Dear Dr. K: I wheeze when I exercise. Does that mean I should stop aerobic activities?
The unequivocal answer to your question is “no” — and I’m sure Roger Bannister would second my answer.
Roger Bannister was the first runner to break the 4-minute mile. What many people don’t know is that he was a medical student when he performed that feat. (Pun intended.) In fact, in the 1950s when he broke four minutes the physicians at that time were mistakenly telling asthmatics not to exercise. Bannister actually changed that approach because of research he did in exercise physiology. He learned that exercise itself might stimulate wheezing with the activity but in the long run (pun intended), it helped lessen the asthma tendency.
Exercise can bring on wheezing for several reasons: airway cooling, airway dehydration and inhalation of allergens and pollutants. The latter is not surprising as the mouth breathing associated with aerobic exercise leads to inhalation of non-filtered air (bypassing the nose and sinuses).
Certain situations are more likely to elicit wheezing: running in cold/dry air, swimming in heavily chlorinated pools and biking along exhaust-laden roadways.
Sometimes exercise-induced asthma manifests as a cough rather than wheezing. This cough can happen during the activity or afterward (when it is known as “locker-room cough”).
The most important fact about exercise-related asthma is that improved aerobic conditioning lessens the asthmatic tendency and, in effect, “strengthens the lungs.”
General measures to manage the problem include identifying triggers such as high chlorine levels or pollutants, and avoiding them. Avoid exercising in extreme cold or dryness and engage in pre-exercise warm-up. For runners, if the asthma occurs while running fast, slowing the pace for a while can allow you to “run through” the asthma.
Finally, using an inhaled bronchodilator prior to exercise often eliminates the problem entirely.