Exercise guide
Exercise is safe and good for you with asthma: training raises fitness, trials found no worsening of asthma, and international guidelines recommend it for everyone with the condition. If exercise brings on coughing, wheezing or a tight chest, that usually means your asthma isn't as well controlled as it could be, and a review with your GP or asthma nurse is the first step.
This guide explains exercise-induced asthma, how to use your inhaler around exercise under your own action plan, warm-ups with short hard bursts that can reduce symptoms, cold air, swimming and other triggers, and exactly what to do in an asthma attack.
In 21 trials, training raised fitness and no study reported asthma getting worse. The Global Initiative for Asthma (GINA) and the European Academy of Allergy and Clinical Immunology (EAACI) recommend regular exercise for everyone with asthma.
For most people, symptoms with exercise are a sign that asthma isn't as well controlled as it could be. See your GP or asthma nurse. If you have a preventer inhaler, or a maintenance and reliever (MART) inhaler, using it every day as prescribed lowers the risk.
Many people now have an anti-inflammatory reliever (AIR) inhaler, which can also be used before exercise, or a MART inhaler: ask your GP or asthma nurse whether to take a puff of it before exercise. Others use a blue reliever beforehand. Needing your reliever for exercise most of the time is a reason to have your asthma reviewed.
In 7 trials, warm-ups that included short, high-intensity bursts reduced the narrowing of the airways after exercise, while steady warm-ups didn't make a significant difference. It doesn't work for everyone, so keep your reliever with you.
Cold, dry air, pollen, pollution and pool chlorine can all trigger symptoms. In the cold, breathe through your nose and loosely wrap a scarf over your nose and mouth, or wear a mask.
Stop, sit up and use your reliever: with a blue inhaler, 1 puff every 30 to 60 seconds, up to 10; with an AIR or MART inhaler, 1 puff every 1 to 3 minutes, up to 6. Call 999 if you feel worse at any point, don't feel better after the maximum, or don't have your inhaler.
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Asthma is a common condition that affects your breathing, with wheezing, coughing, breathlessness and a tight chest that come and go. It can't currently be cured, but if it's well treated you shouldn't have problems with symptoms. About 7.2 million people in the UK have asthma, about 8 in every 100, and about 300 million worldwide.
Exercise-induced bronchoconstriction (EIB) is the narrowing of the airways that exercise can trigger. A US practice guide no longer prefers the name exercise-induced asthma, but it's the one most people know. Symptoms typically get worse after you stop exercising rather than during it: according to one review, they usually start within 2 to 5 minutes of stopping, peak at about 10 minutes and settle within about an hour.
When you breathe hard through your mouth, air reaches your airways without being warmed and moistened by your nose. The drying and cooling can make the airways tighten, which is why cold, dry air makes it worse.
Estimates vary widely. One review puts EIB at about 90% of people with asthma, 5 to 20% of the general population and 30 to 70% of elite athletes, and finds it more common when asthma is poorly controlled. It can also happen in people without known asthma.
Being unfit or carrying extra weight makes anyone breathless with exercise, and that breathlessness eases quickly when you stop. Inducible laryngeal obstruction (ILO), where the voice box narrows, causes noisy or difficult breathing in, a tight throat or a change in your voice that start and stop suddenly, and your reliever may not help much; it is found in about 3 in 10 people whose asthma is hard to control. Breathlessness with dizziness or tingling points to a breathing pattern problem, and breathlessness on exertion with swollen ankles needs a GP check.
Many people now use one inhaler to both prevent and relieve symptoms: an AIR inhaler, used when needed, or a MART inhaler, used every day and when needed. Others use a preventer plus a blue reliever; the NHS says you shouldn't be given a blue reliever to use on its own. NICE (the National Institute for Health and Care Excellence) now recommends AIR for people aged 12 and over who are newly diagnosed, and moving people who use only a blue reliever onto it.
After puberty, more women than men have asthma, and female hormones are thought to be one reason. Symptoms can change around periods, pregnancy and the menopause. In England and Wales, 70% of adult hospital admissions for asthma were women, while 62% of children's admissions were boys.
A Cochrane review of 21 trials (772 people) found training was well tolerated, with no reports of asthma getting worse, and raised fitness: VO2 max, the most oxygen your body can use, rose by about 4.9 mL/kg/min. It didn't change lung function. GINA recommends regular physical activity for its general health benefits, at its highest level of evidence.
In adults, 8 weeks or more of aerobic training improved asthma control and lung function a little, but not airway inflammation (11 trials, 543 people), and EAACI rates this evidence as low quality. Pulmonary rehabilitation for adults with asthma improved how far people could walk in 6 minutes, by about 80 metres, and their quality of life, with a small effect on control. GINA says activity programmes improve symptoms and quality of life in moderate or severe asthma.
Regular inhaled steroid treatment reduces EIB, and symptoms that break through with exercise often mean asthma is poorly controlled. A reliever taken before exercise prevents EIB, but taking it regularly, more than once a day, makes it work less well. An AIR inhaler taken when needed and before exercise worked as well as daily steroid treatment for EIB.
In 7 randomised studies, warm-ups with high-intensity intervals, or with intensity building from low to very high, reduced the drop in lung function after exercise by about 11 percentage points; steady warm-ups at low or high intensity made no significant difference. In 8 athletes, eight 30-second runs with 45 seconds' rest halved the drop.
The bursts work partly through a refractory period, when the airways respond less. A 2007 study says about half of people with asthma get one, and in a 1978 study of 9 children it had worn off within about 4 hours. These are small studies.
The figures for when symptoms start and peak, and for how common EIB is, come from one review, whose authors worked for a drug company. Its own estimates span wide ranges, so treat them as rough.
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In children and teenagers, swimming training raised fitness and lung function without making asthma worse (8 trials, 262 young people), but it wasn't shown to beat other activities. Indoor chlorinated pools raise concerns about chlorine by-products, and in some people chlorine is the trigger. We found no trials of swimming training in adults.
In a Cochrane review of 22 trials (2,880 people), breathing exercise programmes improved asthma quality of life (moderate-certainty evidence) and symptoms, and UK guidance from SIGN (the Scottish Intercollegiate Guidelines Network) says they can be offered to adults alongside medicines. In the BREATHE trial of 655 UK adults, a DVD and booklet worked as well as three sessions with a physiotherapist. They don't improve lung function or reduce the risk of attacks.
ILO can mimic asthma or come with it: about 3 in 10 people with hard-to-control asthma have it too. It mainly affects the breath in, with throat tightness or a change in your voice, and comes on suddenly and eases quickly.
Asthma + Lung UK says that for most people, if exercise triggers your asthma, it's a sign your asthma is not as well controlled as it could be. NICE's definition of fully controlled asthma includes no limits on activity, exercise included.
Check how you use your inhaler, review your medicines and action plan, and step up your treatment if you need it. If you have a preventer or MART inhaler, use it every day as prescribed. If your symptoms only come with exercise, they may add a long-acting bronchodilator (an inhaler that keeps the airways open for longer) or a tablet called montelukast.
Some medicines, including beta blockers, aspirin and ibuprofen, can trigger asthma symptoms in some people. If your symptoms changed after starting a new medicine, tell your GP or pharmacist, and don't stop a prescribed medicine without advice.
Note when symptoms come on, what you were doing, the weather and where you were. Patterns help you and your nurse spot your triggers.
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Your written asthma action plan says what to take and when. If it says to take your reliever before exercise, take it as it says, and carry your reliever every time you exercise.
If you use an AIR inhaler, the same inhaler can be taken before exercise, and you don't need a separate blue inhaler for this. Ask your GP or asthma nurse whether to take a puff before exercise, including if you use MART.
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A short-acting reliever (SABA, a short-acting beta agonist such as salbutamol) taken before exercise prevents EIB, and one review gives the usual timing as about 15 minutes beforehand. The American Thoracic Society recommends it for everyone with EIB.
Taking a SABA regularly, even for a week, makes it work less well and makes EIB worse. In 2025, the UK medicines regulator, the MHRA (Medicines and Healthcare products Regulatory Agency), reminded prescribers about severe attacks and deaths linked to overusing it. If you need your reliever for exercise most of the time, or symptoms break through anyway, ask for an asthma review.
Warm-ups with short, hard bursts reduced exercise-induced symptoms in trials, while steady warm-ups didn't make a significant difference. GINA says training and a sufficient warm-up reduce how often EIB happens and how bad it is.
Our editorial starting point, adapted from the trials and EAACI's advice: 5 minutes easy, building from walking to an easy jog or steady cycling; then 6 to 8 bursts of 20 to 30 seconds at a hard effort (a few words at most, not all-out), with 45 to 60 seconds easy between; then 2 to 3 minutes of moving stretches. Start your main session soon afterwards.
EAACI itself suggests a 5 to 10-minute warm-up at light to moderate effort, with high-intensity intervals for people with EIB, and 5 to 10 minutes of whole-body stretching.
Only about half of people with asthma get the protective refractory period, and in one small study it had worn off within about 4 hours. Keep your reliever with you.
Finish with 5 to 10 minutes of easier exercise rather than stopping suddenly.
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Breathe in through your nose so the air is warmed, loosely wrap a scarf around your nose and mouth or wear a mask, and check the weather: shorten your time outside if it's very cold or windy. In an Asthma + Lung UK survey, 7 in 10 people said cold air made their symptoms worse. Very hot air can tighten the airways too, and GINA advises athletes to avoid training in extreme cold or pollution.
Outdoors, pollen or pollution may be the trigger rather than the exercise itself, and dust in gyms can be too. On high-pollen or poor air quality days, exercising indoors may help (our suggestion).
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Warm, humid air around a pool is less likely to trigger EIB, and swimming training was well tolerated in trials in children. But chlorine can be a trigger: if you only get symptoms when you swim, it could be the chlorine in the pool. A well-ventilated or non-chlorinated pool may help.
The adult guidelines apply: at least 150 minutes of moderate activity or 75 minutes of vigorous activity a week, plus strength exercises on 2 days. EAACI suggests aerobic exercise on 3 to 5 days a week for 30 to 40 minutes, starting moderate (you can talk but not sing) and building to vigorous, including interval training, if you're comfortable; and strength training on 2 to 3 days a week, 2 to 4 sets of 8 to 12 repetitions.
There's little evidence that one kind of activity is better than another, so choose what you enjoy and will keep doing.
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Strength training also helps protect muscle and bone in people who take steroid medicines for their asthma.
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If you're living with obesity, losing weight helps asthma, but GINA says more exercise on its own appears not to be enough for this. Our weight loss guide has more.
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Ask about pulmonary rehabilitation: in adults with asthma it improved walking distance and quality of life. GINA recommends referral for people whose exercise is limited by their asthma, and the British Thoracic Society includes asthma in its standard.
See your GP before you start if you haven't exercised for a while or have other medical conditions, especially heart, metabolic or kidney disease.
The benefits often fade within a year if you stop, so build exercise into your week.
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Our asthma warm-up uses these: easy walking and jogging, short hard bursts, then moving stretches (our editorial starting point).
3 to 5 days a week for 30 to 40 minutes, starting moderate (you can talk but not sing), and adding intervals once regular exercise feels comfortable (EAACI's advice).
2 to 3 days a week, 2 to 4 sets of 8 to 12 repetitions (EAACI's advice). Start with 2 sets, and breathe out on the effort.
Breathing exercise programmes, taught by a physiotherapist or by DVD or video, can improve symptoms and quality of life, and UK guidance says they can be offered to adults alongside medicines. Programmes with more than 5 hours of training were more likely to work.
They don't improve lung function or prevent attacks, so they don't replace your inhalers. In an attack, use your reliever and follow the steps below.
Ask your GP or asthma nurse about a physiotherapy breathing programme; in a UK trial, a DVD and booklet version worked as well as face-to-face sessions. Our slow breathing move, gentle breathing with no holds, is a reasonable way to practise at home, but it isn't a full programme. Skip breath-hold techniques when you have symptoms (our suggestion).
Use the asthma warm-up before any session that brings on symptoms. The runners' warm-up has no hard bursts, so add them if exercise sets you off. The cardio workouts run from easy walking to intervals, and the home workout covers strength.
A 15-minute warm-up for exercise-induced asthma: easy movement, then short hard bursts that can reduce symptoms in the session that follows, then moving stretches.
15 minBeginner5 movesCardio machine, A wallAn 8-minute dynamic warm-up for runners: ankle and hip mobility, lunges, skips and pogo hops.
8 minIntermediate8 movesA wallA steady 30 to 45 minute cardio session at talk-but-not-sing pace: walk, cycle, row or cross-train, counting toward weekly activity guidelines.
40 minBeginner3 movesCardio machine, A wallA 25-minute walk with short faster bouts: notice your heart and breathing speed up, then settle. A gentle way to get used to the feelings of effort.
25 minBeginner5 movesCardio machine, A wallA 25-minute interval session on a bike or rower: one-minute hard efforts with two minutes easy, building from 4 to 8 rounds.
25 minIntermediate1 movesCardio machineA gentle 20-minute beginner home workout with a chair, a wall and a band: sit-to-stands, wall push-ups, band rows, step-ups and dead bugs.
20 minBeginner11 movesA bench or box, A wallA 20-minute beginner yoga sequence: mountain, chair, warrior II, triangle, tree, down dog, cobra and child's pose.
20 minBeginner9 movesA stepSit up straight and try to stay calm. Then:
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Call 999 (911 in the US) if you or someone else is having an asthma attack and:
If you're no better after 10 minutes and the ambulance hasn't arrived, use your inhaler again, up to the same maximum dose. If you're still no better and it still hasn't arrived, call 999 again straight away. Don't drive yourself to A&E.
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See a GP within 2 days, even if you feel better. Asthma + Lung UK suggests a same-day appointment if you managed the attack yourself. Don't exercise again until your symptoms and breathing have recovered.
Carry your reliever every time. Stop the session if symptoms don't settle, and call 999 if your breathing doesn't go back to normal after exercise.
Training is safe for people with stable asthma, and no trial reported asthma getting worse. GINA and EAACI recommend regular exercise. People with asthma tend to be less active, often from fear of symptoms.
For most people, symptoms with exercise mean asthma isn't as well controlled as it could be. Using a blue reliever regularly makes it work less well and makes EIB worse, and the UK medicines regulator has warned about overuse. Get a review.
EIB can happen without asthma, and being unfit, carrying extra weight and ILO can all cause breathlessness with exercise. See a GP for a proper diagnosis.
It's well tolerated and helped fitness and lung function in children and teenagers, but it hasn't been shown to beat other activities, and chlorine can be a trigger. GINA finds no type of activity proven better than another.
They can improve quality of life and symptoms, but they don't improve lung function or prevent attacks.
Asthma can't currently be cured. Training improves fitness but not lung function, and its benefits fade if you stop.
In 7 trials, warm-ups with short high-intensity bursts or varied intensity reduced EIB, while steady low-intensity warm-ups didn't make a significant difference.
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Breathing through your nose, and a scarf or mask over your nose and mouth, help. Guidance for athletes is to avoid only extreme cold.
Yes. Exercise training is safe for people with stable asthma and improves fitness, and trials found no worsening of asthma. International guidance encourages regular exercise for everyone with asthma. Carry your reliever, and see your GP or asthma nurse if exercise brings on symptoms.
It's when exercise makes your airways narrow, causing coughing, wheezing, a tight chest or breathlessness; doctors call it exercise-induced bronchoconstriction (EIB). Symptoms typically get worse after you stop: one review says they usually start within a few minutes, peak at about 10 minutes and ease within about an hour. It's common in people with asthma, and some people get it without having asthma.
When you breathe hard through your mouth, cold, dry air reaches your airways without being warmed and moistened, which can make them tighten. For most people, symptoms with exercise mean their asthma isn't as well controlled as it could be. Pollen, pollution, chlorine and cold weather can add to it.
Follow your asthma action plan. If you have an AIR or MART inhaler, it can also be used before exercise, so ask your GP or asthma nurse whether you should. A blue reliever before exercise prevents symptoms, but needing it often is a sign to get your asthma reviewed, and overusing it carries risks.
There's no single best one: guidelines find little evidence that any type beats another, so choose what you enjoy. Walking, cycling, swimming and strength training all count, building towards 150 minutes a week. If exercise triggers your symptoms, a warm-up with short bursts can help.
Swimming is well tolerated: in children and teenagers, swimming training raised fitness and lung function without worsening asthma. It hasn't been shown to be better than other exercise, and chlorine in indoor pools can trigger symptoms in some people. If you only get symptoms in the pool, mention it to your GP or nurse.
Warm up for 5 to 10 minutes, then add a few short, hard bursts: warm-ups with intervals reduced exercise-induced symptoms in trials, while steady warm-ups didn't make a significant difference. About half of people then get a spell of reduced symptoms. Our 15-minute asthma warm-up follows this pattern, and its timings are our editorial starting point.
It improves fitness, and in adults, regular aerobic training improved asthma control a little, in trials of low quality. It doesn't change lung function or cure asthma, and the benefits fade if you stop. It works alongside your inhalers, not instead of them.
Breathe in through your nose rather than your mouth, and loosely wrap a scarf around your nose and mouth or wear a mask. Keep your reliever with you, warm up well, and shorten your time outside if it's very cold or windy. Guidance for athletes is to avoid training in extreme cold.
Being unfit or carrying extra weight can make anyone breathless with exercise, and that breathlessness eases quickly when you stop. Asthma symptoms typically get worse just after you stop, with wheezing, coughing or a tight chest. A noisy breath in, a tight throat or a hoarse voice that come and go suddenly can be a problem in the voice box instead (inducible laryngeal obstruction), so see your GP if you're not sure.
Stop, sit up straight and try to stay calm. Use your reliever: with a blue inhaler, 1 puff every 30 to 60 seconds, up to 10 puffs; with an AIR or MART inhaler, 1 puff every 1 to 3 minutes, up to 6. Call 999 if you feel worse at any point, don't feel better after the maximum, or don't have your inhaler, and see a GP within 2 days afterwards.
Breathing exercise programmes, such as those taught by physiotherapists or on a DVD, can improve symptoms and quality of life, and UK guidance says they can be offered alongside medicines. They don't improve lung function or prevent attacks, so they don't replace your inhalers.
Exercise education, not a diagnosis or treatment plan, and clinical review of these guides is pending. Stop and get advice for chest pain, unusual breathlessness, dizziness or fainting, or new pain, and check with your doctor or midwife first if they have told you to limit activity. Health disclaimer.
