Playing Hard with Asthma: How Kids Feel About Exercise with Asthma

I used to walk into work at a school-aged daycare in the morning--the kids would run at me, "Miss Kerri!" They'd exclaim before I could even get my jacket or backpack in the staff closet, "What are we playing in the gym today?"
I tried to plan games that kids of all physical abilities, or ages, or sizes, could play--sometimes I did things that would be more appealing of the little ones just so they could enjoy their gym time fully. Regardless of what we played, though, the most eager of these kids were often kids who had asthma. And as I, a young adult with asthma, worked with these kids, I tried to do my best to be an active role model for them too. But, was my group of kids at the daycare--running, jumping, as energetic as the other kids, if not more at times, an anomaly?

It turns out, they were not.

In 2011, a small study of ten kids, from eight-to-twelve years old was done to determine their feelings on physical activity and asthma.¹ And, based on the experiences I've had working with kids with asthma--often in a setting including physical activity--I found the quotes from the children in this study pretty accurate. Generally, kids expressed that they could do whatever anybody else could do.¹ 10 to 15% of kids have exercise induced asthma symptoms, and anywhere from 45-90% of kids with persistent asthma experience symptoms caused by exercise.²

Some children in the study, though, alluded that they are not as "carefree" when it comes to exercise and activity, because of their asthma. Some shared a preparation, or planning aspect that was involved--whether prior to or during physical activity--reflecting on their doctors instructions to pre-medicate for things like team sports or physical education classes, or how they need to re-pace themselves they are doing long runs--for instance, one child noted that by the tenth running lap, he felt he had to slow down because his breathing was starting to be impacted by running--another girl noted her awareness of her exercise tolerance, noting her asthma didn't act up until she'd been running for " a long time", while another child commented that they walked instead of running most in class¹--to avoid exacerbating their asthma. More-so than pre-medicating to prevent EIA, though, kids in the article expressed their self-understanding of when to take a break and then take medicine, or just take a break to catch their breath so to speak.¹ Another article noted that while exercise induced asthma may be prevented by pre-treating with a short acting bronchodilator, it is not a perfect antidote for asthma symptoms²--it may work to decrease symptom severity, or push back onset, but may not stop symptoms caused by exercise completely.² This knowledge, though, could be why the kids in the study had such a high focus on rest rather than medication.¹

Generally, I interpret these things to mean that the kids in the study generally "knew their limits" in response to their asthma, and knew how to do--including taking a break and/or using their inhalers and going back in to the activity ¹--to mean they have a good understanding about their asthma in the context of physical activity, and that they do not let asthma limit them.
A core concept was also defined as striving for normalcy¹, and something that I think many kids with asthma may do without thinking of it this way. Kids are kids--and kids with asthma are kids first. Even if they have asthma, they want to be like their friends, and they'll do what it takes to stay active if that's what they like to do.

With that said, though, if a kid with asthma doesn't really like physical activity, it could either be because they don't know how to manage their asthma effectively, their asthma is not under good control, or--shocker--that they simply don't like physical activity. Physical activity levels are, generally, lower among kids with asthma than their peers³, but, guess what--kids without asthma often don't enjoy physical activity (or sports specifically) for whatever reason, too! So, while it's important to consider asthma's role in a child's aversion to exercise or active play, remember, kids are kids: it may take a bit more work to find an activity that's enjoyable for the kid in question. This could be where discussing your own trial-and-error experiences might help slightly older kids, so that they know it's okay if they don't like the same things their peers do. However, it's important that they try as many things as it takes to find an activity they enjoy. It also may simply mean improving a child's fitness level through going to the playground or simply walking or bike riding, and giving them the skills and confidence to do what they learn they enjoy--so they can live an active life, and enjoy it, even with asthma.