About this Blog

This Blog is designed to provide information about asthma for managers and coaches working with youth football clubs.

It describes an initiative called 'Asthma Friendly Football Clubs', which has been developed with the support of Asthma UK.

The Football Association have also been very supportive of the ideals behind this initiative, recognising that the support of children who suffer from asthma is an important component of a Junior Football Clubs welfare commitment to children.

I would like to offer my thanks to Asthma UK for their involvement and for the help they have given to date.

Dr Andrew Newton - September 2012

What is an Asthma Friendly Football Club

WHAT IS AN ASTHMA FRIENDLY FOOTBALL CLUB

For a youth football club to be considered to be an ‘Asthma Friendly Football Club’, they must have an active asthma policy in place.  This could be a stand-alone asthma policy, or it could be a medical conditions policy which includes asthma as one of its components.   The club should be able to provide evidence that they have the following minimum set of standards in place:

1.    Raising Awareness

All club coaches must be in date for First Aid training. They should have also had an awareness session on the seriousness of asthma in childhood (they must have also studied the short training film on Asthma Friendly Football Clubs). They need to understand how best to support a child with asthma in the context of the sporting environment and to know what to do in an emergency.  To promote this, the club needs to nominate an asthma champion (preferably a member of the club committee) who needs to ensure that the club and its coaches are all following the best practice described in this document.

2.    Register and Asthma Cards

The club must maintain a centralised register of children with asthma.  This should be updated from the club’s registration forms each season. (To achieve this, the annual registration form must include a question about whether the child has a diagnosis of asthma and, if so, what medications they use).  All children who are on this centralised register need to have a medical action plan completed by their parents, which should then be held by the year group coach as part of the first aid kit provision for that squad.  (Ideally, a second {photo-copy} of this plan should be kept along with the central asthma register). 

3.    Access to Inhalers

All children with asthma should be encouraged to routinely carry and administer their own inhalers as and when required.  Coaching staff should routinely remind those children that need to take prophylactic doses of reliever medication before sport to do so as part of the standardised warm-up routine. 

Children whose parents advise the club that the child is not yet able (or old enough) to self manage their own reliever inhaler, must know exactly where their reliever inhaler is stored and how to access it and, where appropriate, how to get help in using it. 

During matches and training sessions, children’s inhalers should be stored in a secure but not locked box in close proximity to the field of play.  This box should be appropriately labelled so all are aware of what its role is. (Inhalers should not be kept in the team First Aid Kit).

 

4.    Posters

The club should display posters detailing the action for coaches / first aiders to take in an asthma attack.  These need to be in prominent locations within the clubhouse and / or changing room complex.

5.    Assessment of Triggers

Coaches should be aware of the common triggers for asthma.  By knowing the children who have asthma within their squad, the coach will be better able to make appropriate judgements about the influence of triggers (and thereby act according to the perceived risk for individual children within their group).

6.    Inclusion

The club should ensure that all club activities are accessible to children with asthma. 

In year groups where rolling substitutions are permitted, any child that needs to leave the field of play because of asthma symptoms should be re-introduced into the game as soon as their symptoms have settled, providing that they feel well enough to do so and are confident to continue.

No child should ever be left on their own (or sent away from the field of play on their own) if they have needed to use an inhaller.

A word version of this can be obtained by e-mail - Please contact  asthmafriendlyfc@gmail.com

Why is there a need for this programme

Asthma is serious. Three people die each day in the UK from asthma, and thousands are hospitalised every year due to potentially life-threatening asthma attacks.

There are 1.1 million children with asthma in the UK, so it's essential that all those who work with children have a good understanding of what the condition is and what to do in an asthma attack.

Around one-third of children with asthma miss out on PE and sports about once a week because of their condition, despite the fact that most should be able to take part as long as their asthma is under control.

Asthma UK's 'Out There & Active' campaign aims to encourage children with asthma to take part in sports and physical activities by promoting understanding about exercise and asthma. The Asthma Friendly Football Club initiative is a part of that campaign.

Asthma UK

Asthma UK is the main Asthma Charity in the UK, it provides a wealth of useful information and educational materials as well as funding research and developments in the field.

The Asthma UK Website has a host of useful resources and some materials can be downloaded for free.

http://www.asthma.org.uk/

Asthma UK also have an Advice Line available 0900-1700 Monday to Friday (staffed by Specialist Nurses) ; 0800 121 6244

Asthma Friendly Football Clubs - The Video

Follow this You-Tube link to find and download the Asthma Friendly Football Clubs training video -:

http://www.youtube.com/watch?v=8dD7eUAPrlM&feature=plcp

The video was produced by 'Concert One Limited' - Many thanks to those who helped in its production.

 

Asthma and Sport

Asthma UK have published an excellent synopsis of issues relating to Asthma whilst Exercising

 

It can be downloaded at the following link

http://www.asthma.org.uk/about-asthma/living-with-asthma/exercise/managing-your-asthma-while-exercising/

The text is copied here :

Managing your asthma while exercising 

What are the symptoms to look out for when you are active?

When you exercise it's normal for your heart to beat faster and your breathing to be quicker. If you're doing vigorous activity you'll feel out of breath, hot and sweaty.
Make sure you can tell the difference between feeling out of breath through exercising, which is normal, and the symptoms of asthma. Then you can stop and take your reliever if you need to. Ask your doctor or nurse about what symptoms to look out for.
Remember, exercise won't harm your lungs. When you feel short of breath, it's a sign that your body is working harder. If you control your breathing you'll be able to keep going for longer.
When exercising it's normal if:

• you're breathing faster and harder
• your heart is beating faster
• you're feeling hot and sweaty
• you're looking flushed.

Stop exercising if you:

• start coughing/wheezing
• are gasping for air/very short of breath/can't get enough air
• feel tightness in the chest
• have trouble speaking in short sentences
• younger children may complain that their chest or tummy hurts.

You're having an asthma attack if any of these happen:

• your reliever inhaler doesn't help
• your symptoms are getting worse (cough, breathlessness, wheeze or tight chest)
• you're too breathless to speak
• cyanosis (a blue tinge on the skin or lips). This is a sign of lack of oxygen in the blood and means you need urgent medical attention.

Click here for information on what to do in an asthma attack

 

If exercise triggers your asthma

Exercise can be a trigger for asthma. This can happen to anybody with asthma: children or adults, people who play sports or elite athletes.

 

How does exercise trigger asthma?

It's not known exactly how exercise triggers asthma. When people exercise they breathe faster. This makes it more difficult for the nose and upper airways to warm up and add moisture to the air breathed in, so the air is drier and colder than usual. It's thought that this cold, dry air in the airways triggers the symptoms of asthma.

 

Managing exercise-triggered asthma

Asthma shouldn't stop you doing any type of exercise as long as you:

• see your doctor regularly
• keep your asthma well controlled
• take the right medicine
• slowly build up the amount of exercise you do and the level of intensity, starting with gentle exercise before trying more vigorous activities.

Factors that may trigger asthma when exercising include:

• continuous physical activity
• long distance and cross country running (as this often talks place outside in cold air and without breaks)
• high intensity exercise
• low physical fitness
• cold, dry air
• recent respiratory infection
• some adventure sports or outdoor activities may bring on asthma symptoms. This is more likely to be related to emotional or environmental factors associated with the activity, e.g. excitement, anxiety, stress, weather, pollen count, altitude.
• fitness tests
• dusty equipment
• chlorine in swimming pools.

 

Activities less likely to trigger asthma

Activities that require short bursts of energy alternated with slower paced exercise are less likely to trigger asthma. These include:

• team games such as football, hockey, netball and volleyball

• badminton or table tennis, as they are slower than tennis or squash

• field games, like cricket or rounders
• swimming, as the warm humid air is less likely to trigger asthma, but chlorine used in pools or cold pools may be a trigger for some people
• yoga, Pilates or t'ai chi, provide a workout for both your body and mind. Postures are performed in harmony with breathing techniques. Some people find that breathing techniques are helpful for their asthma. However, don't stop taking your normal asthma medicines unless your doctor or asthma nurse advises you to.
• low-moderate intensity exercise, e.g. walking, cycling, yoga.

 

Asthma that only comes on with exercise

Some people find that they have symptoms of asthma only when they exercise and not at any other time. This is unusual and affects only a small number of people. It is sometimes called exercise-induced asthma.

 

What would the symptoms be?

The symptoms are the same and include coughing, wheezing, chest tightness and difficulty in breathing. Symptoms usually begin after exercise and worsen about 15 minutes after exercise stops.
If you think you have asthma that comes on only when you exercise let your GP or asthma nurse know. To help you manage your asthma they may ask you to record some peak flow readings during and after exercise.
Asthma brought on by exercise is still treated the same, usually with preventer and reliever inhalers. The good news is that many top athletes have asthma and are still able to complete at a very high level.

This is a further factfile which was produced on the topic :

Asthma UK's  'Out There and Active Campaign' has produced this advice for the families of children with Asthma.

Tips to help children with Asthma exercise safely

1. Make sure your child's teacher/instructor/coach knows they have asthma

2. Increase your child's fitness levels gradually

3. Always ensure that your child has their reliever inhaler with them when they exercise

4. If exercise triggers your child's asthma ensure they use their reliever inhaler immediately before warm up

5. Ensure a good warm up before sport  (and a warm down after as well)

6. Try to avoid your child coming in contact with things that trigger their asthma

7. If you child has asthma symptoms when they exercise, they should stop, take their reliever inhaler and wait five minutes before starting again

8. If you child uses a preventer medicine, they should take it as prescribed by your doctor or nurse

 

Asthma Champions - Who / How / Why

Youth Football Clubs are all run by volunteers (mostly parents) who give up a lot of their valuable time to allow children to participate in sport.

Inevitably club committees have a large range of issues to consider, ranging from subscriptions and sponsorship through to fixture lists and training schedules.

Because the welfare of children within a youth club is so vitally important, all  Football Association Youth Football Clubs have to have a Welfare Officer who is a member of the Club Committee (and who's job it is to ensure that Welfare Issues are not overlooked).

Matters relating to the health of children within the club (whilst they are involved in club activities e.g. Matches and Training)  are part of the Welfare Officers responsibility.

As described in the Asthma Friendly Football Clubs document; "What is an Asthma Friendly Football Club" ..

The club needs to nominate an Asthma Champion (preferably a member of the club committee) who needs to ensure that the club and its coaches are all following best practise

Club Welfare Officers may well be happy to take on the role of being the Asthma Champion, equally there may another person within the Club Committee who is more suited to this role (perhaps a health care worker or a parent who has a child with asthma within the club).

The Asthma Friendly Football Clubs - Asthma Policy gives more details on this topic  (this can be found elsewhere on this blog).

Other Educational Videos

There are a large number of useful educational videos on the internet - These links are to some of the best ones.

Asthma First Aid

http://www.youtube.com/watch?v=MTYByUUND0o&noredirect=1

http://www.youtube.com/watch?v=1Ceh9CWHS7k&feature=related

General information on Asthma

http://www.youtube.com/watch?v=P5igitbIKEc&feature=fvwrel

http://www.youtube.com/watch?v=7EDo9pUYvPE&feature=related

Emergency Action Poster

Emergency Action Poster

Asthma UK has produced a poster on what should be done to help a child who is experiencing an attack of Asthma.

Asthma Friendly Football Clubs should ensure this poster is displayed in their club house / changing rooms.

A Copy of the poster can be downloaded from the Asthma UK website by following this link

http://www.asthma.org.uk/media/93787/howtodealwithanasthmaattackschoolsposter.pdf

Information for Individuals with Asthma, and for the Parents of Children who suffer with Asthma.

What to do in an asthma attack

The following guidelines are suitable for both children and adults and are the recommended steps to follow in an asthma attack:

1. Take one to two puffs of your reliever inhaler (usually blue), immediately.
2. Sit down and try to take slow, steady breaths.
3. If you do not start to feel better, take two puffs of your reliever inhaler (one puff at a time) every two minutes. You can take up to ten puffs.
4. If you do not feel better after taking your inhaler as above, or if you are worried at any time, call 999.
5. If an ambulance does not arrive within 10 minutes and you are still feeling unwell, repeat step 3.

If your symptoms improve and you do not need to call 999, you still need to see a doctor or asthma nurse within 24 hours.

You can order a free, pocket size 'What to do in an asthma attack' card to carry with you here.

You're having an asthma attack if any of the following happens:

• Your reliever inhaler does not help.
• Your symptoms are getting worse (cough, breathlessness, wheeze or tight chest).
• You are too breathless to speak, eat or sleep.

Do not be afraid of causing a fuss, even at night. If you go to A&E (accident and emergency) or are admitted to hospital, take details of your medicines with you if possible.

After an emergency asthma attack:

• Make an appointment with your doctor or asthma nurse for an asthma review, within 48 hours of your attack.
• You will also need another review within one or two weeks to review your current asthma treatment and ensure your asthma is well controlled.

Do not ignore worsening symptoms

Asthma attacks are the result of gradual worsening of symptoms over a few days that you may not have noticed.
Needing to use your reliever inhaler more than three times a week may suggest that your asthma is not as well controlled as it could be.
Think about it - if your asthma symptoms are getting worse or you're using your reliever inhaler more, don't ignore it.
If your symptoms continue to get worse, make an urgent appointment to see your doctor or asthma nurse within 24 hours.

Information on the Use of Inhalers

Most medication for Asthma is given by the inhaled route. Part of the process for prescribing these medicines should involve the patient being trained how to use their inhaler by their Doctor, Nurse or Pharmacist.

These videos show how inhalers should be used

Metered Dose Inhalers

http://www.youtube.com/watch?v=rfAvAI6_oCY

Breath Activated (Automatic) Inhalers

http://www.youtube.com/watch?v=fuI3I_qnfuI

Spacers

http://www.youtube.com/watch?v=ykYrX7VNUpw&feature=related

http://www.youtube.com/watch?v=SLyhe1yttic&feature=relmfu

http://www.youtube.com/watch?v=NIDwcj8XuOM&feature=related

http://www.youtube.com/watch?v=w4a_vXmmcmc

Asthma Friendly FCs - An Example Club Policy

ASTHMA POLICY FOR YOUTH FOOTBALL CLUBS

Club Name:

Date of Policy:

Policy Statement

This club is committed to:

q  Providing the necessary procedures to ensure the health and safety of all persons with asthma involved with the club

q  Raising the awareness of asthma amongst those involved with the club

q  Providing an environment in which young people with asthma can participate in all activities to their full potential

Purpose

The aim of this policy is to document strategies for implementation of best practice asthma management within a sporting environment so that:

 q All children enrolled at the club who have asthma can receive appropriate emergency attention as required

Implementation

Asthma management should be viewed as a shared responsibility.  To this end, each of the key groups within this club gives the following undertaken:

q Identifying children with asthma during the enrolment process.  This information needs to be documented appropriately and maintained as part of the child’s club record

q  Promptly communicating any concerns to the parents / carers if they are worried about the child’s asthma limiting his / her ability to participate fully in all activities

q Encouraging children of appropriate age and ability to self-manage their asthma, including the use of their reliever medication as soon as symptoms develop

q  Displaying Asthma First Aid posters in key locations within the club

q Ensuring that all regularly prescribed asthma medication is administered in accordance with the child’s asthma care plan

q  Identifying and, where possible, minimising asthma triggers

q  Ensuring that parents / carers of a child with asthma have been provided with a copy of this policy

q  Providing families with the contact details of Asthma UK if further asthma advice is needed

The parents / carers are responsible for:

q  Informing the club management upon enrolment (or upon initial diagnosis) that their child has asthma

q  Providing all relevant information regarding their childs asthma via the Asthma Care Plan.  Asthma Care Plans should be updated at least annually.

q  Notifying the team coach in writing of any changes to the Asthma Care Plan, if this occurs during the year.

q  Providing an adequate supply of appropriate medication (reliever) and a spacer device if appropriate.  These need to be clearly labelled with the child’s name.

q  Communicating all relevant information about a child’s asthma as and when the need arises (eg if asthma symptoms were present during the night before a match or training session).

q  Reading and being familiar with this policy.

Authorisation

This policy was considered and accepted by the following on (date)

__________________________________

…………………………………….                           ………………………………………….

Club Chairman                                                        Club Secretary

……………………………………..                          …………………………………………..

Club Welfare Officer                                               Club Asthma Champion

Review

This policy will be reviewed annually by the Club Committee

The review process will assess whether the policy has achieved its purpose by:

·         Taking into account feedback from all parties regarding the effectiveness of the policy

·         Reviewing the adequacy of staff response to an emergency if one has occurred during the previous year

A PDF / Word copy of this doccument is available by e-mail  : Contact asthmafriendlyfc@gmail.com

CHECK LIST FOR TEAM MANAGERS IN

ASTHMA FRIENDLY FOOTBALL CLUBS

Ø   Do you know which players in your team suffer from asthma?

Ø   Do you have a completed Asthma Action Card (or Medical Conditions Proforma) for all of the children that suffer from asthma?

Ø   Do you have a safe box in which inhalers are kept during matches and training sessions (and is this kept by the field of play)?

Ø   Do you ensure that those children in your team who suffer with asthma always bring their inhalers to matches and to training sessions (or do you have a spare inhaler for them that has been provided to you by their parents)?

Ø   Have all of the parents of children that suffer with asthma that are in your team been given a copy of the club’s Asthma Policy?

Ø   Do you know which trigger factors are likely to be relevant to the children that suffer with asthma in your team?

Ø   Have you watched the training video that is available on the Asthma Friendly Football Clubs’ website?

A PDF / Word copy of this doccument is available by e-mail  : Contact asthmafriendlyfc@gmail.com

Application Process & Current List of Asthma Friendly FCs

How does a Club register as being Asthma Friendly

To register as an Asthma Friendly Football Club, the Club Committee need to complete and return the form bellow (cut and paste it onto a word doccument - and send it as a Word File / PDF). Alternatively please e-mail asthmafriendlyfc@gmail.com and request a copy of the application form.

------------------------------



APPLICATION TO BE LISTED AS AN ASTHMA-FRIENDLY FOOTBALL CLUB

Please complete this form and return it by email, either as a Word document or as a PDF, to asthmafriendlyfc@gmail.com.

Name of club:

Football Association County with which Club is affiliated:

Contact details for Club Chairman: 

Contact details for Club Asthma Champion: 

Please also send a completed copy of your Club’s Asthma Policy appropriately signed and dated.  If you would wish your Club Badge to appear on the Asthma Friendly Football Club’s website, then please also email an image of that Badge. 



------------------------------

The following clubs have registered to be recognised as an Asthma Friendly Football Club

(In alphabetical order)

AXBRIDGE SAXON JUNIOR FOOTBALL CLUB



Medical Conditions in Schools (Health Education)

Useful advice on Asthma in School can be found on the Asthma UK website

http://www.asthma.org.uk/about-asthma/my-child-has-asthma/your-child-at-school/

The Medical Conditions at School Partnership (which includes Asthma UK) has a website which includes educational information on Asthma, Anaphylaxis, Cystic fibrosis, Diabetes and Epilepsy.

http://medicalconditionsatschool.org.uk/

One has to register (registration is free) to access this information. Asthma Champions may find it a useful resource.

There is also an excellent free poster that can be ordered from Asthma UK

http://www.asthma.org.uk/how-we-help/publications/publications-for-the-public/ucProduct?product=394

Information for Other Sports

Asthma UK have produced this guidance for managing asthma whilst exercising

Managing your asthma while exercising

What are the symptoms to look out for when you are active?

When you exercise it's normal for your heart to beat faster and your breathing to be quicker. If you're doing vigorous activity you'll feel out of breath, hot and sweaty.
Make sure you can tell the difference between feeling out of breath through exercising, which is normal, and the symptoms of asthma. Then you can stop and take your reliever if you need to. Ask your doctor or nurse about what symptoms to look out for.
Remember, exercise won't harm your lungs. When you feel short of breath, it's a sign that your body is working harder. If you control your breathing you'll be able to keep going for longer.
When exercising it's normal if:

• you're breathing faster and harder
• your heart is beating faster
• you're feeling hot and sweaty
• you're looking flushed.

Stop exercising if you:

• start coughing/wheezing
• are gasping for air/very short of breath/can't get enough air
• feel tightness in the chest
• have trouble speaking in short sentences
• younger children may complain that their chest or tummy hurts.

You're having an asthma attack if any of these happen:

• your reliever inhaler doesn't help
• your symptoms are getting worse (cough, breathlessness, wheeze or tight chest)
• you're too breathless to speak
• cyanosis (a blue tinge on the skin or lips). This is a sign of lack of oxygen in the blood and means you need urgent medical attention.

 

What to do in an asthma attack

The following guidelines are suitable for both children and adults and are the recommended steps to follow in an asthma attack:

1. Take one to two puffs of your reliever inhaler (usually blue), immediately.
2. Sit down and try to take slow, steady breaths.
3. If you do not start to feel better, take two puffs of your reliever inhaler (one puff at a time) every two minutes. You can take up to ten puffs.
4. If you do not feel better after taking your inhaler as above, or if you are worried at any time, call 999.
5. If an ambulance does not arrive within 10 minutes and you are still feeling unwell, repeat step 3.

If your symptoms improve and you do not need to call 999, you still need to see a doctor or asthma nurse within 24 hours.

 

If exercise triggers your asthma

Exercise can be a trigger for asthma. This can happen to anybody with asthma: children or adults, people who play sports or elite athletes.

 

How does exercise trigger asthma?

It's not known exactly how exercise triggers asthma. When people exercise they breathe faster. This makes it more difficult for the nose and upper airways to warm up and add moisture to the air breathed in, so the air is drier and colder than usual. It's thought that this cold, dry air in the airways triggers the symptoms of asthma.

 

Managing exercise-triggered asthma

Asthma shouldn't stop you doing any type of exercise as long as you:

• see your doctor regularly
• keep your asthma well controlled
• take the right medicine
• slowly build up the amount of exercise you do and the level of intensity, starting with gentle exercise before trying more vigourous activities.

Factors that may trigger asthma when exercising include:

• continuous physical activity
• long distance and cross country running (as this often talks place outside in cold air and without breaks)
• high intensity exercise
• low physical fitness
• cold, dry air
• recent respiratory infection
• some adventure sports or outdoor activities may bring on asthma symptoms. This is more likely to be related to emotional or environmental factors associated with the activity, e.g. excitement, anxiety, stress, weather, pollen count, altitude.
• fitness tests
• dusty equipment
• chlorine in swimming pools.

 

Activities less likely to trigger asthma

Activities that require short bursts of energy alternated with slower paced exercise are less likely to trigger asthma. These include:

• team games such as football, hockey, netball and volleyball

• badminton or table tennis, as they are slower than tennis or squash

• field games, like cricket or rounders
• swimming, as the warm humid air is less likely to trigger asthma, but chlorine used in pools or cold pools may be a trigger for some people
• yoga, Pilates or t'ai chi, provide a workout for both your body and mind. Postures are performed in harmony with breathing techniques. Some people find that breathing techniques are helpful for their asthma. However, don't stop taking your normal asthma medicines unless your doctor or asthma nurse advises you to.
• low-moderate intensity exercise, e.g. walking, cycling, yoga.

 

Asthma that only comes on with exercise

Some people find that they have symtoms of asthma only when they exercise and not at any other time. This is unusual and affects only a small number of people. It is sometimes called exercise-induced asthma.
What would the symptoms be?
The symptoms are the same and include coughing, wheezing, chest tightness and difficulty in breathing. Symptoms usually begin after exercise and worsen about 15 minutes after exercise stops.
If you think you have asthma that comes on only when you exercise let your GP or asthma nurse know. To help you manage your asthma they may ask you to record some peak flow readings during and after exercise.
Asthma brought on by exercise is still treated the same, usually with preventer and reliever inhalers. The good news is that many top athletes have asthma and are still able to complete at a very high level.

Exercise can be divided into three categories, and you should aim to do a combination of all three.

Aerobic activity

Aerobic activity uses all your major muscle groups, is usually rhythmic, and raises your heart rate and makes you breathe quicker.
Moderate-intensity aerobic activity means you're working hard enough to raise your heart rate and break into a sweat. One way to tell if you're working at a moderate intensity is if you can still talk but you can't sing the words to a song.
Moderate-intensity activities include:

• brisk walking
• gentle swimming
• dancing
• cycling
• jogging.

Vigorous-intensity aerobic activity means you're breathing hard and fast, and your heart rate has gone up quite a bit. If you're working at this level, you won't be able to say more than a few words without pausing for a breath.
Vigorous intensity aerobic activity for most people include:

• fast running  
• aerobics
• swimming fast
• riding a bike fast or on hills
• playing singles tennis
• playing football
• hiking uphill
• energetic dancing, eg Zumba, Ceroc
• martial arts

If you have painful and stiff joints avoid weight-bearing high-impact exercise such as aerobics and running. But even with stiff joints, there are plenty of exercises you can do - such as swimming and some forms of yoga. These put very little stress on weight-bearing joints such as knees and ankles. There are even exercises you can do while sitting in a chair.

Strengthening exercises

As well as aerobic activity, you should also do muscle strengthening exercises. Muscle-strengthening exercises are counted in repetitions and sets. A repetition is one complete movement of an activity, like lifting a weight or doing a sit-up. A set is a group of repetitions. For each activity, try to do 8 to 12 repetitions in each set, eg 8 - 12 sit-ups would be one set.
Try to do at least one set of each muscle-strengthening activity (eg back, chest, abdomen, shoulders, legs and arms). Even better, do two or three sets, with a short break (about one minute) in between.
There are many ways you can strengthen your muscles, whether at home or in the gym. Muscle-strengthening activities include:

• lifting weights
• working with resistance bands
• doing exercises that use your body weight for resistance, such as push-ups or sit-ups
• heavy gardening, such as digging or shovelling
• yoga, Pilates or t'ai chi.

You can do activities that strengthen your muscles on the same day or on different days as your aerobic activity, whatever's best for you.
Some vigorous-intensity aerobic activities provide both aerobic and muscle-strengthening exercise at the same time. Examples include circuit training, aerobic dancing or running. If you use the gym your exercise programme will probably include a combination of aerobic and strengthening exercises.

Stretching

This is an important part of your warm up and cool down, and can help to improve flexibility and range of motion in your joints. This will usually be included in a gym based exercise programe or class. Yoga, Pilates and t'ai chi also involve stretching exercises. Stretching is also something that can also be easily done at home.

 

 

Where can I exercise?

Exercise wherever you feel comfortable. Walking, running and cycling are free and you can enjoy them at any time. Some people prefer to go to a gym or a leisure centre, or even a community centre, which offers a range of activities such as aerobics classes, dance, circuits, yoga, Pilates or other sports.
You may have a local Exercise on Referral scheme. This means your GP can refer you to a nearby gym, where specially qualified instructors run supervised exercise sessions (gym or classes). These are often at a reduced price and are specifically for people who have health conditions. Ask your GP or asthma nurse if there is a scheme in your area.

 

 

Adventure sports

People with asthma may need to take special care when doing adventure sports. It is important that you contact your doctor before undertaking these activities. Always tell the instructor you have asthma and ensure that your reliever is easily accessible. You should mention your asthma on medical insurance, fitness declaration and medical waiver forms; if you don't and something happens you may not be covered.

Scuba-diving

In recent years medical opinion has recognised that people with controlled asthma symptoms can take part in scuba-diving. However, if you have asthma you may have greater problems when scuba-diving because of the triggers to which you are exposed when you dive (cold air, exercise, stress, emotion).
Regulations on scuba-diving by people with asthma vary between countries. It is important that you check the regulations of a particular country before you plan to dive, as some do not allow anyone with asthma to scuba-dive. The British Sub-Aqua Club suggests that those with mild, controlled asthma may dive provided that:

• you do not have asthma that is triggered by cold, exercise, stress or emotion
• your asthma is well controlled
• you have not needed to use a reliever inhaler or had any asthma symptoms in the previous 48 hours
• your peak flow must be within 10% of your best value for at least 48 hours before diving.

You may also be asked to undertake an exercise test.

Mountaineering

The clean air of the mountain environment is ideal for those whose asthma is triggered by pollution. You are unlikely to be troubled by house-dust mites - a very common asthma trigger - as they cannot live at the low temperatures above 'the snow line'.
The mountain environment contains several triggers for people with asthma (cold, dry air and exercise). If you are physically fit with well-controlled asthma and prepare adequately for your trip you should not be restricted in your activity. Always consult your doctor before planning a trip. Medical advice on mountaineering at high altitudes is available from the British Mountaineering Council.

Skiing

Skiing involves many of the same asthma triggers as mountaineering. Cross-country skiing is thought to be a stronger trigger for asthma than downhill skiing or mountaineering.
People with well-controlled asthma should be able to ski safely. You should make sure that your asthma is well controlled before you go. Always take your medicines with you when you ski and discuss your trip with your doctor in advance.

Parachute jumping

Always consult your doctor before planning a parachute jump or skydive. Medical advice on skydiving and parachuting is available from the British Parachute Association. As a general rule you can parachute jump or skydive if:

• your asthma is completely controlled
• cold air does not trigger your asthma
• exercise does not trigger your asthma

News and Updates

About me : I am a Consultant in Emergency Medicine in Weston s Mare and I am also a qualified FA football coach.

The Asthma Friendly Football Clubs  initiative was developed as a result work done by University of Bristol Medical students who undertook research with me on this particular area of Child Health.


Dr Andrew Newton - September 2012