9 tips that help me prevent an asthma attack while exercising

I talk a lot about my previous stroke and heart attack, so you would be forgiven for not knowing that I also have asthma–I have since I was about 10 years old. The Asthma and Allergy Foundation of America (AAFA) has recently announced that May is “National Asthma and Allergy Awareness Month” so no better time than to share some advice for those exercising with asthma.

What is asthma?

“Asthma is a condition in which your airways narrow and swell and produce extra mucus. This can make breathing difficult and trigger coughing, wheezing and shortness of breath.” (source)

Why does exercise trigger asthma?

I have managed to control many asthma triggers in my life, but the one that is the hardest to overcome is exercise-induced asthma, more accurately known as exercise-induced bronchoconstriction (EIB):

“When you exercise, you breathe faster and deeper due to the increased oxygen demands of your body. You usually inhale through your mouth, causing the air to be dryer and cooler than when you breathe through your nose. The dry and/or cold air is the main trigger for airway narrowing (bronchoconstriction).” (source)

What has helped me manage my asthma while exercising?

Your asthma triggers can be somewhat unique to your body, so always consult with your doctor before starting any exercise plan, but these are the tips that have helped me avoid an asthma attack while exercising.

1. Take your inhaler early

Scientists and doctors recommend that, when you know you’re going to do an exercise that could trigger your asthma, take your inhaler 15-20 minutes BEFORE you start. I learned this when I first started running in May of 2019. It was important for me to do that because I had yet to learn my limits so it was safer to try and help my lungs ahead of time.

2. Take your inhaler with you

Whenever I start a new cardio exercise, I bring my inhaler along for the ride (or run, or walk, or…). I rarely need to take it, but there were some occasions when I tried to mix in 400-meter sprints and quickly discovered those would be too fast and cause my asthma to flare-up.

3. Warm-up

Whatever exercise you’re doing, start out with a warm-up. Before running, I start with a short walk. Before tennis, I hit some short, easy balls. Just as you should warm up your muscles, you should also warm up your lungs.

4. Recognize early signs

Now that I have settled into regular cardio exercise, I know the signs that indicate I am approaching what I call my “asthma threshold”–the speed, pace, exertion levels that could trigger an asthma attack. For me, it’s a cough. Not a coughing fit, just a forceful exhalation of CO2 in the form of a cough. The more frequently the cough, the more I know that I could end up wheezing and trying to catch my breath.

5. Build up your exercise

If you do find yourself often reaching your own asthma threshold, make a note of your Rating of Perceived Exertion (RPE). Adjust your RPE so that you get close to that level, but rarely cross over it. If your asthma is triggered when you run at a sub-10min pace, then keep above that pace. If you find you hit that asthma-inducing RPE number when you jump rope for 3 minutes, dial it back to 2 minutes.

6. Give your lungs a break

When I approach my asthma threshold, I dial things back. With running, that means I slow my pace to a jog or walk. When biking, I often just pull over to the side, catch my breath, and sip some water. Whatever exercise, don’t be ashamed if you have to take a break or slow down in order to prevent an asthma attack. In fact, I have found such breaks can actually improve my performance!

7. Wear a mask in cold temps or pollen season

When I workout in the cold winter temperatures, I often wear a bandana around my mouth–who knew those would come in so handy during the Coronavirus pandemic! If you find that cold temps, pollen, or even dust/smoke are triggers for your exercise-induced asthma, a gaiter is great to wrap around your neck and pull up over your nose and mouth when needed.

8. Learn your limits, but know you may improve them

I always try to stay below my asthma threshold, but sometimes I do test those limits to see if they have improved. I no longer take my inhaler before a run or bring it with me, because I know my limits, my triggers, and early signs. However, when I try something new or want to push myself a little harder, I bring that inhaler.

9. Enjoy your improvements

Before I started running, I had my VO2 max tested–it was pretty poor. Over the past year, my Garmin watch has shown my improvements and suggests my VO2 max is now in line with a 20-year-old! Wishful thinking, perhaps. That said, I have noticed considerable improvements in my cardio-respiratory endurance. I do often get breathless (which is different from an asthma attack), but so do even the greatest athletes in the world. 😉

The above tips have helped me control my asthma and avoid an exercise-induced asthma attack. I hope one or two may help you as well. If you need further guidance please consult your doctor and feel free to sign-up for one of my custom training plans.

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