Exercising With Asthma and Allergies

By Carolyn Comer, MD

Regular exercise is beneficial for everyone and may be particularly helpful for individuals with asthma and other allergic diseases. Exercise helps stimulate the cardiovascular and respiratory system. Although exercise will not cure asthma, exercise will help individuals to feel their best, both physically and psychologically.

Where Do I Begin?
An exercise program should be planned in consultation with a physician. The doctor can advise which activities may provoke asthma or other allergic symptoms, and how to treat the symptoms. The allergic or asthmatic individual should consider what form of exercise would best meet their needs. Exercise that has stop-and-go activity tends to cause fewer symptoms than an exercise using continuous motion. Continuous running most commonly causes bronchial constriction, while swimming poses the least amount of respiratory irritation.

What Can I Do?
The nose should be as clear as possible when exercising so that nasal breathing can take place. This is important because the nasal passages contain a natural filtering and humidifying system. This system will help keep the air at proper temperature and humidity. This nasal filtering system will help to keep out pollutants, irritants, and allergens. It may be necessary or helpful for the allergic patient to use a medication prior to exercising that will keep the nasal airways open. Mouth breathing can introduce irritants to the bronchial tubes and lungs, and the exercise program will be less effective.

The asthmatic patient may need to use medication for the bronchial tubes if exercise causes symptoms of chest tightness, cough, wheezing, or shortness of breath. People can often prevent asthma symptoms by taking medication prior to exercising. The type of medication used depends on the frequency and duration of physical activity, how often exercising is done throughout the day, and the practicality of taking medication before exercise. An inhaler, such as Albuterol, taken 10 to 15 minutes before exercise, is one type of medication that can be used. A physician should be consulted on the best medication to use before exercise. Performing a series of warm-up exercises for 5 to 10 minutes prior to using the pre-treatment inhaler may provide additional benefit.

What Should I Avoid?
Exercise should not be done if the patient is sick or not feeling well and a person should never push beyond his/her capabilities. If you have allergies, vigorous exercising should obviously not be done near a field full of grasses and weeds. It may be more appropriate to exercise indoors at certain times of the year. If allergens cannot be avoided, certain preventative methods, such as medication taken before exercise or wearing of a mask, may be appropriate.

Exercising should also be avoided in areas where there are large amounts of chemical irritants. Vigorous sports should not be done near a heavy traffic area where there is a large amount of exhaust from vehicles, or near factories that emit large amounts of pollutants in the atmosphere. Indoor areas where there are noxious or irritating odors should also be avoided. This is good advice for all!

Special precautions should be taken by those individuals who have severe allergies to stinging insects (such as bee, wasp, yellow jacket, etc.). If exercising is done outdoors, injectable epinephrine must be kept on hand. Another person should also be nearby to assist in an emergency. Individuals with bee-sting allergy should avoid wearing bright-colored clothing, strong perfumes, or lotions that may attract stinging insects. Areas where insects tend to inhabit should always be avoided. These include flowerbeds, fields, bodies of water, and areas near garbage.

Individuals who develop hives, swelling, or anaphylaxis when exercising should also take precautions. (Anaphylaxis is the most severe form of an allergic reaction and can be life threatening.) Patients must carry injectable epinephrine with them, should never exercise alone, and should not exercise or jog in remote areas. These individuals should also inform those they exercise with of their condition and what steps should be taken in case of an emergency.

In Summary
Though many people with asthma and allergies avoid exercise because they fear Ògetting sick,Ó a well-planned exercise program can improve their overall physical and emotional well-being. All contributing factors should be taken into consideration before an exercise program is begun or before any type of physical activity is planned. These suggestions and precautions are not meant to discourage exercise but to help in choosing suitable activities. Many competitive athletes (including Olympic gold medallists) have severe allergies and asthma. Exercise programs can be quite vigorous and helpful if undertaken with care and a physicianÕs guidance. Successful asthma and allergy management enables a person to enjoy all aspects of a physically active lifestyle.

Dr. Carolyn Comer is a graduate of the University of Alabama College of Medicine. She is currently in private practice in Vancouver, WA, specializing in adult and pediatric asthma and allergic diseases. She is a Diplomate of the American Board of Pediatrics as well as The American Board of Allergy and Immunology. To contact Dr. Comer call 360-567-1773.