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Running with allergies and asthma

Exercise, which helps stimulate the cardiovascular system, is an important activity for everyone, including patients who have asthma or other allergic disorders. Although exercise will not cure or necessarily improve their condition, it will help them to feel their best, both physically and psychologically.

Is exercise recommended for patients with allergies and asthma? - In general, a patient with allergies or asthma is usually able to exercise as much as desired, as long as a few precautions are followed. Exercise should not be done if the patient is sick or not feeling well. A person should never push beyond his or her capabilities. An exercise program should begin carefully, and it is a good idea to discuss such a program with your physician before starting. Once a patient is feeling well, has discussed an exercise program with his or her doctor and is ready to start, the following suggestions and precautions should be used.

Why is breathing through the nose important? - The nose and sinus (upper airway) should be as clear as possible when exercising so that nasal breathing can take place. This is important because the nasal passages contain a natural filtering and humidifying system. This system will help keep the air at proper temperature and humidity. In addition, this nasal filtering system will help to keep out pollutants, irritants and allergens. If a person breathes through the mouth, this filtering and humidifying system is bypassed. Mouth breathing can introduce irritants to the bronchial tubes and lungs, and the exercise program will be less effective. It may be necessary or helpful for the allergic patient to use a medication that will keep the nasal airways open, such as an antihistamine, decongestant, nasal cromolyn sodium or a nasal steroid spray. (Check with your doctor, as many of these are prescription medications.) The asthmatic patient may need to use medication for the bronchial tubes if exercise causes symptoms of chest tightness, cough, wheezing or shortness of breath. This can commonly occur in patients with asthma, chronic bronchitis or chronic obstructive pulmonary disease. In addition to immediate bronchial constriction and wheezing, exercise has recently been shown to cause delayed reactions several hours after the initial exercise has been performed. Some common delayed symptoms include chest tightness, cough and shortness of breath.

How can I control my symptoms during exercise? - Patients can often prevent these symptoms by taking medication prior to exercising. The type of medication used depends on the frequency and duration of physical activity, how often exercising is done throughout the day and the practicality of taking medication before exercise. An inhaler, such as albuterol or cromolyn, taken five to ten minutes before exercise, is one type of medication that can be used. Sometimes theophylline or other bronchodilator tablets are recommended before exercise. A physician should be consulted on the best medication to use before exercise. After the medication decision has been made, the choice of the exercise activity and the location are very important. If you have allergies, vigorous exercising should obviously not be done near a field full of grasses and weeds. It may be more appropriate to exercise indoors at certain times of the year. If exercise is done outdoors, it should be in areas where there are not large concentrations of allergens (pollens, dust, mold, etc.). If allergens cannot be avoided, certain preventative methods, such as medication taken before exercise or wearing of a mask, may be indicated. Exercising should also be avoided in areas where there are large amounts of chemical irritants. For example, running and other vigorous sports should not be done near a heavy traffic area where there is a large amount of exhaust from vehicles, or near factories that emit large amounts of pollutants in the atmosphere. Indoor areas where there are noxious or irritating odors should also be avoided.

What form of exercise is best? - The allergic or asthmatic individual should consider what form of exercise would best meet their needs. Exercise that has stop-and-go activity tends to cause less bronchial constriction than an exercise using continuous motion. Continuous running most commonly causes bronchial constriction and spasm to those with respiratory problems, while swimming poses the least amount of respiratory irritation. Weather conditions should also be considered when exercising. Cold and dry or very dry weather can be quite irritating to the bronchial tubes.

Special precautions - Special precautions should be taken by those individuals who have severe allergies to stinging insects (such as bee, wasp, yellow jacket, etc.). If exercising is done outdoors, injectable epinephrine must be kept on hand. Another person should also be nearby to assist in an emergency. Individuals with bee-sting allergy should avoid wearing bright-colored clothing or strong perfumes or lotions that may attract stinging insects and increase the risk of being stung. Areas where stinging insects tend to inhabit should always be avoided. These include flowerbeds and flowering fields, bodies of water and areas near garbage. The most care should be taken by individuals who develop hives, swelling or anaphylaxis when exercising. (Anaphylaxis is the most severe form of an allergic reaction and can be life threatening.) Patients must carry injectable epinephrine with them, should never exercise alone and should not exercise or jog in remote areas where medical help is not nearby. These individuals may also find it necessary to take antihistamines or other medication before they exercise.

All the above factors should be taken into consideration before an exercise program is begun or before any type of physical activity is planned. These suggestions and precautions are not meant to discourage exercise but to help in choosing suitable activities, taking into account different medical conditions and circumstances. Remember, patients with bronchial asthma have even participated (and won medals) in the Olympics. Exercise programs can be quite vigorous and helpful if undertaken with care and a physician's guidance.

Credits - WorldwideRunning.com would like to thank the American College of Allergy, Asthma & Immunology for the permission to reprint the article "Exercising with Allergies and Asthma". The ACAAI is a professional medical organization of allergists-immunologists and allied health professionals. Members live and practice throughout the United States and internationally. The College fosters a culture of collaboration and congeniality in which its members work together, and with others, toward the common goals of patient care, education, advocacy and research.