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Can asthma and triathlon co-exist?

What to do when your love for the sport literally takes your breath away. Here’s a look at the relationship between asthma and triathlon

Photo by Louis Tricot/Unsplash

More often than not, athletes are diagnosed with exercise-induced asthma (EIA) when they experience difficulty in breathing that appear out of nowhere. Common complaints I encounter include, “It just started one day during swim training” or “I’ve never had this problem before, but I had difficulty catching my breath on an easy run the other day.”

An asthmatic attack doesn’t necessarily paint a horrific picture of an athlete gasping for breath and turning blue. There are a number of symptoms that heralds an asthma attack that, when unrecognized, may lead to fatal outcomes. Here are some common questions triathletes ask me:

What is exercise-induced asthma?

EIA is a temporary narrowing of the airways (bronchoconstriction or increase in airway resistance) after intensive sport. Increased training load and impact of the surroundings can trigger EIA. The prevalence of EIA is high among endurance athletes, especially those who do outdoor sports. Other triggers are temperature and humidity that affects stress level in the air passages.

There are a number of symptoms that heralds an asthma attack that, when unrecognized, may lead to fatal outcomes

Cold and dry winter air, like in Ironman Melbourne, is more harmful to the respiratory tract than hot and humid air in the summer (like the conditions at Ironman 70.3 Vietnam and Cebu). Some people have the hereditary traits of being more sensitive to these triggers than others and are more likely to manifest asthma symptoms. A pulmonary function test is used to diagnose EIA.

The symptoms of asthma may range from mild, such as intermittent coughing, sneezing, and shortness of breath after exertion. Asthma may manifest with increased severity of symptoms, which includes shortness of breath even at rest, prolonged coughing, back pain, chest pain, or a life- threatening difficulty in breathing.

The problem with asthma is you cannot predict the severity of an attack when it happens. It’s possible to experience frequent but mild attacks, but you can never tell when that fatal asthma attack will happen. The severity isn’t dependent on how much the exertion is or the amount of the trigger that causes the attack.

I have asthma, can I run or do triathlon?

Contrary to beliefs that it’s best to avoid physical activities, pulmonologists encourage exercise if there are no acute attacks present. Exercise is even persuaded to asthmatic patients with good control because it is found in studies to improve lung function. So the answer is, yes, you can do sports if your asthma is controlled and preferably when cleared by a pulmonologist.

How does my condition affect my training strategies?

When an asthma attack is well-controlled or attack-free, there’s really no difference in the approach to training compared to non-asthmatics. The lung function in asthma is completely reversible and can go back to normal when it is well controlled. However, if there are signs of asthma, have a pulmonologist control it first. Having an asthma shouldn’t deter you from pursuing a love for triathlon. Sharon Donnelly, 39, is a former triathlete from Ontario. Despite her asthma, she won three championships as Canada’s top female triathlete. She was also victorious in her triple-sport event at the 1999 Pan Am Games and competed as an Olympian at the 2000 Sydney Games.

Contrary to beliefs that it’s best to avoid physical activities, pulmonologists encourage exercise if there are no acute attacks present

Isn’t it dangerous for me to engage in such a strenuous activity?

As long as the asthma is controlled, you can do what non-asthmatics can do (sometimes even better). Precautionary reminders however are vital

  • You should be able to recognize early symptoms of asthma, postpone your training, and seek medical advice
  • If you have been coughing for more than two to three days and it’s not going away, consult a doctor
  • If you have even the slightest shortness of breath at rest, consult a doctor
  • If you feel unusually weak, with shortness of breath, dizziness, chest or back pain, consult a doctor
  • Even if you don’t have these symptoms but are engaging in intense training or workouts, have your lungs checked by a pulmonologist to be on the preventive side of things

Is asthma curable?

It cannot be cured. It can only be controlled.

Nina Beltran: Nina C. Beltran, MD is an avid marathoner and triathlete from Team Tribe. She's the key speaker on nutrition for endurance athletes for the Philippine College of Physicians. She is practicing doctor specializing in internal medicine and pulmonology.