Asthma and Physical Activity

Physical activity is part of a healthy lifestyle. Asthma should generally not be used as an excuse to avoid participating.

A child/youth can participate and perform better in almost any sport if their asthma is well controlled and breathing problems are recognized early.

For additional information, refer to the Exercise and Asthma video. 

Physical Activity/Exercise-Induced Asthma 

Some children/youth with asthma only have exercise-induced symptoms. Exercise-induced bronchoconstriction (airway narrowing) or exercise-induced asthma affects most people without asthma and may be the only trigger of asthma symptoms for some people. Exercise-induced bronchoconstriction or asthma can progress to become life threatening. 

Symptoms and Triggers

Common symptoms:

  • can start within ten minutes of starting exercise 
  • can worsen after exercise stops 
  • often last for up to 60 minutes after exercise if no reliever inhaler is given 

Note: most children/youth with well controlled asthma will NOT experience symptoms with exercise.

Common triggers include:

  • exercise occurs during extreme weather conditions (hot, cold, windy, humidity) 
  • when asthma is not well controlled 
  • when a child/youth has or is recovering from a common cold or infection 
  • high levels of aeroallergens (trees, grasses, weeds, moulds) 
  • poor air quality 

Strategies to Support Participation

The following strategies can help children and youth with asthma to participate in physical activity.

Awareness (Asthma Management Plan)

For each child and youth with exercise-induced asthma or physical activity identified as a trigger, the adult/staff should:

  • review the Asthma Management Plan for specific information on managing asthma during physical activity  
  • have a conversation with parent(s)/guardian(s) and/or child/youth (where appropriate) to learn more about the child’s/youth’s asthma

Medication (Use of Reliever)

A reliever inhaler is prescribed to be taken 10 to 15 minutes before the activity is started to prevent asthma symptoms.  

If asthma symptoms begin after starting physical activity, have the child stop the activity and take the reliever inhaler as directed by the child’s health care provider, which is typically two puffs. When more than one puff is recommended, give one puff at a time, with 30 seconds between puffs, making sure to re-shake the spray inhaler. When the child is fully recovered, they may resume the activity.   

If a student uses the reliever inhaler before the activity and symptoms develop during the activity, the reliever can be used again to relieve symptoms.

Important: For incomplete relief or worsening asthma, the student should not continue the activity and their asthma should be monitored. 

Activity Strategies

  • The child/youth should not start physical activity if they are already experiencing asthma symptoms. 
  • Ensure a gradual warm-up has occurred before activities requiring sustained exertion.
    • In cold weather, warm-ups should be a little longer.
  • Encourage child/youth to stay hydrated, before, during, and after physical activity. 
  • Be aware of potential asthma triggers in the area and remove the child/youth from triggers. Refer to Physical Activities and Corresponding Triggers for more information.  
  • Encourage the child/youth to wear a scarf or face mask in cold weather to help warm and humidify the air. 
  • Move planned outdoor activities to well-ventilated indoor sites if there are extreme weather conditions (cold, hot, humid, windy), high pollen counts, and/or poor air quality.
    • Check pollen levels in your community at www.theweathernetwork.ca.
    • Check the Air Quality Health Index (AQHI) and forecasts at www.airhealth.ca.
    • Consider modifying plans for outdoor physical activity if the AQHI is between four and ten for those with asthma or between seven and ten for the general population.

Note: Some children and youth with asthma may experience triggering of their asthma at a lower level if they have poorly controlled or severe asthma, while others with asthma may have no problems in the upper range of the AQHI if their asthma is well controlled.

Managing Recurring Asthma Symptoms

If a reoccurring pattern of asthma symptoms with physical activity is seen, talk to the parent(s)/guardian(s) and/or child/youth (if age-appropriate) and let them know what you are observing, as a visit to a health care provider may be required.