By Robert Grabko, R.P.F.T., B.S.

Athletes with asthma may experience airway tightening with sudden, increased breathing. Such breathing has a drying and cooling effect on the airway, causing it to react and tighten. There is also an increase in capillary blood flow to the airway that, through a series of metabolic reactions, can cause release of histamines leading to airway constriction.

A proper warm-up will vary for all athletes, depending on the activity, the asthma severity and the athlete's fitness level.

A Gradual Warm-up: Getting Started
The general rule is to measure the baseline peak flow with a peak flow meter prior to warming up. Choose an activity for a 10-minute warm-up that will increase the heart rate to below anaerobic threshold levels (bike, jog, jumping jacks, etc.). Measure peak flow at five and 10 minutes. The peak flow will increase during this time due to airway recruitment and the body’s natural production of catecholamine bronchodilators with exercise. If the warm-up routine is too intense, the airway will tighten and the warm-up benefit lost. Try this method several times and use the peak flow meter to help you identify your risk for airway tightening relative to warm-up intensity.

Once you establish and practice a warm-up routine, use this to find the proper five to 10 minute warm up intensity to increase peak flow and keep the airway open prior to and during competition. This window is termed the “refractory period” and occurs between a proper warm-up and the start of a competitive event. Athletes should stay warm with stretching and movement during this time. Exercise-induced asthma can be prevented with this method. Remember, once the airway is tightened, 50 percent of athletes will experience no relief, even with an Albuterol inhaler.

Finding a Warm-up that Works for You
Some athletes find it helpful to work with a knowledgeable respiratory therapist who can help him or her develop a customized warm-up routine. The therapist can also help to develop a non-medication plan that works well when performed properly. A non-medication plan can include managing asthma triggers, nutrition, hydration, breathing and muscle relaxation, a proper warm-up and managing airway tightness once it occurs. To learn more, refer to related Athletes With Asthma resources on this web site.

Reaching optimal fitness is possible for athletes once the asthma is properly treated and brought under control!

This information is produced by Athletes With Asthma, a program of C.O.R.E. respiratory services. To learn more, call 612-360-8679.