If you have asthma, exercise can sometimes worsen your symptoms. The symptoms may include wheezing, coughing, and shortness of breath.

Typically, these symptoms begin within 3 minutes after starting physical activity, peaking within 10 to 15 minutes, then resolve within 60 minutes. Occasionally, these symptoms occur immediately upon stopping activity.

When this occurs, it’s called exercise-induced bronchoconstriction (EIB). The term “exercise-induced asthma” was used in the past to describe this phenomenon, but it’s considered outdated because exercise itself doesn’t cause someone to develop asthma.

On the other hand, you can have EIB without having asthma. But if you already have asthma, EIB can be a feature of it.

Understandably, you may be hesitant to start running. But with the proper precautions, it’s possible to run safely with asthma.

Running can even ease your asthma symptoms by strengthening your lungs and reducing inflammation. This can make it easier to enjoy daily activities and exercise in general.

Before starting a running routine, make sure your asthma is well controlled. Your doctor can help you manage your asthma before you hit the pavement.

For a safe and effective workout, follow these tips for running with asthma.

1. Talk with your doctor

Before starting a running routine, consult your doctor. They can provide safety tips and precautions based on the severity of your asthma.

Your doctor may also recommend more regular checkups as you develop a running routine.

2. Know your asthma action plan

Work with your doctor to create an asthma action plan.

This plan will include preventive measures to control your symptoms. For example, your doctor may have you use a daily inhaler for long-term management. This can soothe airway inflammation, which decreases your overall risk of flare-ups.

They might also have you use a rescue inhaler 15 minutes before running. A rescue inhaler contains medication that rapidly opens the airways. You can, of course, use your rescue inhaler as soon as symptoms arise while running.

Also, ask your doctor what to do if you’re running without an inhaler and have an asthma attack. They can show you the signs to watch out for in case you need emergency help.

Breathing exercises are unlikely to help in such a case — they’re more likely to help if dysfunctional breathing or vocal cord dysfunction is the contributor to breathlessness.

3. Pay attention to your body

While it’s easy to zone out while running, it’s important to stay in tune with your body.

Make sure that you’re familiar with the normal signs of exercising, such as:

  • flushed skin
  • faster, deeper breathing
  • sweating
  • feeling warm

You should also know the symptoms of an asthma attack, which aren’t normal during exercise. They may include:

  • coughing
  • wheezing (a high-pitched whistling sound that happens when you breathe)
  • shortness of breath
  • chest tightness
  • breathing that doesn’t slow down

4. Carry your rescue inhaler

Always take your rescue inhaler. This will help you prevent an asthma attack if you experience symptoms while running.

If you tend to forget your rescue inhaler, try posting a reminder near your door.

5. Check the weather

Look at the weather forecast before running outside. Avoid running in extremely cold or hot weather, which can induce asthma symptoms.

Exercising in cold, dry air may worsen EIB. Breathing through a loose-fitting scarf or mask may help reduce symptoms because these measures help to warm and humidify the inhaled air entering your airways.

Another option is to exercise indoors on very cold, dry days.

6. Avoid high pollen counts

Pollen allergies are commonly associated with asthma. If you have pollen allergies, consider checking your local pollen counts before heading out for a run.

If the pollen counts are high, you can opt to exercise indoors to prevent getting asthma symptoms. If you don’t have pollen allergies, it may be unnecessary to avoid exercising outside.

Besides the actual pollen counts, other factors, such as windy conditions or thunderstorms, can also worsen symptoms of your pollen allergies and asthma.

7. Reduce your exposure to air pollution

Air pollution is another common asthma trigger. To reduce your exposure, avoid running near busy, high-traffic roads.

8. Run in the morning

There are many reasons why running outside early in the day can help prevent symptoms of asthma. The levels of certain pollutants are lower in the morning.

It’s also possible that EIB symptoms are milder in the morning. This is partly related to the higher level of endogenous corticosteroids in our body in the morning. These hormones lower inflammation and thus allergic reactions.

However, running in the morning may not be the best option for everyone who has asthma. Generally, the air is cooler or colder in the morning, especially in the winter or on colder days in the fall and spring. Running in the morning when the air is colder may trigger EIB symptoms.

During the warmer months, the level of grass pollen tends to be highest in the early morning and early evening. This is another reason running in the early morning may not be a good idea if you have a grass pollen allergy.

If you’re allergic to tree and weed pollens, then avoid running outdoors at midday and in the afternoon, when their counts are highest.

9. Understand your limits

Start at a low intensity to warm up your body for about 10 minutes, then increase your speed over time. As your body gets used to running, you can begin to run faster with asthma.

Take frequent breaks. Long-distance running can trigger an asthma attack, as it requires prolonged breathing.

Run shorter distances and stop when necessary. This will make it easier to run more regularly, which can help increase your lung capacity over time.

When you’re winding down, reduce your pace for about 10 minutes to cool down your body.

Warming up and cooling down is especially important if you’re entering or leaving an air-conditioned or heated room, as drastic temperature changes can trigger symptoms.

10. Cover your mouth and nose

EIB often gets worse when the air is cold and dry air. If it’s cold outside, wrap your mouth and nose with a scarf. This will help you breathe in warmer air.

11. Take extra precautions

Run with a friend whenever possible. Let them know what they should do if you experience asthma symptoms.

Always bring your phone, and avoid running in remote areas. This ensures that another person can get help if you need medical assistance.

When done with a doctor’s guidance, running may help control your asthma symptoms. It has the following benefits:

Improve your lung function

Poor lung function is a hallmark of asthma. However, in a 2018 study, researchers determined that physical activity could improve lung function in people with asthma.

It can also slow down the decline of lung function, which normally happens with age.

Increase your oxygen uptake

Regular aerobic exercises, such as jogging, improve the oxygen uptake of your lungs and the health of your heart and lungs in general, according to a 2020 review of studies.

The search also found that such exercises can help reduce asthma symptoms and improve your quality of life.

Decrease airway inflammation

According to a 2015 study, aerobic exercise can help reduce inflammation in the airways. This could ease the symptoms of asthma, which are caused by airway inflammation.

To improve breathing during physical activity, try the following breathing exercises for asthma. You can also do these exercises before or after running to further manage your symptoms.

They work by opening your airways and normalizing your breathing.

These breathing techniques will only work in the case of breathlessness while exercising if the exercise-induced symptoms are partly due to vocal cord dysfunction or dysfunctional breathing. These contributing factors can worsen the symptoms of breathlessness from asthma.

It’s important to know that the following breathing techniques won’t specifically help reduce your symptoms if you have pure bronchoconstriction.

Some breathing techniques, such as Buteyko breathing, may help reduce perceived asthma symptoms over time, but may not necessarily be helpful when exertion triggers acute bronchoconstriction.

Pursed lip breathing

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If you’re short of breath, try pursed lip breathing. This technique helps oxygen enter your lungs and slows down breathing.

  1. Sit in a chair, back straight. Relax your neck and shoulders. Pucker your lips, like you’re about to whistle.
  2. Inhale through your nose for two counts.
  3. Exhale through your mouth for four counts, lips pursed.
  4. Repeat until your breathing slows down.

Diaphragmatic breathing

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Diaphragmatic breathing, or belly breathing, expands the airways and chest. It also moves oxygen into your lungs, making it easier to breathe.

  1. Sit in a chair or lie in bed. Relax your neck and shoulders. Put one hand on your chest and the other on your belly.
  2. Inhale slowly through your nose. Your belly should move outward against your hand. Your chest should stay still.
  3. Exhale slowly through puckered lips, two times longer than your inhale. Your belly should move inward, and your chest should stay still.

Buteyko breathing

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Buteyko breathing is a method that’s used to slow down breathing. It teaches you to breathe through your nose instead of your mouth, which soothes your airways.

  1. Sit up straight. Take several small breaths, 3 to 5 seconds each.
  2. Breathe out through your nose.
  3. Pinch your nostrils shut with your thumb and index finger.
  4. Hold your breath for 3 to 5 seconds.
  5. Breathe normally for 10 seconds.
  6. Repeat until your symptoms subside.
  7. Use your rescue inhaler if your symptoms are severe or if they don’t go away after 10 minutes.

Before going on a run, follow these tips to stay safe and comfortable:

  • Take your rescue inhaler 15 minutes before running or as directed by your doctor.
  • Carry your phone and rescue inhaler in a running pouch.
  • Stay hydrated.
  • If you’re running in cold weather, wear a scarf around your mouth and nose to prevent cold-induced asthma.
  • Check the pollen and air pollution levels.
  • If you’re running alone, let a friend know where you’ll be running.
  • Carry a medical tag or card, if you have one.
  • Plan your route so you can avoid busy, polluted roads.

Extreme temperatures can worsen your asthma symptoms. This includes hot, humid weather and cold, dry weather.

Therefore, it’s best to run outside when the weather is mild and pleasant.

Talk with a doctor if you:

  • want to start a running routine
  • feel your asthma isn’t well controlled
  • have developed new symptoms
  • have questions about your asthma action plan
  • continue having symptoms after using an inhaler

You should also see a doctor if you think you have asthma but haven’t received a diagnosis.

It’s possible to run safely with asthma. Start by working with your doctor to control your symptoms. They can provide an asthma action plan, along with a rescue inhaler.

When it’s time to run, carry your inhaler and avoid extreme weather. Take frequent breaks and practice breathing exercises. With time and patience, you’ll be able to enjoy a regular running routine.