Running with Asthma can be a major concern for most of you. You went out for a morning run on Sunday. You felt great and enjoyed the adrenaline rush of your speed workout. But you haven’t been able to step out for training since. You have been coughing, wheezing, and experiencing shortness of breath. Normally, when you breathe, your nasal passage warms, moistens and filters the air. However, when you are running, you tend to breathe faster and through your mouth. So, the air you inhale is colder and drier. 

The change in temperature and humidity can sensitize the airways, causing swelling of the inner linings, tightening of muscles, and formation of thick and sticky mucus. It might lead to wheezing, difficulty in breathing, and coughing. If you have these symptoms, you could be experiencing an asthma attack triggered by exercise such as running, and is called exercise-induced asthma (EIA).

What causes asthma?

Asthma is a chronic lung condition that occurs when the inner lining of the air passages that transport oxygen to the lungs are inflamed. The inflammation leads to narrowing of the passages and blocks the flow of air, resulting in shortness of breath. 

Also read: Asthma: Symptoms, Causes, and Management

There are numerous factors that can trigger an asthma attack like allergies to pollen, dust, mites, pollution, stress, strong emotions, extreme temperatures, exercise, or even lack of sleep. 

Should you exercise if you have asthma?

You might be hesitant about running if you have been diagnosed with asthma. About 80% of asthmatics have EIA. But, exercises, including running can help improve lung function and reduce inflammation. 

Look no further than Great Britain’s Paula Radcliffe if you want proof. The fastest woman marathoner, who held her title for 16 years, was diagnosed with asthma at the age of 14. She went on to become a six-time world championship-holder. 

How to manage EIA

So, what can you do to manage the symptoms and enjoy your run without experiencing an asthma attack? The key is to find a balance.  

If you are asthmatic, determining the severity of your condition by consulting a doctor and creating an asthma action plan is essential. This will help you take your medications regularly to control the symptoms and also manage your triggers.

1. Control your asthma  

Work with your doctor to understand your triggers and symptoms. They will help you control asthma with a combination of medication and other treatment modalities that are best suited for you. 

An asthma plan will cover the following: 

What medicines to take?

Inhalers are anti-inflammatory medications that help reduce airway inflammation and help relieve or prevent symptoms of asthma 

What can trigger asthma?

Cold air, pollen, fast pace, dehydration

Know when to stop the run

When you feel tightness in your chest, wheezing, or an  unstoppable cough

What do early symptoms of a spasm look like? 

Shortness of breath, cough

What to do if they occur? 

Stop the run or any other activity, breathe slowly, use the inhaler, and have a warm fluid 

Indications of full flare-ups

Increasing phlegm and coughing, wheezing that does not decrease in spite of using inhalers, rapid breathing that does not slow down, bluish discoloration of the nails. Any of these symptoms indicate that you need to seek medical care.

2. Take it slow

If you are experiencing symptoms, wait until your condition improves. You need normal airway function to exercise. Focus on increasing duration more than the intensity. Over time, exercise will help control the frequency and severity of asthma episodes.

3. Exercise in warm, clean air

Run indoors when it is cold outside or the pollen level is high. Include a strength workout instead or run on a treadmill in such a scenario. Plan your run so as to avoid running on busy roads with heavy traffic and pollution. Morning runs could be better. These small changes help minimize triggers and thereby prevent attacks.

4. Incorporate a dynamic warm-up 

How does a warm-up work? It may seem difficult for  people with asthma to warm up just before a run. However, incorporating a proper warm-up strategy triggers a refractory period during which rigorous exercise activities result in significantly less severe or no exercise-induced bronchoconstriction (EIB). Exercise-induced bronchoconstriction (EIB) is the transient narrowing of the lower airway after exercise either in the presence or absence of clinically recognized asthma.

Nearly 40%–50% of individuals, who have had an episode of EIB, experience a refractory period that can last one to four hours after the initial warm-up exercise. Practicing warm-up induces a refractory period that limits the extent of EIB. This could result in fewer symptoms, decreased medication use, and improved exercise performance.

5. Learn to breathe correctly

There are some techniques you can follow to improve breathing while running. 

• Pursed lip breathing helps oxygen enter your lungs and slows down the rate of breathing 
• Diaphragmatic breathing or belly breathing expands the airways and chest
• The Buteyko method teaches you how to breathe through your nose instead of the mouth, and slows down your breathing

6. Carry your inhaler and phone 

Carry your quick-relief inhaler and phone all the time. If you feel the inhaler is not taking the desired effect, you can use your phone to reach out for help in case of a flare-up.

7. Run with a friend

Whenever possible, find a running partner and let them know about your condition and what they should do in case the condition aggravates (call a medic, for instance). 

Checklist before you run 

1. Check the outdoor weather  
2. Stay hydrated
3. Take your medicines  
4. Carry your inhaler and phone 
5. Wear a nose-mouth cover in case of high pollen in air 
6. Do a dynamic warm-up 
7. Pick up your pace gradually 

The American Lung Association encourages people living with chronic lung diseases such as asthma to make exercise a part of their daily routine. As you become more fit, you will feel less breathless while performing the same quantity of exercise. Research also suggests that exercise reduces airway swelling and lowers the severity and frequency of symptoms. Your quality of life would likely improve overall. Start slow, be mindful, listen to your body, and start running.

You can start your running journey with the help of our podcast, Walk to Weight Loss for audio-guided workouts.

References
1. Exercising with Asthma. Exercise is Medicine by American College of Sports Medicine. https://www.exerciseismedicine.org/support_page.php/asthma/ (accessed March 24, 2021).
2. Asthma and Exercise. John Hopkins Medicine. https://www.hopkinsmedicine.org/health/conditions-and-diseases/asthma/asthma-and-exercise (accessed March 24, 2021).
3. What are the best forms of exercise if you have asthma? Patient. https://patient.info/news-and-features/what-is-the-best-exercise-if-you-have-asthma (accessed March 24, 2021).
4. Being Active with Asthma. American Lung Association. https://www.lung.org/lung-health-diseases/lung-disease-lookup/asthma/living-with-asthma/managing-asthma/asthma-and-exercise (accessed March 24, 2021).
5. Stickland MK, Rowe BH, Spooner CH, Vandermeer B, Dryden DM. Effect of warm-up exercise on exercise-induced bronchoconstriction. Medicine and Science in Sports and Exercise 2012; 44: 383–91.