ACTIVITY GUIDELINES FOR

Sport Medicine Council of Alberta YOUTHS AND ADULTS

WITH ASTHMA
Did you know that more than 1 in 10 Canadian
children have some form of asthma? It is a
Activity common problem and many of your friends and
schoolmates may also have asthma. Some people
have asthma only when they exercise and others
Guidelines have it both when exercising and at other times.

This booklet is about exercise and asthma. It

for contains simple guidelines to help you avoid or
decrease the severity of an asthma attack, and to
ENJOY exercise and sports.
Youths
1. Why should I exercise?
and
Exercise makes
you strong,
Adults flexible, and
healthy. It gives
you more energy
with and makes you
feel better about
yourself.
Asthma
2. Can I exercise if I have asthma?

Yes! Exercise may even help your asthma.

Administered by the Alberta Medical Association

3. What is asthma?
Asthma is a problem of the airways of the lungs.
Signs of asthma may include COUGHING,
WHEEZING, and SHORTNESS of BREATH.
The wheezing is due to narrowing of the air tubes
(bronchi) in your lungs due to spasm and mucous.
During exercise, drying and cooling of the tubes
by air may make your asthma worse.
4. How do you get asthma?
It usually runs in families and may appear at any
time in life. There are many possible causes, and
some believe it is a combination of factors that
results in asthma. It an be made worse by
allergies, infection, irritants such as smoke or
dust, weather conditions, and some medications.
5. Can I ever become an athlete?
Yes! Just like anyone
else. You can be
involved in any
number of activities
if you learn to manage
your asthma. People
with asthma have won
many Olympic medals
and broken world records.
One year, 15% of the U.S.A. Olympic athletes
had exercised induced asthma and they captured
41 medals.
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6. How can I tell how bad my asthma is?
By how you feel, your symptoms, and by how
much you use your asthma medications. You
may also monitor your asthma using a diary
and/or a ‘peak flow meter’. This device
measures how much air you can blow out.
You can measure the difference when you feel
good and when you feel short of breath. Your
doctor, pharmacist or respiratory therapist can
help you choose one and teach you how to use it.
7. I have some medicines from my doctor that I use
for asthma. What are they for?
Some medicines relieve asthma attacks
(relievers) (italic indicates inhalers):
• ß-agonists (e.g., Ventolin, Berotec,
Bricanyl)
• Anti-cholinergics (e.g., Atrovent)
Some medicines treat asthma attacks and
prevent them from coming back (preventers)
(italic indicates inhalers):
• Long acting ß-agonists (e.g., Serevent)
• Corticosteroids (e.g., prednisone)
• Inhaled Corticosteroids (e.g., Beclovent
Pulmicort, Becloforte,
Flovent, Bronalide)
• Airway anti-inflammatory (e.g., Intal,
Tilade)
• Leukotriene inhibitors (e.g., Accolate,
Singulair)
• Theophylline (e.g., Theo-Dur, Uniphyl)
Note: For more information, talk to your pharmacist or doctor.
The drugs mentioned above are not a complete list. If your doctor
prescribes a drug this is not on the list, please check with your
pharmacist whether they are relievers or preventers.
8. Which drugs are not allowed in sport 10. How can I use medicine to prevent asthma
competitions (“banned drugs”)? problems when I exercise?

Drugs that are thought to give athletes an unfair First, you should try to have your asthma under
advantage in competition or that may harm the good control before exercising or competing.
user are considered ‘banned’. All “puffer” For some individuals, treatment with Ventolin,
medicines for asthma are okay, except Berotec Intal or Tilade about 20 minutes before exercising
(Fenoterol). However, athletes need to declare helps to stop problems with asthma. If Ventolin
the use of puffer medications before competing. makes your heart beat faster, you must wait until
Many pills, liquid medicines or injections are it slows down before commencing.
banned, including some non-prescription
medicines. Check with your team doctor or 11. How do I take my pulse?
pharmacist before taking ANY medicine if you
are in serious competition and eligible for drug You can count your pulse for
testing. 15 seconds on the side of
your neck (carotid artery)
9. How can I control my asthma during or on your wrist
exercise? (radial artery). To find
the pulse on your neck,
Keeping your asthma under control is an locate the midpoint of your
important first step. (‘Under control’ means you jaw bone (half way between
do not need to use your reliever medications your chin and ear), move down about 4 cm,
very often, you are sleeping well and your and use your fingers (not thumb) to count
asthma symptoms are minimal.) By getting in the beats.
shape you may be able to tolerate exercise
better. An adequate “warm up” and “cool To find the pulse
down” are important to prevent the asthma on your wrist, place
from getting worse during and after exercise. your palm upward
Keeping well hydrated by taking in fluids also and move your fingers
helps. Finally, some people may need to take about 4 cm down the
medication before exercise. outside of your wrist
from your thumb. For
a one minute count,
multiply your 15 second
count by 4.

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12. What else can I do to prevent an attack?
Warm up for 15-20 minutes before
exercising. It helps to prevent attacks
by creating a “refractory period”, and
prevents injury to muscles and ligaments.
A refractory period is a time of a few hours
when there is less chance of an attack.
13. What is a ‘warm up’?
A ‘warm up’ is a light exercise that makes
your body ready for strenuous exercise.
You should GRADUALLY increase the
heart rate and loosen muscles by game-like
activity and stretching exercises for 15-20
minutes. It is the same activity you are
going to do, but at lower intensity.
14. Tell me about some ‘warm ups’ for some
sports.
On the next few pages, we’ve provided
some examples that can be altered to suit
your chosen activity and your own needs.
If you cough or wheeze, slow down and
consider using your reliever medication
(e.g., Ventolin) to help you.
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WARM UP EXERCISES
ICE HOCKEY
Skate easily for 8-10 minutes, working the puck.
Stretch all the muscles. Then skate faster, mixing
sprints with light skating.
BASEBALL
Walk around the field, increasing to a slow jog for
7-10 minutes. Stretch then alternate slow and fast
jogging and start throwing the ball. After each turn
at bat, jog slowly to your position and warm up by
throwing the ball.
SOCCER
Walk around the field, increasing to a slow jog for
7-10 minutes. Stretch. Then slow jog with the ball,
passing and doing other skills. Lastly, mix sprints with
slow jogging with and without the ball.
VOLLEYBALL and BASKETBALL
Walk around the court. Then jog for 7-10 minutes.
Stretch. Then do jumping and ball drills until the
game.
RACQUET SPORTS
Start with easy strokes, hitting the ball to your partner.
After 7-10 minutes, stretch. Then increase power
and speed until you equal game conditions.
 RUNNING, CYCLING and
SWIMMING
Go slow to start. After 7-10 minutes, stretch. Then
return to your activity, gradually increasing the speed.
body position and ease up a little. Remember
all stretching should be pain-free. When you
have more time, stretch all your muscles for
longer periods of time. Hold the stretch for
15 seconds or longer, while breathing in and
out easily.

16. How do I know if I’m doing too much?

GYMNASTICS
By the way you feel. Unless you are in
competition, you should feel comfortable.
Walk around the mats and apparatus, increasing to a
You should feel that you are working fairly
slow jog for 7-10 minutes. Stretch. Then do easy
hard to very hard, but not at maximum of very,
exercises on each apparatus increasing the intensity
very hard. Another way to tell – you should be
slowly.
able to talk to a companion without too much
difficulty. You should feel ‘pleasantly-tired’ at
15. How do I stretch properly?
the end of your workout. Increase the time you
exercise by no more than 5-10 minutes/week
Start to stretch after some warm up activity. A
for each session.
good stretching program involves all the major
muscles in the body. During a warm up,
17. What do I do if I get a problem with
however, you may not have enough time to
asthma while I’m exercising?
stretch all your muscles. If so, stretch the
muscles you are going to use. Hold these
Slow down or stop. Use your reliever
stretches for about 10 to 15 seconds
medication (e.g., Ventolin), and if needed,
without bouncing. Concentrate on bringing
wait for your pulse to slow down before
your muscles to a gentle stretch where you feel
starting again.
mild pulling. Note that muscle tension varies
from day to day. If you feel pain, check your

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18. What sports or exercises are best for
people with asthma?
Any sport you want to do is okay as long
as you are prepared. Those sports that
incorporate ‘interval training’ and those
involving breathing warm, moist air are
best. ‘Interval training’ is training that
alternates strenuous and light exercise.
Try to avoid any sports that expose you to
your allergens, such as grass and pollens.
Swimming is great, but some people have
problems with chlorine. Other good sports
include racquet sports, basketball, baseball,
some track and field events, volleyball,
soccer, or hockey. Long distance running
or cycling with continuous hard effort may
not be as easy and exercising in cold dry
air may be difficult. But with suitable
medication and training you can do those
too. Don’t use asthma as an excuse for not
participating. Be realistic as to how much
you can do until you are conditioned.
19. How often should I work out?
Ideally, 3-6 times a week, or as much as
you want. Start with 5-10 minutes and
work up to half an hour or more per
session. Remember to increase by no
more than 5-10 minutes/week per session.
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20. After exercise, then what?
‘Cool down’. After vigorous activity,
don’t stop suddenly but slow down
gradually over about fifteen minutes, until
you are breathing easily. Drink lots of cool
fluids (not ice cold). This will help prevent
more asthma symptoms later on. Before
you get cold, you should also stretch again,
as you did in the ‘warm up’.
21. Any other tips?
Yes lots! However, common sense is your
best guide. If you do something that makes
you feel bad, stop it. Keep away from the
things that set off an attack.
* If you are allergic to trees or
grasses, you may have to avoid
woods or parks, use a mask or
exercise indoors.
* If your asthma is triggered by dust,
smoke or fumes, stay off main roads;
try residential areas.
* If cold air makes you have an asthma
attack, warm the air with a scarf or
mask over your mouth and nose.
* If you can, choose the time of day
and weather best suited to you; for
example ragweed is worst in the
morning.
* Windy weather is usually cold or may
create dust which may tigger an attack.
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 * If asthma symptoms develop during or
after exercise, use your reliever medication
(e.g., Ventolin) to help relieve symptoms.
Try to breath in through your nose and out your
mouth whenever possible. The nose filters,
warms and moistens the air.
22. What should I tell my teacher or coach
about my asthma?
Tell them you have asthma and explain your
symptoms. Tell them what medicines you are
taking and how you use them. Let them know
how you try to avoid symptoms and what to do
if you experience them. An action plan is what
you do when you have asthma symptoms. It is
best if your parents give a copy of the action
plan to your teacher or coach. Also, agree on
a signal with your coach to show you need to
sit out. If you have a new teacher, make sure
he or she is also told the same things.
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23. Then is it okay to take part in Physical
Education class?
Yes, as much as you can as long as your asthma
is well controlled (see question 9). Remember
to take your medication before you exercise, if
needed, and warm up and cool down every
time.
24. Should I carry my medication with me
always?
Yes! Always keep your reliever medication
(e.g., Ventolin) with you because you never
know when you may need it.
25. What else can I do?
Make sure YOU know what YOU can do to
control your asthma. Work with your parent
and doctor to keep it under control all the time.
Learn how you can manage it so that you can
enjoy doing anything you want. You should also
include active living in your lifestyle: take the
stairs instead of the elevator or escalator; ride a
bike or walk instead of driving.
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 STRETCHING EXERCISES 2. Clasp your hands behind you and lift. Feel
your shoulder blades move together and
A number of simple warm up and stretching your chest move out.
exercises are shown on the following pages.
You should do them before you begin any physical
activity.

Remember the golden rule: these exercises should

NOT hurt you.

For all these exercises, remember to stretch both

sides, to hold the tension for between 15 and 30
seconds, and to cause NO pain.

1. Lean to one side. Feel the pull in the

side and upper area. Now repeat this
for the other side.
3. At shoulder level, bring your arm back to
grab onto a solid object. Turn your body
slowly towards the outside until you feel a
stretch in your arm and shoulder. Change
sides.

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4. With your arm over and behind your head, 6. Push your hip towards the wall. Stretch
pull the elbow down. This will loosen the the calf muscles. Make sure the knee of
shoulder joint. Change arms. your front foot stays over the ankle and
that you can see your toes. Change legs.

5. Pull your right foot up behind you with the 7. Put the soles of your feet together. Then,
right hand to stretch the quads. Keep your from the lower back, lean forward to
knees together, bending your supporting stretch the inner thigh muscles.
leg slightly. Change sides.

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8. Bend forward and reach for the ankle. Well, that’s it! We hope this will answer some
This stretches your trunk and the back of of your questions. If you need any more help,
the leg. Change sides. talk to your doctor or other health care
professional or contact the:

Sports Medicine Council of Alberta.

11759 Groat Road
Edmonton, Alberta
T5M 3K6

Telephone: (780) 415-0812

Fax: (780) 422-3093

OR

Alberta Lung Association

Alberta Asthma Center
Allergy, Asthma Information Association
9. Pull knee to your chest. This loosens
your hip and hamstrings.
GOOD LUCK! And always work hard, play
hard, and have fun.

A version of this pamphlet is available on the

Alberta Medical Association web site:
http://www.albertadoctors.org

Original Artwork by Laurel Hawkswell.

September 1999

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