exercise and asthma- having a few difficulties!

Hi all, hope everyone's well

I just have a few questions about exercise and asthma.

First of all, I think I may have asked this before, but how long before exercising should salbutamol be used? I've been using it about 10-15 minutes before I head to tge gym but it doesn't seem to make any difference.

Secondly, how long is it normal to have asthma symptoms for after exercising? I seem to have the, all night ans sometimes into the next day. A nurse told me once that it's ok to be sob for a while, I'm just not sure how long a while is!

Finally, how far is it safe for me to push myself whilst at the gym? Im trying to improve my fitness so im doing lots of cardio stuff. Should I stop when I start feeling that my chest is tight or wait until I start couching and canr take deep breaths?

My new year's resolution is to become better at managing my asthma, rather than just ignoring it, so im trying to educate myself about what I should be doing. I have a few questions ready to ask at , y review in april but I cant wait until then to exercise- im one of those odd people that find going to the gym relaxing!

Sorry abour any typos, I'm still getting to grips with a new tablet!

Thanks :)

22 Replies

  • Hi Rachel

    As a newbie to asthma, I'm interested in this too. I take my blue inhaler before I swim, but feel chest tightness afterwards for a while and have to retake the inhaler a few more times. Plus, I get out of breath when swimming and cough etc. Not sure about inhaler use and exercise either. X Sue

  • Hi, I also get exercise induced asthma. I take my inhaler 15 minutes before and ensure I warm up slowly. I listen to my body and slow up or rest for a few minutes if my asthma starts. If necessary using more inhaler during if I need to but I find by doing the above I can usually avoid it.

    I also use my inhaler post exercise as and when I need it to nip any symptoms in the bud.

    I started treating my asthma more aggressively when exercising because I had become so de-conditioned in my latest flare up (since 2010) that the consultant said my de-conditioned body would make my asthma worse and it made me rethink how to manage exercise.

    I also love the gym but sadly can't afford to go.

  • Thanks JF!

  • Hi Rachel, before coming ill with chronic fatigue I was a gym bunny and also taught exercise classes for a few years . Up until 18 months ago l've exercised regularly throughout my asthmatic life . I would say ten to fifteen mins after taking your inhaler is adequate time before starting. Generally I always stopped during a/ workout if I became sob or wheezy and took more ventolin then carried on when I felt relief again. If you don't stop at that point and carry on til your really struggling to breath or coughing a lot I think you run the risk of having an attack. It can also be hard sometimes initially to tell when it's your asthma and when its natural exercise induced SOB. I also found , like JF, warming up slowly really helped. After a workout I'd always continue taking ventolin if tight/wheezy/sob/coughing but it generally settled quickly or within a couple of hours at most. If its lasting throughout the evening / overnight/ into the morning I'd say that's a long time afterwards and I don't think you should have to suffer symptoms that long. I'd make sure you use your ventolin after and take a good 2 puffs or more and repeat when necessary.. As your fitness continues to improve hopefully your asthma symptoms during and after will improve. That's certainly my experience. But above all else, listen to your body and your lungs, in the longer run it will help you as your more likely to enjoy your exercise and therefore to stick to your exercise regime and then your asthma/ lungs should benefit as a result! Good luck! X

  • Hi Rachel

    I agree with the others that 15 mins before is about right and warming up slowly is important. Also that when you have symptoms during exercise stop and take reliever and when you have symptoms after take your reliever again, and again if needed.

    If your reliever isn't doing its job, particularly if you have symptoms for more than a few hours after exercise then I think you should arrange an asthma review, you don't have to wait for your annual review, you could book one in the next couple of weeks.

    As to how far you can push yourself, it's difficult to know and although I've exercised successfully with uncontrolled asthma for several years now and also in my teens I still get it wrong sometimes. I have to be careful, warm up slowly, listen carefully to my body and lungs and adjust intensity accordingly. It's worth knowing what your resting heart rate is, measuring before you get out of bed in the morning and if it's say 10 above normal per minute then your body might be fighting something and it's better to rest that day or at least avoid any intense workout. I also use peak flow as a measure of when to push it or not.

    I hope you can get your asthma as controlled as possible and enjoy your exercise. x

  • I find this really tricky as well! Especially at the moment when it feels like just walking anywhere slowly is setting things off but I don't want to get too sedentary...especially on the pred ughh. But then I have to get the balance right or will be on pred for (even) longer.

    I would like a measure to use as well but sadly HR is a bit odd and so is PF - seeing physio again soon for no reason in particular except asthma nurse thought it could be generally helpful and see how it goes, so I might ask about exercising. I'm really fed up with being told all the time how great exercise is for asthma and how elite athletes (who, hello, have dedicated people to help them!) are asthmatic and manage without anyone ever saying how you do it safely/without feeling rubbish when you have daily symptoms, since obviously you can\t then use the standard advice so easily - glad to see you do it Lou!

    Does anyone else get the issue that sometimes the effects can be delayed? I find it especially tricky that if I push myself too far (at the gym or just walking around eg on the Underground) I often won't know till later, and haven't yet worked out how to tell at the time. I do know that if my walking, which is slower than I'd like anyway, is becoming even slower I should pay attention to that and not try to go too fast.

  • I'm really lucky in that my pf/lungs are good most of the time and most dips respond well to ventolin. I know what you mean about not noticing at the time and then suffering later on, I've had many nights without much sleep as a result. I think our lungs are just deliberately random to be annoying, although it's often after I've run or whatever when the pollen's been high or the air has been dry. My lungs like moist air so the best time for me to go for a run without upsetting my lungs is when it's raining (stupid things, why can't they like dry air???). It's sometimes hard to tell at the time.

    I wonder if your physio Philomena would have some ideas of what would be good to do with such easily upset lungs.

    I would like to ask some of those elite athletes how many drugs they take for their asthma, how often they get symptoms and if they've ever had any severe attacks. I've only ever seen or read interviews in magazines where they say how important if is to control your asthma well by always taking your brown inhaler. I think exercising with uncontrolled asthma is really difficult and an area that asthma cliinics lack in knowledge, guidance and support for their patients.

  • Thanks Lou! I also wonder about these athletes - I don't see how they could do what they do if at the level of some of the users here. I do see that exercise is important and it's not good to let mysef get too unfit which is why I want to try and keep up with it, and I know that even severe asthmatics can still exercise, but I think the control aspect is important. And while it's good to see that they have managed it well, I do sometimes get tired of those with control going on about how important it is to 'get good control and don't let asthma stop you' - a good message for those who haven't realised or aren't doing what they could, but very frustrating when you try and try and can't get control. I got really annoyed with a mild asthmatic on a scuba diving forum (yes, I am a masochist and eternally optimistic :p - was actually looking for stuff on snorkelling though) saying that his lungs had been loads better since he was exercising regularly and more asthmatics should do that rather than 'sitting around and feeling sorry for themselves'.

    I think it would be hard if you aren't used to exercise even for someone who wasn't too bad but new to asthma to know how much they can do. At this end of things, argghh, espeially for someone like me who doesn't even know much about how to do it effectively with good lungs! I think you're right and I hope the physio can help - my last one was great but I wasn't quite at this level then, and a previous physio I saw told me I was breathing wrong during exercise but didn't help much with fixing that. I may be breathing wrong but I also feel I could do with some help on gauging the actual asthma side of things during exercise as well! So far I have managed to put myself in hospital at least once due to my desire to move through the Underground as fast as possible, and got thoroughly told off. All that stuff about getting exercise into your daily life doesn't seem to work well for me right now - makes me laugh as by the lifts in the hospital there is a sign saying 'think of your health - take the stairs' which for me is pretty much the opposite atm - and I will quite happily take the stairs etc as well unless really struggling or someone sensible is around to tell me not to.

    It is definitely hard so thanks for starting the thread Rachel - hope you work it out! How are things with you?

  • I definitely know what you mean about the delayed reaction to exercise, it's like my body suddenly catches up with the fact that I've been to the gym (although how the messages makes it to my legs before my lungs I'll never know!). Usually it's kind enough to wait until I get back home though. It's a shame there isn't something you can wear or do that tells you as soon as the asthma starts up!

    You'll have to let us know what the physio says Philomela, there must be some secret they aren't telling us! I hope they are able to help you out a bit.

    I only managed 15 minutes at the gym today before I had to give up, I ended up sat in the changing rooms for a while and then my friend walked me back home. I hope things improve tonight since tomorrow I'll be volunteering at a hospital, which is 2 and a half hours of running around the wards and to and from the pharmacy, and a twenty minute walk to and from the bus station! I'm thinking about going to see the nurse, but she's never very helpful. She's lovely and sympathetic but I never seem to get further than 'your pf is fine so just give it time'. Once when I went she said my pf was fine but that I should sit in the waiting room for a bit before walking back as I seemed really out of breath! I'm just not sure if I'll be able to get an appt anytime soon. I'm registered at a weird health centre where there are same day appts available with the docs, but usually a 2 week wait for the nurse! I don't feel bad enough to bother the docs.

    I have a lecturer who specialises in respiratory conditions- I'll ask him what he knows about asthma and exercise at the end of my next lecture with him.

    Does this site have anything on it about exercise? I've never looked... I think I'll do it now!

  • Just searched my uni journal database and found this from Revue médicale de Bruxelles which seems to suggest that a delay in symptoms is expected in exercise--induced asthma:

    'Exercise-induced asthma is characterized by a transient rise of the airways resistances, associated with asthmatic symptoms, 5 to 10 minutes after the end of a submaximal effort. The treatment is based on a pre-effort warming, cover the mouth with a mask (when the weather is cold), the use of beta-mimetic bronchodilators before exercise and, chronic treatment with antiinflammatory drugs'

    Unfortunately I can't access the rest of the paper, it looks like an interesting read.

    There is from a different article from The Cochrane database of systematic reviews:

    'Dietary antioxidants, such as vitamin C, in the epithelial lining and lining fluids of the lung may be beneficial in the reduction of oxidative damage (Arab 2002). They may therefore be of benefit in reducing symptoms of inflammatory airway conditions such as asthma, and may also be beneficial in reducing exercise-induced bronchoconstriction, which is a well-recognised feature of asthma and is considered a marker of airways inflammation'

    So there is some research going on into what happens.

    This will keep me amused for hours! :D

  • Dear Marvin,

    i am akeen swimmer but a severe asthmatic too, i swim a mile in 45 mins, but as i get breathless i swim most of it on my back, this allows me to breathe as much as i need.

    may be worth a try xx

  • Philomela,

    When my asthma was at its worse and I was told to start exercising again, I started with walking only and focussed on steps with a pedometer to increase my stamina as any increase in pace was a no no. A snail's pace it was with frequent rests. I knew all of the benches and walls in my local area and I would rest as long as I needed. My abilities varied on a daily basis and this is when I really learned to listen to my body. My starting place was 5-10 minutes max but I was really happy to be getting 'active' again. It will be interesting to hear what the physio says!

    I always interpret that professional sports people who have asthma must have it well controlled and maybe do not have difficult to control asthma. I did read an article in recent months that Alex Ferguson said Paul Scholes was limited at times by his asthma.

  • I might have to try that approach! Problem is I am ridiculously impatient and because I don't always feel it till later, I tend tp push myself beyond what I should be doing at that time then regret (quote from resp registrar when I admitted to certain habits re work and commuting in hospital in Nov: 'you really are your own worst enemy aren't you?'). I think I need a personal trainer who tells me NOT to go for the burn lol, at least not when I can't. I do have a fierce friend who was channelling the reg and yells at me if I go too fast but mainly I just want to be like I was before - fast walker, zipping through the tube etc.

    How are you doing atm JF?

  • Philomela, I'm exactly the same, when we were little my dad had us practically marching everywhere, or little legs going like mad trying to keep up, so now I can't bear to walk slowly I'm always overtaking people...But I don't know I've pushed myself too much until it's too late.

  • I am the best I have been since my flare up started in May 2010 Philomela. I can't quite believe it! This is my best time of year so February onwards and especially June/July will be the true test but I am very, very excited! The consultant back when I was seeing him advised me to only reduce my meds after 6 months of stability and I am 5 weeks in! My goal date for starting to reduce my symbicort is 1st August, if I have an excellent summer. Fingers crossed.

    I really hope I never go through such a bad time with my asthma again. I hope this gives hope to you and others who have difficult, 'non-classic' asthma.

  • yay! :) really happy for you and crossing fingers it lasts and you get through your worst times of year ok. It would defiinitely be good if you got a break as you deserve it, and maybe if that happens your lungs could come and do the 'reformed ex-con' talk with mine? ;) They're currently being like delinquent teenagers who are trying to keep up with the hardened criminals and think that racking up spells in prison is cool (err no it really isn't lungs!!)

  • Rachel - do you have the citation for that article you cited - I ran across it a long while ago and was trying to look it up to respond to you! -

    I have found that the short/long reaction is exactly what typically happens to me: within 5-10 minutes of starting exercise - even sometimes just going out on a walk to run errands - I'll start coughing or be short of breath. Even without ventolin those symptoms will spontaneously resolve a few minutes later. Because of that, I usually wait a bit to use ventolin if I have problems in the first 15 minutes of exreccise - but if they don't resolve spontaneously, out comes my inhaler.

    If I've really pushed myseelf or have exercised on a bad day (I go on a regularly scheduled walk with a friend every monday morning) - then I often have more problems than usual later in the day and sometimes on through the next day.

    However, I consider exercise so important that I think it well worth the price. Overall, I feel that if my body is in good shape, I'll be better able to handle the asthma when it gets bad. I (and meds) don't fully control my asthma, so I figure I'm better off making the rest of me as healthy as possible.

  • I'll have a look Beth, but I think I can only access the full thing if I on a networked computer at uni- I found them by going through the journal search on library website.

    Edit: I can't access the full article but can get the citations.

    The first article is: 1. Michel O. Exercise-induced asthma. Revue médicale de Bruxelles. 2010;31(4):255.

    The second article is: 1. Milan SJ, Hart A, Wilkinson M. Vitamin C for asthma and exercise-induced bronchoconstriction. The Cochrane database of systematic reviews. 2013;10:CD010391.

  • Hi

    I am new to this forum .I suffer from Asthma especially in cold weather,does anybody have any tips in combating

    this ?

  • Tried Google Scholar? Sometimes I find free PDFs that way (don't get me started on the academic publishing industry and open access...).

    Beth -good point, I think what I struggle with is how to know what I can put up with and what is really going to cause trouble! I can deal with being a bit more symptomatic (like you say, it's there anyway...all the time it seems like) but I don't want to make it a lot worse and make myself miss work/something else/land up in jail if I really go too far.

  • Thanks George! I do swim on my back when I get puffed -but prob need to do it more. I always swim 30 lengths, but since having asthma, its got much harder to do. Puffed out, coughing etc. Annoying. X Sue

  • Like many others on here I too am my own worst enemy - specially when it comes to exercise! I enjoy running (10 years ago I never thought I'd be saying that!) despite the fact it's the one form of exercise absolutely guaranteed to set my asthma off! It doesn't seem to matter what precautions I take or how long before I run that I take my inhaler I still end up being a coughing mess. On a Sunday I go for a run, usually 2-3 miles and then I go into the baths for a swim - at the baths I'm known by / for my cough!

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