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September 2010
Exercise Induced Asthma
Dr. Viral D. Shah
Asthma should not be a reason for you to stop exercising –not while Commonwealth Games are on, at least!
At least 80 percent of asthmatics get an asthma attack following vigorous exercise, called Exercise Induced Asthma (EIA). These symptoms are frequently triggered, if the exercise is performed in cold and dry air. But that should not stop you from exercising and letting your body have a good time. Appropriately adapted exercises can actually improve one’s asthma, in fact.

The Attack
  • The way to recognise EIA are the clear symptoms - cough, chest tightness, wheezing and difficulty in breathing appear as soon as person stops the exercise.
  • Normal breathlessness after exertion subsides quickly as exercise is stopped. Asthma induced breathlessness however, kicks in five minute or so after the exertion has been stopped.
  • This breathlessness can then get rapidly worse over few minutes and the attack can last up to half an hour or so.

When to Avoid Exercise
  • Usually, exercise induced asthma begins about five minutes after starting a particular exercise or play, indicating that your asthma is not controlled completely and the medicines are inadequate. The logical way then, is to stop exercising or playing till the asthma is controlled.
  • If asthmatic symptoms appear as you are finishing your exercise or match, the next time, have a shot of preventive medicines before starting the exercise.
  • If your asthma is not controlled, you should avoid doing exercises, games and hard physical work – that is the thumb rule.
Exercise for Asthmatics
Exercise, when done in the asthmatic style, reduces severity of asthma. So change into your tracks, and try these out.
  • Warm up: To reduce your chances for getting an asthma attack while exercising or during a match, start with a warm up. This could comprise of around 20 minutes of sub maximal exercise, or five sprints of 30 seconds, half an hour before you get into strenuous exercise.
  • Prophylactic medicines: Some medicines, if taken before exercise, would prevent EIA. These include:
    • Beta 2 agonist short acting: Take two to four inhalations a few minutes before you begin exercise.
    • Beta 2 agonist long acting: Take two inhalations at least 30 minutes before exercise.
  • Breathing: During your exercise or match, asthmatics should strictly breathe only through nose – mouth inhalation is a no-no. Increase the speed of your exercise slowly, keeping the rapidity of your breath under control.
  • Cool Down: Do not stop your exercise abruptly. After hard work or play, one should stop exercise slowly with a cool-down period of a few minutes. You could jog lightly or walk, to get your body accustomed to the cessation of rapid activity.
  • Climate: An asthma patient should play in warm and moist climate rather than cold and dry climate. If at all you should exercise in a cool and dry climate, it should be done after wearing a mask or a scarf over the face.
Exercises like swimming and walking do not induce asthma. And games like tennis, golf and cricket can be played without invoking Exercise Induced Asthma. So don’t let asthma stop you from enjoying your favourite sport – you’d be surprised by the number of renowned world-class athletes who have asthma. Maybe they’ll mention that during these Games, when some winners receive their medals – who knows? Gone are the days when asthma was something to be defensive and embarrassed about.
Dr.Viral D.Shah is Consultant & Head - Department of Pulmonary Medicine, Apollo Hospitals, Ahmedabad

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