Indoor Swimming Recommended for Children with Asthma

For the more than 6 million children with asthma in the United States, finding ways to safely exercise and stay fit can be a challenge. 

Physical activity is essential for lung function and overall fitness levels, but fearing asthma attacks, some children and their parents avoid it.

It can be a dilemma for many families,” said Tod Olin, M.D., a pediatric pulmonary specialist at National Jewish Health in Denver. “All it takes is one asthma attack, and suddenly patients can become very tentative about overdoing it.”

Dr. Olin says there is one activity that parents of any child with asthma should consider. “When it comes to cardio activities that are well-tolerated, swimming, specifically, is highly recommended, particularly in indoor swimming pools.”

Dr. Olin says the humidity associated with indoor swimming pools tends to protect against asthma attacks by keeping airways open. Conversely, it’s when children exercise in cool, dry air that problems with asthma typically occur.

“We think that the way asthma attacks happen is that the airways dry out, and that sets off a cascade of reactions that ultimately squeezes down the airway,” said Dr. Olin. “If we can prevent that initial airway-drying step by staying in a humid environment, we prevent the asthma attack all together.”

Like many children, 11-year-old Kristian Jackson struggled for years to find safe ways to exercise. “Whenever it would start to flare, my shoulders would go up, and it felt tight, like I was blacking out or going to faint,” he said. “It was really scary.”

Then, Jackson enrolled at Morgridge Academy on the campus of National Jewish Health in Denver. Morgridge Academy is a school specifically for children with chronic conditions who need daily medical treatments, and there, swimming is actually part of the curriculum.

“When Kristian first came to our school, he had been hospitalized for asthma and was having constant emergency room visits,” said Jennifer McCullough, director of education at Morgridge Academy. “Since he’s been here, all of that has been dramatically reduced.”

McCullough says knowing the benefits of humid air, the pool at Morgridge Academy is kept above 90 degrees, and swimming is considered more than just an activity. For many of the students here, it’s therapeutic.

“When you get our kids into that pool with the warm air, and teach them how to regulate their breathing, we find they can do a lot more physical activity than they would be able to do otherwise,” she said. “Often, within a matter of weeks, we see dramatic improvements in their health.”

“The water introduces this level of complexity with breathing,” said Dr. Olin. “They become much more conscious of their breathing in the swimming pool. It forces them to control their breathing, and they are much less likely to hyperventilate or experience an asthma attack in that environment.”

Overtime, students who regularly play and exercise in the indoor pool have gained better control of their asthma and improved their cardiovascular health.

“We track the progress of each student, and we’ve found that swimming in the pool, along with proper management of their asthma, has reduced their symptoms as well as emergency room visits and hospital stays.” said McCullough.

The methods used at Morgridge Academy can help children with asthma adopt an exercise routine, and swimming can help them strengthen their lung function and transition into playing other sports they enjoy.

“I think, as a society, we’ve told children that, if they have asthma, they should be limited with respect to exercise,” said Dr. Olin. “More recently, we’ve changed our approach. We now encourage kids to exercise, especially as the obesity epidemic has become more and more problematic.”

Dr. Olin says starting with swimming and allowing kids to choose sports they love will make them more likely to stay active and grow into healthy adults.

“I generally recommend that they use their albuterol inhaler about 15 minutes before exercise, but if their asthma is well-controlled, there is no reason to limit any activity,” said Dr. Olin. “If their heart is taking them toward a certain sport, they should be encouraged to pursue that.”