Asthma and Exercise

Exercise can trigger asthma symptoms in children and adults – even those who don’t otherwise suffer from the condition – and can aggravate the problem in up to 80 percent of those who do have asthma. The symptoms – coughing, wheezing, shortness of breath or tightness in the chest – usually come on after exercise, although they can occur soon after exercise has begun. It can be treated with medication and by taking precautions to prevent or minimize symptoms.


Here’s a rundown of medication options, provided by pediatrician John Mark, MD, an assistant professor of pediatrics at the University of Arizona who treats asthma in both adults and children.

  • Albuterol – A short-acting bronchodilator that’s inhaled 15 to 20 minutes prior to exercise and that protects against symptoms for about four to six hours.
  • Salmeterol – A long-acting bronchodilator that’s inhaled twice a day which offers protection for up to 12 hours. You can also use salmeterol as a preventive before you work out.
  • Montelukast (Singulair) – A drug that blocks the action of leukotrienes in the lungs, resulting in less constriction of bronchial tissue and less inflammation. Leukotrienes are one of several classes of chemical messengers produced in the body that can trigger bronchial constriction and inflammation. Montelukast is available in pill form and is taken the night before you exercise.
  • Cromolyn (Intal) – An anti-inflammatory drug inhaled 15 to 20 minutes before exercising that prevents the release of histamines and leukotrienes. It’s most useful in asthma when an allergic component is present.

In addition to medication, the following approaches can help prevent or minimize symptoms:

  • A very slow warmup. Even to the point that your child reports the beginning feelings of the “tightness” associated with exercise-induced asthma. Then your child should stop and stretch, or slow down if exercising vigorously. By taking this break, the development of asthmatic symptoms can often be blocked and a normal pace can be resumed. This may take some getting used to, but can sometimes eliminate the need for medication.
  • Try breath work. The most effective approaches are pranayama techniques – breath control exercises taught in some yoga classes for adults. You can have your child do these after the initial warm-up, again, when the symptoms are almost felt. For most children, you can start with Dr. Weil’s technique for  “The Relaxing Breath.”
  • Find a form of physical activity that minimizes exercise-induced symptoms. Sports or activities that have intermittent rest periods (such as tennis, softball and golf) can allow your child to regain control of his or her breathing. Swimming may be better than running outdoors in cold weather, but no type of exercise is off-limits with proper treatment. In fact, some of the world’s top athletes have exercise-induced asthma, and they’re still able to compete successfully in Olympic-level events.
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