14 Best and Worst Exercises for Asthma

Love to work out? If you're one of the roughly 20 million Americans with asthma, this may not be a problem. But for some people, exercise can trigger shortness of breath or other symptoms.

Fortunately, having asthma, even exercise-induced asthma, doesn't have to keep you out of the game. In fact, as many as one in 12

Olympic athletes take asthma medication.

The trick is to make sure asthma is well controlled with medication and to choose your activity carefully. Some are good choices, others may be more of a challenge.

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One

recent study found that adults who walked three times a week for 12 weeks actually improved asthma control and fitness levels without provoking an attack.

They did half an hour at a time with five minutes of warm up and five minutes of cool-down. "A moderate-to-brisk walk is the best way to describe this level of activity," says study author Lisa M. Schwiebert, PhD, associate professor of cell, developmental, and integrative biology, University of Alabama at Birmingham.

"Warming up is really important because it will help your tolerance," says Lianne Marks, MD, an internal medicine physician at Scott & White Healthcare in Round Rock, Texas.

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Yoga is great for people with asthma. The magic ingredient?

"I think it's breath control," says Robert Graham, MD, an internist and integrative medicine specialist at Lenox Hill Hospital in New York City. "Breathing exercises can activate more areas of the lung."

One study found that people who practiced Hatha yoga two-and-a-half hours a week for 10 weeks were able to cut down on their asthma medication. The same benefit would probably result from Tai Chi, a martial art that also emphasizes breathing, says Dr. Graham.

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As a general rule, any activity where your heart rate and breathing rate is sustained for at least 5-to-6 minutes continuously is more likely to trigger asthma than stop-and-start activities, says Mark Holbreich, MD, an Indianapolis-based allergist.

That makes baseball with its spurts of running alternating with plenty of down time one of the safer sports for people with asthma. Even so, asthmatics should make sure they're prepared with appropriate medication. One study found that 75% of children who played baseball or soccer did not have a rescue inhaler handy.

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Biking at a leisurely pace isn't likely to exacerbate your asthma. But ramp it up to 18 miles per hour and you could be in trouble, says Dr. Holbreich. The rapid in-and-out breathing necessary to keep up this pace can dry out airways, potentially triggering an asthma attack.

Mountain biking could be a problem as well. Negotiating steep hills and curves is likely to require heavy breathing, just the thing a person with asthma wants to avoid. But it's not impossible to do: One study found that cyclists and mountain bikers were more likely to have asthma than other Summer Olympians, yet they were still able to compete.

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A round of golf is not only good for the mind, it isn't likely to induce an asthma attack.

Again, the activity is staggered, alternating swings with walking on to the next tee. But given that golf is played outside, you might want to take into account the pollen factor before you hit the links. "If you have an allergic component to asthma and if pollen counts are high, you may want to stay inside," says Dr. Marks.

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Tennis and other racquet sports allow you to expend energy on the court with regular rests between games and access to a water bottle (dehydration can exacerbate exercise-induced asthma).

You also have some control over the pace of the game, for example, walking leisurely to the baseline to serve and bounce the ball on the court surface before swinging the racket. The bursts of activity are even less intense if you're playing doubles with a partner.

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Short-distance track and field with its finite bursts of activity isn't likely to provoke

exercise-induced asthma. Try running a marathon, however, and you could have problems.

Again, the huffing and puffing required to go the distance will dry out and irritate your airways. On the other hand, if going for a long run is your favorite activity, don't forego it. Just make sure you're being treated adequately, says Dr. Holbreich.

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Cross-country skiing may be the worst exercise for an asthmatic, says Dr. Marks. Not only does the strenuous activity dry out your airways, so does the cold air. A survey of U.S. Olympic winter athletes found that 25% had exercise-induced asthma, with cross-country skiers reporting the highest incidence: 50%.

But don't cancel the Taos ski vacation just yet. Downhill skiing is surprisingly gentle on the airways. "You're not physically exerting yourself," says Dr. Holbreich. "The mountain is taking you down even though it's cool air." That's if you're on an easy trail, not a double black diamond.

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"The ideal sport for asthmatics is swimming because you’re breathing in air that is highly humidified and often warm," says Dr. Holbreich.

And staying in that horizontal position may actually loosen mucus accumulated in the bottom of your lungs.

But be careful of pools with excessive chlorine as the chemical can

trigger an asthma attack. How do you know if it’s excessive? If you can smell the chlorine, then it’s too much.

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Like baseball, softball involves plenty of time in the dugout or hanging out on a base in anticipation of the next fly ball. And you can use your dugout time to drink water.

With this and other forms of exercise, using an inhaler 15 to 30 minutes before exercising and taking time to warm up may keep you breathing easier throughout the whole game.

And avoid exercising when you’re sick. “That makes the chance of a flare higher,” says Dr. Marks.

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Volleyball is faster than its start-and-stop cousins baseball, softball and football but it can also be a good choice for asthmatics. Setting and striking don't involve too much movement and when a player does run, it's on a small court with five other players ready to pick up the slack.

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There's just too much running up and down the court and not enough time to rest to make basketball a comfortable sport for asthmatics—even if it is a favored sport of the current President.

That doesn't mean it's impossible. NBA player Tyson Chandler was diagnosed with asthma in 2004, but still runs the court for the New York Knicks thanks to proper management of his condition.

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This worldwide craze has players running and chasing an elusive ball almost nonstop. If you have asthma, that level of activity could morph into a flare.

But like basketball, the sport is not out of bounds for asthmatics, especially if you prepare.

In one study, boys who did interval training for eight weeks saw an improvement in their breathing when they actually played soccer on the field.

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The many breaks between downs that can sometimes make viewers impatient with the game can also reduce the chances of an asthma exacerbation.

That doesn't mean football is necessarily a safe sport. Researchers are finding plenty of reasons why football may not be good for your health in other ways, namely an increased risk of head injuries. If you're going to play football, asthmatic or not, wear a helmet.