Don’t run out of puff
Asthma affects many Australians but it doesn’t have to stop you enjoying life or exercising. Accredited exercise therapist Lucie Richards explains.

Volume 11, No. 41, April 20, 2006

ASTHMA is a chronic disease, which can be controlled with proper treatment. Unfortunately it cannot be cured. It affects as many as one in five children and one in 10 adults in Australia.

People with asthma have sensitive or “twitchy” airways (bronchi and bronchioles). When they are exposed to certain triggers, the airways become narrowed and this makes breathing difficult.

The main ways the airways become narrow are:

• the lining inside the airways becomes red and swollen,
  
• the muscles around the airways tighten, and
  
• extra mucus may be made.
  

This in turn makes it difficult for air to pass through the airways to and from the lungs.
This increases the effort required to move fresh air containing oxygen (O2) in, and the “stale” air containing carbon dioxide (CO2 ) out of the body.

What are the symptoms of an asthma attack?
The main symptoms include:

• wheezing (noisy breathing when breathing out),
  
• coughing,
  
• chest tightness, or
  
• difficulty breathing or shortness of breath.
  

Asthma symptoms vary from one person to another. Some people can have all the symptoms while others may only have a cough or wheeze.
Symptoms can also vary in severity from mild chest tightness during exertion, to a life-threatening attack of severe breathlessness requiring urgent medical treatment.
What are the triggers for an asthma attack?
Many factors trigger asthma and vary from one person to another. These triggers (apart from exercise) should be avoided. Some of these triggers include:

• viral infections (eg cold and flu),
  
• inhaled allergens (eg mould, pollens, animal hair),
  
• sudden changes in air temperature (eg going out in a cold night),
  
• air pollutants (eg cigarette smoke, chemical fumes, paint),
  
• certain medications (eg aspirin, non-steroidal anti-inflammatories),
  
• some food and food additives (eg monosoduim glutamate (MSG)),
  
• emotional reactions (eg stress, laughter), and
  
• exercise (this can be managed).
  
  

What is exercise-induced asthma (EIA)?

Exercise-induced asthma is brought on by the physical exertion of exercising or playing sport. At least 80 per cent of people with asthma have symptoms triggered by vigorous exercise.

During rest we primarily breathe through our noses. The nose warms and moistens the air.

During exercise, the greater need for oxygen means an increase in the breathing rate through the mouth. The air is colder and drier as it hasn’t been warmed and humidified by the nasal passages. Therefore colder and drier air reaches the bronchioles, causing water loss and cooling.

It is believed that this cooling and drying effect of the air passages results in an irritant chemical released by the body, causing the airways to constrict. Asthmatic bronchial tubes are abnormally sensitive to these released chemicals which cause them to narrow.

In most cases, symptoms of EIA tend to be at their worst three to 15 minutes after exercise ceases. This, in many instances, occurs in the cooling-down period, rather than during the exercise.
How to prevent EIA
You can reduce the chances of experiencing exercise-induced asthma with a few precautions, including:

• make sure your asthma is managed properly on a daily basis,
  
• understand the severity of your asthma and establish an action management plan with your GP,
  u avoid known triggers,
  
• use your asthma medication around five to 10 minutes before you warm up – your doctor will advise you on the most suitable medication,
  
• always warm up by lightly moving and stretching for 10 to 15 minutes before you play sport or exercise, and
  
• always cool down.
  

What exercise is suitable for people with asthma?
Almost all sports are recommended for people with asthma and should be part of a daily management plan. Swimming is a fantastic aerobic exercise for asthmatics and is less likely to trigger a severe asthma attack because the air surrounding water is humid.

Scuba diving is the only sport not advised for asthmatics.
For more information about asthma or exercise-induced asthma contact your local Asthma Foundation on 1800 645 130.

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