie suggests incorporating the breathing technique “exhale on effort”, focusing slow inhalations while lowering into a movement and quick exhalations to help “push” through reps. She also recommends yoga, as “it allows people to focus on their breathing, and can positively impact future exercise by promoting controlled rhythmic breathing strategies.” DrWhittamore also recommends swimming as a low-impact exercise that’s great for the cardiovascular system.

Below is How To do a classic yoga pose – puppy dog. It’s great for calming the breath and stretching out the upper back. 

Don’t be put off by past events

Even before being diagnosed with asthma, I assumed that there were certain exercises that were off-limits to someone like me, but Dr Diamandis says that “if you have asthma and want to exercise, that’s great! The key is finding an activity that you enjoy and learning how to do it safely.” This doesn’t need to be complicated – all you have to do is stay “aware of your symptoms, avoid triggers and know how to use your medications in an emergency.” 

Like a lot of people with asthma, I have a few cardio horror stories that end in me lying on the floor out of breath after attempting what looked like a simple workout. Now I know that the key to exercising successfully with asthma is about pacing yourself and breathing. “I focus a lot on breath work through exercise and calming the mind, remembering it’s one step at a time and no more than (a client) feels they can do at that moment,” Samantha concludes.

Usually, any exercise can be done safely by someone with asthma if you are in the right environment. Dr Diamandis recommends exercising indoors when the pollen count is high if pollen triggers your asthma, and Dr Whittamore advises against exercising when you are experiencing asthma symptoms for other reasons.

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6 top tips for exercising with asthma

1. Seek help. It might take some trial and error to find activities that are both enjoyable and don’t aggravate your condition – just be sure to talk to your GP or asthma consultant before you start any new fitness regime. 
2. Find your triggers. Everyone’s asthma has different triggers, so before you find the perfect exercise regime you need to find what sets off your asthma. This could be the environment you work in or the exercises.
3. Start small. t’s so tempting to jump in all guns blazing with a HIIT workout or long run, but that could do more harm than good. Start off with exercises such as yoga or interval training to build up your stamina and strengthen your muscles.
4. Experiment. Your asthma needn’t stop you from doing exercise. If you’ve found an exercise that you really want to try, go for it! You may be surprised with how well your body copes.
5. Find a buddy. Staying motivated while exercising can be harder for asthmatics. If you know someone else with asthma, buddy up with them so you can try new things together and support each other.
6. Stay safe. Make sure that you have your medication near you at all times. If you do find yourself forgetting it en route to the gym or while out on a walk or run, set a reminder on your phone or ensure you pack it as part of your gym kit.

If you think you may have asthma or have concerns about your asthma, speak to your GP. Visit the Asthma UK website for more information.

Check out loads of stretches and low-impact moves that are designed to get you stronger without putting additional stress on the body in our How To library. 

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