I was diagnosed with asthma in the past year, and wondered if anyone had any tips for managing this while working out. I don't smoke and I take my asthma medication faithfully, but I still have problems.

One thing I've noticed is that hard workouts often make me sick - I end up with a sinus infection which always used to turn into bronchitis. Now the Advair helps control the bronchitis part, but I wonder if there's something else I need to do (or not do) to deal with this. I've also heard that cold air makes asthma worse, and I wonder if I should tailor my workout in the winter so that I breathe in as little cold air as possible.

Hi there! Yes, you will want to stay out of the cold air as much as possible as that will aggravate your asthma. I have asthma too, so I know.

Do you have access to a pool? Swimming is great for us asthma sufferers because of the humid air. Also, I have noticed that although I can't "run" on a treadmill like many of my fitness counterparts, I have found that if I set the inclines or intensities higher, and still take it slower, I burn just as many calories and get my heart rate just as high as if I were running. I tried this with my friend Katie to test it. We both got on the treadmills and she jogged for 30 minutes at no incline, and I walked for 30 at a 7.5 incline, and I burned only 25 less calories than her while keeping my heartrate at 155-165 the whole time.

Lastly, keep working with your doctor until you find something that works. I haven't perfected my treatment yet either, but my doctor assures me that asthma should not be able to keep me from what I want to do, so we just need to find the right remedy, and build up our depleted lungs through training.

Don't get discouraged, and keep up the good work!

Jen

Thanks so much for letting me know of the "research" you did on on walking vs. running on the treadmill. I too have noticed that I am more likely to get sick after running with no incline vs. walking with some incline, but it's nice to hear an independent opinion (and you also checked to make sure you were getting as good a workout)!

I've had asthma all my life, so I've picked up a trick or two. If you have an Albuterol inhaler -- which is likely, since you have an Advair inhaler -- try taking a puff or two five minutes before you work out, even if you're not feeling tight. This should help prevent any bronchial spasm that might occur while you exercise.

One thing I used to do when I rode my bicycle every day during the winter was get a scarf and put that over my nose and mouth. It was kind of uncomfortable, but it warmed up the air I was taking in and helped prevent asthma and nasal congestion.

If you have problems with frequent sinus infections, the best thing to do is just keep your hands as clean as possible, and try to avoid touching your face as much as possible. This is especially true in a gym, where people often use machines even when infectious (and they may not know it) without cleaning up thoroughly afterwards.

And, of course, stay hydrated. Really, really hydrated. Your lungs will love you. Your pulmonologist will love you.

Swimming is really good for asthmatics, as Jennie pointed out.

Howdy,

Another asthmatic here, inhibited in exercise all my life. And barely escaped death last year when I lived in a mold infested house. Twice actually, I was hospitalized, and was unconscious for a day the second time. That was just last August, and this year I am working out and living more or less asthma free. Obviously, I have some thoughts about asthma.

I now have insurance and take Advair (and keep Albuterol inhalers with me all the time) I was actually uninsured and on over the counter meds (the horrible, almost deadly Primatene Mist) when I started getting healthy. When I saw a real doctor 2 months ago and got on meds, I was practically asthma free, which amazed them because doctors don't believe in much that isn't made in a lab. I believe I pretty much got 90% over asthma with dietary and lifestyle changes alone. And I have some specific things to add about exercise.

As for my general feelings about asthma and how I improved my situation...

I cut way down on wheat, which is nice if you are trying to lose weight because those foods are mostly carbs. I eat a lot of vegetables and take a multi. I choose soy milk over regular milk, and keep all dairy to a minimum (altho I don't think I could have stuck to my eating regimen without fat free cheese and cottage cheese - moderation in all things, especially dairy).

And I drink a lot of water. I mean, a lot. There are actually some who say asthma is a dehydration response, and not a disease at all. While I don't go that far, there is something to be said for this. Most of the water in your body is expelled not thru sweat or waste, but thru respiration. If you are dehydrated, your body needs to above all else save your brain from death, and it will shut down your lungs if it has to. I don't know how credible this is in scientific circles (but own doctor claims to have never heard of such a thing) but it certainly seems possible, and feels true to a lifelong asthmatic. The feeling of an asthma attack is very much like your lungs just tightening up to not let so much air in or out. Seems perfectly reasonable to think this is a defense mechanism to keep you from expelling more water when it believes you are approaching dehydration.

I wouldn't toss the theory around if I didn't believe I have also demonstrated it. The main times I still suffer are when I first get up in the morning, and a couple of big glasses of water often seems to clear it up or go a long way toward clearing it up. So that is after not having anything to drink since the night before. And when exercising, and I've also felt it was less a threat when I was drinking plenty of water. Still testing this, but drinking water never hurt anyone and I think it very possible you will see a difference. So while exercising, and all the time, drink drink drink... lots of water. I really believe it is the number one thing, along with....

Relaxation. Seriously. When I have that morning tightness, some water and just sitting calmly seems to get me thru it. There is a lot going on in asthma that has to do with fear, anxiety and stress. Especially for someone like me who has felt the finger of death twisting its way into his bronchial tubes.... Every time I tighten up a bit, whether it's on the treadmill or at home in bed, anxiety kicks in. The feeling of being in a public place intensifies it, so if I start to feel it at the gym I get self conscious and a little scared and I have stepped down from exercise many times when I was not really threatened, just because my whole life I have backed off in fear.

When I had these terrible attacks last year I was sick, sick, sick, and then suddenly I panicked realizing how sick I was and suddenly, just like that, I was incapacitated and had to be carried to the hospital. It happened in an instant, and I know for a fact, stress and fear have a lot to do with escalating asthma you have an attack. I've seen many times how quickly it gets out of control once your mind begins to worry about it, and I will insist emotional fear and stress is what kills people. I now try hard to relax when I feel sick, and to tell myself I am not going to die. You can do this too while exercising. I'm not saying do nothing else, but am saying that when I feel some tightness or loss of breath on a bike or treadmill I remind myself I have always survived it, and of course exercise is pushing me to the edge, but I will be fine. Try to relax and tell yourself you are going to be fine, and just listen to your body and see if that pulls it back a bit.

All "allergic" responses in fact are partly physical and partly not... even if the dehydration theory is true, it may not be because you are really dehydrated so much as your body worrying about approaching dehydration. Allergies, and I count asthma as one for the sake of this discussion, are defenses against what the body perceives as danger. Exercise, pretty much by definition, is a stress on the body. Athletic asthma could be a (confused but well meaning) response to stress. This could be why some people have asthma only in exercise, and almost all of us experience it in exercise. The body believes it is being killed when you elevate your heart rate and pound your feet on the pad for 30 minutes. It's not, but the body goes into survival mode and perhaps for some of us that includes asthma attacks. I have noticed my asthma, when it bothers me in exercise, seems to come at a point where I am starting to get tired but still have plenty of gas still in me. It's easy to imagine the body is starting to think about the pain and stress and wants you outta there, especially if you (as I have) have retreated from exercise in fear many times in your life. I would go so far as to say it isn't the stress of exercise as much as the mind analyzing and getting prepared for stress and pain. Make sure you get experience determining where the real stress and the perceived stress meet, and try to feel comfortable about that place.

So what kind of exercises?

I can run and walk on a treadmill, and I can bike. I tend to do intervals, which in my case means I go hard until I can feel it, then I slow down and once I recover start pushing hard again. I feel like this kind of work keeps you in the zone, burning calories and fat, but minimizes stress, both real and perceived. There are a lot of ways to describe and structure interval training, but to me it's the ultimate way to keep from hurting yourself because it's all about listening to your body. I don't ever do "X minutes at X speed". I do rising and falling intensity, listening carefully to my own body. a) less likely to physically stress yourself in the bad way and b) less likely to induce any emotional stress or panic because you are so well in control of your own mind. I'm never working against anybody but myself, and I think that makes a lot more sense, especially to an asthmatic. I believe moderation and not hurting yourself physically is important. I believe feeling confident you are in control may be even more so.

I think what someone said about swimming above is true, but I don't personally think there is any kind of exercise an asthmatic can't do. In fact, somewhere on the web there is a long list of well known world class athletes with asthma, and it includes champions and gold medal winners. I might go find that list and bring it back here... for all of us interested in this matter.

I could add more about foods that decrease inflamation, herbal remedies, Omega 3s, anti-oxidants, etc. In fact I could talk all day about this (as you can see). And not so much about drugs. I would personally do anything to avoid drugs, and my study and observation of my own condition has been all about getting this under control without drugs.

But I want to add one more thing, about breathing exercises. And by that I mean, outside of the gym (altho what I am going to describe can be done while working out too). Since I obviously believe a lot of asthma has to do with emotional things, stress and feeling secure... and since this is a respiratory problem, controlled and conscious breathing can be very important, both as meditation and as medicine.

And by that I means something as simple as monitoring your breath.

Breathing is a weird thing. It is connected both to your voluntary and involuntary systems (you can control your breathing, but it also goes on with or without you - both systems, and that is unique). So consciously working with your breathing is a very powerful way to sort of get under the hood and work with things like your nervous and immune systems you might think work independently of you. They do and they don't.

Breathing fast and shallow, as we asthmatics probably have most of our lives, is unhealthy at the surface level, but in a deeper sense it sort of trains the nervous system to be unstable and not at ease. Many asthmatics suffer from a number of stress related peripheral illnesses and this may be a part of why. When I was sick last year, I wasn't just sick... I was messed up in every way imaginable. My immune system was just in rubble. I was often sick with other ailments, and was generally fatigued and nervous. Now that I breath better, I am never sick and I'm emotionally much more on my game as well.

When you take up conscious breathing, first of all deep slow breaths are just good for you in every sense you can imagine. But secondly, I think it soothes and trains the less obvious systems to be relaxed and healthy. I think it can be like giving your immune system a massage.

Pranayama, yoga breathing, is an infinitely complex study, and I can't begin to understand it or try to teach it. But at it's most basic and simple sense, just breathing mindfully... taking slow long deep breathes and feeling every part of it, noticing the air coming in and out, is a very easy and safe practice. And the resulting oxygenation of your body and calming of your mind will reach out to all corners of your life including your workouts. Dr. Andrew Weil has a very good CD about breathing that includes a

I wish I could offer more great advice, but I noticed after I lost the 65+ lbs. i've lost, that I don't have any asthmatic reactions to anything anymore. I have had asthma my whole life, and I've had inhalers and all sorts of other contraptions since I was a very tiny baby.

What helped more than my inhalers ever did, is breathing excercises, and meditation/self awareness. WHile meditating its easier to pay close attention to yourself and your body. When I used to have an asthma attack, i would sto what ever I was doing and either sit or kneel and slow my breathing to the point where my heart rate would drop (natural tnedancy s to hyperventalate) way below normal, and breathe very very slowly.

I do breathing excercises daily to maintain a strong diaphragm, and keep my lungs conditioned. That has helped me more than my inhaler ever has.

Nathan,

I've had more than one doctor recommend some breathing exercises for me. I agree, they help plenty (when you remember to do them regularly).

The best book I've found for breathing exercises was Andrew Weil's Eight Weeks to Optimum Health, which a neurologist I was seeing for migraines recommended to me. Not everyone agrees with everything he's written in that book, but I found his breathing exercises useful, at least.

I hadn't thought about breathing exercises. I do yoga, and find the breathing-through-my-nose part difficult because my nose is always so stopped up (despite lots of prescrip and OTC drugs). I do think I find yoga more difficult now after having developed asthma (which happened in 2000, after a severe respiratory infection) than it was before developing this.

I did interval running/jogging outside this morning and did feel the tightness in my chest right away. I used the Albuterol when I came inside, but next time I'll remember to do so beforehand. I'm actually pretty stingy with it, so perhaps I should be more liberal.

Richard, I'm pretty good about cleaning gym machines AFTER I use them, so maybe I should do that BEFORE I use them as well.

Yeah, you should clean machines before you use them as well as after. Though the staff at my gym is pretty good about maintaining the machines and keeping them clean, I've occasionally thought about bringing in a little bottle of Purel to clean my hands after each machine anyway (being careful, of course, not to touch your face while you're exercising).

So, definitely stay away from cold air anyway you can. You want warm, humid air, just like they are saying.

Another trick is to change your breathing patterns. "In through nose, out through mouth" helps, particularly if you change how you exhale to keep you from sucking in air too often and too quickly. The trick is to kind of exhale in to your cheeks, and then open up your mouth a bit and kind of blow the air out with your cheeks. This usually results in a rhythm where you go through the full cycle in slightly less than a second. This pacing and rhythm seems to help calm your respiratory system. I can't promise results, but it's worked for several other asthmatics.