Asthma and sport – an absolute no-go?
There’s no reason why an asthmatic shouldn’t be an athlete! Moderate exercise appropriate to the disease progression helps to alleviate asthma symptoms and develop a new attitude to life: no longer the passive sufferer, but an active sports enthusiast with a chronic, but manageable illness.
However, you should always consult your doctor before taking up sporting activities. They can measure your current fitness status and help to adapt your drug therapy to your sport of choice.
Which is the right sport what are the positive effects?
There is no one-size-fits-all answer to this question. It depends very much on your individual preferences and current state of health. In general, we recommend moderate endurance sports. It’s important to note that the body can tolerate continuous strain better than abrupt changes. Sports recommended for asthmatics therefore include jogging, Nordic walking, cycling, swimming, cross-country skiing, dancing, or hiking. These relax and promote well-being, increase endurance capacity, boost the immune system, and strengthen the respiratory muscles, making it easier to breathe in and out deeply. This also increases oxygen uptake. Sport also has positive effects on the transport of mucus from the lungs. This additionally helps you to breathe more freely. What’s more, it also reduces the probability of developing exercise-induced asthma. While untrained asthma sufferers live in fear of an asthma attack when undertaking everyday activities, sporty asthmatics on the other hand are much less affected. 1-3
Before doing sports – check what you can cope with today
No two days are the same. Even if your meds are well adjusted, asthma is subject to daily fluctuations. External stimuli such as cold, environmental allergen exposure, or your current state of health can on some days make you less resilient. On such days, you should if possible avoid intensive strain on the respiratory tract or adjust your meds in line with your doctor's instructions. It is therefore important to check before taking exercise how strongly your asthma symptoms are affecting your breathing at the time. In most cases you can test this with peak flow measurement, which every asthmatic can easily do at home. Another control method is FeNO measurement. This measures an inflammatory marker in your exhaled breath that shows the current degree of inflammation of your lower airways. With the help of regularly measured FeNO values, you have a good handle on the inflammatory state of your lungs and can decide whether doing sports is a good idea or not. With the Vivatmo me home monitoring device, you can measure your FeNO value yourself quickly and easily from the comfort of your own home. One advantage over peak flow measurement is that with regular use you can recognize a trend in how the values are developing, allowing you to identify any deterioration early on and take timely countermeasures.
Healthy people and asthmatics in particular should as a matter of principle avoid overexertion. Only otherwise healthy asthmatics who feel well and whose meds have been correctly adjusted should engage in sports.
Depending on your level of training, experts recommend4 three to five 20 to 60 minute units of medium intensity per week. You should get started with a 10-minute warm-up phase to get your circulation going, followed by the actual phase of endurance sport. As soon as you notice any signs of shortness of breath or breathing difficulties, you should reduce the intensity immediately or take a short break. Just as important is the cool-down phase. This helps to bring the body back into normal mode and reduces the risk of an asthma attack.
Emergency medication always to hand
Having their medication to hand at all times gives asthmatics more confidence. Asthmatics with sporting ambitions should also remember to take their emergency medication with them to training. That way, when symptoms occur, they can react promptly – even when jogging in the forest or touring through the mountains. Whether it makes sense to take preventive medication before exercise should be clarified with your doctor beforehand.
Good physical well-being, which can also be trained through sport, minimizes the risk of overexertion. Regular exercise is best done together with like-minded people. This is more fun and, if the worst comes to the worst, you are not alone.
Sport with allergic asthma
Allergic asthma can also be triggered by harmless substances such as pollen or house dust. For this reason, allergic asthmatics should always check the current pollen count before doing sports. With the help of special pollen count apps or the pollen count information in the , you can obtain up-to-date pollen information for a specific location, enabling you to avoid exercising outdoors precisely when the pollen count in the air is particularly high. For house dust allergy sufferers, the situation is completely different: in their case, outdoor training is more suitable. So the general rule is: avoid known allergens, especially when exercising.
Avoid extreme climatic stimuli
When doing outdoor sports, asthma sufferers should also pay attention to the weather. If the temperature drops and you start breathing through your mouth instead of through your nose during sports in order to get more oxygen, a cold shock can severely irritate the respiratory tract and in the worst case lead to an asthma attack. It’s advisable to check with your doctor first about possible temperature influences.
In summer, ozone levels are often high. You should therefore avoid outdoor sports activities in the afternoon, because that is when the ozone levels are at their highest. The best time of the day for training is in the early morning. After a rain shower, the air is particularly clean. Pollen allergy sufferers can take advantage of this situation for a spontaneous woodland run, for example.
Asthma attack during sports – first response
Unfortunately, the risk of an asthma attack while doing sports cannot be entirely ruled out. This is most acute in patients who suffer from exercise- or stress-induced asthma. Exercise outdoors, often coupled with inhaling deep breaths of cold air, triggers an asthma attack during or shortly after exertion. However, allergens such as pollen, which are inhaled when running in the woods for example, can also cause breathing difficulties for those with a predisposition.
At the first signs of an asthma attack, in principle the same rules apply to sports as at home. It is important to remain calm, because fear makes breathing even more difficult. When doing sports, you should always carry an emergency spray that dilates the bronchial tubes with you, as well as a cell phone. Like this, you can quickly alert the paramedics in an emergency. Certain postures facilitate breathing. Outdoors, one possibility is the so-called goalkeeper’s position. In this position, you stand with your legs hip-width apart and your upper body bent slightly forward, with your hands on your knees or your thighs for support. Breathing techniques such as pursing your lips can also facilitate breathing. Here, you exhale against the resistance of your half-closed lips.
In addition, asthmatics should always carry an emergency document with them that provides information about the illness and its course and about what medication must be taken.
Asthma and competitive sports
It’s no secret that competitive sport makes very high demands on the body, which is why only a small minority of asthmatics engage in sports at this level. But it’s not impossible. However, it does require close medical supervision. Asthma drugs are on the doping list and therefore require an appropriate medical certificate and an special approval from the responsible anti-doping agency. However, provided that their asthma is well controlled and adjusted, there is no reason why asthmatics shouldn’t achieve performances comparable to those of healthy athletes.
Asthmatics who have already successfully participated in the Olympic Games, such as speed skater Anni Friesinger or professional soccer players like David Beckham show that nothing is impossible.
1 Exercise is associated with improved asthma control in adults S. Dogra et all.European Respiratory Journal 2011 37: 318-323
2 Physical training for asthma Kristin V Carson et all. https://pubmed.ncbi.nlm.nih.gov/24085631
3 S2k-Leitliniezur Diagnostik und Therapie von Patienten mit Asthma (guideline for diagnosis and therapy of patients with asthma) AWMF (Association of the Scientific Medical Societies in Germany) register number 020-009 published by the Deutsche Gesellschaft für Pneumologie und Beatmungsmedizin e.V.and the Deutsche Atemwegsliga e.V. with the participation of the Gesellschaft für Pädiatrische Pneumologie e.V. and the Austrian Gesellschaft für Pneumologie. In cooperation with the following German scientific societies:Deutsche Gesellschaft für Arbeitsmedizin und Umweltmedizin e.V., Deutsche Gesellschaft
4 Nationale Empfehlungen für Bewegung und Bewegungsförderung (National recommendations for exercise and the promotion of physical activity) special issue ISBN 978-3-946692-30-0