asthma exercise guidance

Overview

Asthma is a long-term condition that affects the small tubes in the lungs. It makes them sensitive to certain triggers, causing them to narrow and produce extra mucus, which makes it harder to breathe.

Yes. Asthma is one of the most common long-term conditions in the world, affecting people of all ages.

Asthma affects people of all ages, but it often starts in childhood. It can also first appear in adulthood, sometimes after a viral infection or due to workplace triggers.

Symptoms

Common symptoms

• Wheezing or a whistling sound when you breathe
• Feeling out of breath
• A tight feeling in the chest
• Coughing, especially at night, early in the morning, or during exercise

Symptoms in children

• The same symptoms as adults, but children may also be less active or avoid sports.
• They may say their chest hurts or feels funny.
• They may cough or wheeze when playing, laughing, or running.
• They may wake up at night with coughing or noisy breathing.

Symptoms in older adults

• Breathlessness during everyday tasks like climbing stairs or carrying groceries
• A persistent cough, sometimes with more mucus
• Wheezing that may be mistaken for ageing or heart problems
• Feeling unusually tired because the lungs have to work harder

Causes

Main causes

• Asthma is not caused by one single thing. The airways become oversensitive to certain triggers, which cause them to swell, tighten, and fill with mucus.
• Common triggers include pollen, dust mites, pet fur, mould, cold air, smoke, strong smells, and viral infections like colds.
• Exercise itself can be a trigger for some people, leading to a type of asthma called exercise-induced bronchoconstriction. This does not mean you should avoid exercise—it means you need good management.

Risk factors

• Family history of asthma, allergies, or eczema
• Having other allergic conditions, like hay fever or food allergies
• Being around tobacco smoke, air pollution, or workplace dust and chemicals
• Obesity or being very overweight
• Multiple severe respiratory infections in early childhood

When to see a doctor

See a doctor urgently if:

• If your symptoms are getting worse day by day, or you need your reliever inhaler more than usual
• If you wake up most nights with cough, wheeze, or breathlessness
• If a chest infection or cold is making your asthma hard to control
• If your peak flow readings are dropping

Book a routine appointment if:

• If you have been newly diagnosed or think you might have asthma
• For a regular asthma review at least once a year, even if you feel well
• If you want to update your written asthma action plan
• If exercise is consistently bringing on asthma symptoms despite using your inhalers as prescribed

Diagnosis

Your doctor will listen to your symptoms, ask about your medical and family history, and do breathing tests to see how well your lungs work. They will also check for other conditions that can cause similar symptoms.

Tests that may be done

• Spirometry: you take a deep breath and blow hard into a machine to measure how much air you can breathe out
• Peak flow test: you blow into a small hand-held device to measure how fast you can push air out
• Reversibility test: you do spirometry, then take a reliever inhaler, and test again to see if it improves

What to expect at your appointment

Your doctor may ask you to keep a symptom diary and measure your peak flow at home. If the diagnosis is clear after tests, you will be started on treatment and given a written asthma action plan that tells you exactly what to do every day.

Treatment

There is no cure for asthma, but effective treatments can control symptoms, prevent attacks, and let you exercise and live normally. Treatment works best when you follow a written asthma action plan agreed with your healthcare team.

Self-care at home

• Take your daily preventer inhaler exactly as prescribed, even when you feel fine
• Learn to use your inhaler with the right technique—ask your pharmacist to check
• Warm up for 10 to 15 minutes before exercise and cool down afterwards
• Avoid known triggers, such as cold air, pollen, or poor air quality, when planning your activities
• Carry your reliever inhaler with you during exercise

Medical treatments

Asthma medicines are usually given through inhalers. There are two main types: preventer inhalers (taken daily to reduce swelling in the airways) and reliever inhalers (used quickly to open the airways when symptoms happen). Some people need a combination inhaler or additional treatments, such as other inhaled medicines, tablets, or newer biologic therapies for severe asthma. Your doctor will tailor the treatment to your needs and adjust it based on your symptoms and peak flow readings.

Living with this condition

Most people with asthma can live very active lives. The key is managing your condition every day, not just when symptoms appear. That means taking your preventer medicine, avoiding triggers, doing regular physical activity, and knowing what to do if symptoms flare up.

Lifestyle tips

• Take your preventer inhaler as prescribed, even on days you feel well
• Warm up before exercise and cool down gradually afterwards
• Choose low-irritant activities like indoor swimming, walking, cycling, or yoga if cold or outdoor air bothers you
• Check air quality and pollen forecasts before planning outdoor exercise
• Keep your reliever inhaler nearby at all times and use it if your action plan says so

Diet and exercise

Eating a healthy balanced diet, staying hydrated, and keeping a healthy weight all support better lung health. There is no special 'asthma diet,' but eating plenty of fruits, vegetables, and whole grains is good for everyone. Exercise is encouraged—it strengthens your breathing muscles and improves your fitness, which can make asthma symptoms feel less severe. If exercise triggers symptoms, talk to your doctor about adjusting your medication before you work out.

Mental health and emotional wellbeing

Living with a long-term condition can sometimes cause worry, stress, or low mood. Feeling anxious about having a flare-up during exercise is understandable. It can help to talk to your healthcare team, or to a counsellor or psychologist if that support is available. Remember: you are not alone, and with the right plan you can still do the activities you love.

Prevention

Asthma itself cannot be prevented, but you can do a lot to prevent symptoms and attacks. The most effective way is to follow your asthma action plan, take your preventer medicine regularly, use a reliever inhaler when your plan says to, and avoid known triggers.

Vaccines

Getting vaccinated against flu is recommended for many people with asthma, because infections like flu can make asthma worse. Talk to your doctor or pharmacist about which vaccines are right for you, including COVID-19 and pneumonia vaccines if recommended in your country.

Complications

If left untreated

• Frequent asthma attacks that require urgent medical care
• Trouble sleeping because of coughing or wheezing
• Days missed from school or work
• Long-term loss of lung function if symptoms are poorly controlled
• In severe cases, life-threatening asthma attacks

Long-term outlook

With today's treatments and a good action plan, most people with asthma can live full, active lives, including participating in sports and exercise. The outlook is very good if you stay engaged with your healthcare team, take your medicines as prescribed, and keep your symptoms monitored over time.

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