Exercise and Asthma

Physical activity is not a new concept.

For the Stone Age man, physical activity needed for hunting and escaping from wild animals was of paramount importance for daily survival. As the ancient man settled along river banks and raised colonies of people and before the advent of machines, physical exercise was still required for agriculture, farming and raising cattle. With further progress in civilization, physical activity was emphasized in dance and music, sports, military tactics and training and martial arts. With the advent of machines and division of labor, for the first time physical exercise became an option rather than a necessity. Cultures emphasizing literacy excluded physical training as part of their education for young people. With advances in Science, it became apparent that physical exercise was necessary not only for a fit body but also for a sound mind required for excellence in all aspects of living. With the advent of obesity and related illness and with their impact on the economy, physical exercise is promoted not only by people and organizations but also by governments. Recent surge in interest in national and international sports and field and track events is reflective of this trend. Activities promoting physical exercise are now a multi-billion dollar industry.

How is exercise- induced asthma caused?

Physical activity while it is beneficial and important for many people, in some it could cause health related concerns. In this article, we will look at how exercise could cause asthma, hives and even anaphylaxis (a serious form of allergic reaction) in some people. Exercise-induced bronchospasm or asthma (Sports-induced asthma) is an established concept. In fact, it is one of the leading triggers for asthma exacerbation in children and young adults with asthma. There are two theories how physical exercise or sports could induce spasm of bronchial tubes in the lungs. According to one theory, the volume of air is entering and leaving the lungs increases during exercise that results in drying up of secretions lining the bronchial tubes. This triggers the release of chemicals from various immune cells such as mast cells. This leads to constriction of bronchial tubes. The second theory that is more widely accepted states the following: during exercise inner surface of the bronchial tubes cool down due to increased air currents. With the cessation of activity, the bronchial surfaces rewarm again. This initial cooling followed by rewarming of the airways somehow causes bronchial constriction by stimulation of nerve endings and release of chemicals from mast cells. It is widely known that exercising in the cold and dry air is more likely to cause asthma symptoms in susceptible people than training in warm and humid climates.

What can you do about it?

Although it is commonly stated that patients with asthma have airflow limitation during strenuous activity, this is a rare event unless the workload is decreased so that volume of air breathed in and out falls, thus allowing for airway rewarming which triggers the bronchospasm. Such a phenomenon occurs in stop-and-go sports (e.g., baseball, football, basketball). If you have Exercise-induced Bronchospasm or Asthma, then doctors recommend the following: take two puffs of a short-acting bronchodilator such as albuterol 20 minutes before exercise. Grab your controller medications for asthma regularly if you have any prescribed. Remember inadequately controlled asthma could limit your exercise tolerance severely. If you experience asthma symptoms during exercise such as a cough, tightness of chest, chest pain, wheezing or difficulty breathing, then you should stop exercising immediately, take two more puffs of albuterol and seek medical attention if you do not feel better within 5-10 minutes. Please do not persist in your activities ignoring the warning symptoms for any reason! It is a sure recipe for disaster; deaths have been reported. Also, avoid exercising or playing sports outdoors, if you are sick or during high pollen count or high pollution days and when the weather is cold and dry. Under these circumstances, it is a lot safer to exercise indoors provided you are not sick. Also, experts suggest a period of warming up and cooling down before and after exercise and sports. This permits your body to get adjusted in time for the activity.

Therefore if you have asthma and exercise is one of the triggers, then you should follow the above recommendations to avoid trouble. In the next article, we will read about how exercise could cause hives and even life-threatening anaphylaxis in some people.

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