Warm ups for Asthma sufferers

 old man winterHere in the Northeast this past weekend we got a little taste of Spring with temperatures that reached the lower 50’s. This upcoming weekend we will be returning to more seasonable temperatures with temperatures in the low 40’s to upper 30’s. Unfortunately for 10-15% of the US population that suffer from Exercise-Induced Asthma (EIA) or Exercise Induced Bronchoconstriction (EIB),  these colder temperatures mean they will need to manage their asthma symptoms. According to a New York Times article, 40-90% of asthma attacks are due to exercise. EIB is very prevalent even among Olympic athletes.  Jackie Joyner-Kersee who set many Olympic records in the long jump, the 50 and 60 meter hurdles, and the heptathalon suffers from EIB.  It did not hold her back.

Researchers do not completely understand how exercise can cause asthma to flare up, but along with exercise other factors such as environment, a rapid change in temperature, air pollution, a rapid rise in heartrate, etc. can all exacerbate symptoms.

I personally find it so much easier to breathe on my runs when it is warmer, and my running times were reflected by that when I was finally able to hit the track for some speedwork in warmer temperatures. This is because the colder air gets into your lungs and can affect the nerve endings in your throat. No freezing air ever actually gets into your lungs though. By the time the air you breathed in reaches the bottom of your wind pipe (trachea) your body has already warmed it due to your body temperature, and has also become more humid from the cells lining your trachea. The burning feeling in your lungs is because your cells get dehydrated from the cool dry air entering your mouth and throat and becomes irritated.

Running is at the top of the list as far as exercises that have a strong link to EIA&EIB, especially after running in the cold as discussed above. Does this mean that asthma sufferers cannot run outside all Winter?  I know  how horrible it can be during the Winter months to log miles on the “Dreadmill.” But take heart! There is great news according to a couple studies.

One study I read divided a group into four separate groups with four different warm up protocols.

Group #1-Performed intervals.

Group #2-Performed a continuous low-intensity warm up

Group #3-Performed a high-intensity, but sustained

Group #4-Performed a warm up at a variable intensity (gradually building up the intensity of the warm up)

The conclusion of their study showed that the group that had the most consistent and effective result was the high-intensity interval group as well the variable intensity group.

“These findings indicate that an appropriate warm-up strategy that includes at least some high-intensity exercise may be a short-term non-pharmacological strategy to reducing EIB.”

This study truly is an important one and one that is extremely personal to me. I run often with my oldest daughter who suffers from asthma, and she also loves playing soccer. She often had to take her inhaler. When she began to run or play soccer she did suffer at times but we did not know how to warm up properly. Once we started to incorporate some slow warm-ups and some pre-run sprints her symptoms got better, to the point where I cannot remember the last time she used her inhaler.

The study found that the protection from EIB lasted up to 80 minutes. The length of the intervals used in the above study was duration of 30 seconds. While a 20-30 minute warm up which I have used with my daughter might be a bit long based on time and logistics before a race, etc., but the longer more prolonged the warm up the better.  We would start with some easy body weight exercises to gradually raise the heart rate like bodyweight squats, lunges and then move on to some higher impact exercises like jumping jacks. Then we finally progress to a series of sprints somewhere between 80-90% of your maximum intensity.

So a sample warmup should look something like this.

  1. Bodyweight squats x 10
  2. Lunge matrix-
    • Forward Lunge x 5
    • Forward Lunge with Twist x 5
    • Side Lunge x 5
    • Transverse Lunges (Back and to the side) x 5
    • Reverse Lunge x 5
  3. Jumping Jacks x 10

You can repeat this sequence a couple times.

After the body weight sequence. Begin doing your series of sprints building to an intensity of 80-90% of your maximum intensity. This last part should last 2-5 minutes building to race time.

Now, This does not mean you should throw away your inhaler today, or not run with it, but this warm up protocol may be helpful to you.  For more tips on how to exercise safely with asthma please check out.

http://www.webmd.com/asthma/guide/exercising-asthma

Other resources:

http://www.ncbi.nlm.nih.gov/m/pubmed/23038787/

http://m.bjsm.bmj.com/content/33/2/100.full.pdf