Blog · Training with asthma

Exercising with asthma: how hard can you actually train?

By Remko Opdam · 21 August 2026 · 5 min read

In short

The European guideline actively recommends exercise for asthma: three to five times a week, plus strength training two to three times a week.
Training usually does not improve your lung function, but it does improve your grip on the symptoms and your fitness. In the research, nobody got worse.
Strength training with real rest between sets carries a lower risk of exercise-induced asthma than twenty minutes of continuous running in the cold.

Ask someone who has never trained with a personal trainer what they picture, and you almost always get the same image: a trainer standing next to you shouting until you drop to your knees. If your lungs are healthy, that is mainly an unpleasant idea. But if light effort already makes your breathing take over, it sounds dangerous. If a flight of stairs leaves me short of breath, what happens to me in a gym like that?

So let us turn the question around. Not whether you are allowed to exercise with asthma, but how hard you can actually train with it. The answer is: harder than you think, and differently than you fear. For the record, I am a personal trainer and not a doctor. Your medication and your lung function belong with your GP or your lung specialist.

Where that breathlessness comes from

First, what makes that fear reasonable: exercise-induced asthma is real. During hard effort your breathing can rise to around two hundred litres of air per minute. All of that air has to be warmed and humidified on the way in, and that cools and dries out your airways. That is what sets the narrowing in motion.

What strikes me most is how predictable the pattern is. It usually starts after more than five to eight minutes of continuous intense effort, peaks ten to fifteen minutes after the effort, and settles within thirty to ninety minutes. What follows is a period of one to three hours in which your airways are actually less sensitive. That pattern is where the opening lies: it is not effort that triggers it, but sustained high ventilation, often in cold or dry air.

What training does and does not do

Being honest is part of this subject, so: your lungs do not get better from it. In a review of twenty randomised studies, measured lung function improved in only six of twenty-two measurements. What did improve was asthma control, in seven of the thirteen studies that looked at it, and quality of life in five of nine. And more important than any of those numbers: no study saw people get worse.

So you do not get new lungs. You get a body that asks less of your lungs for the same task. The same stairs, less breathlessness. It works the other way round too: fear of breathlessness leads to moving less, moving less leads to worse fitness, and with worse fitness you are already panting at a lower effort. The European guideline names that fear explicitly as a cause of inactivity, and adds something I like to pass on. Getting out of breath from hard effort is a normal response of a healthy body, not a sign that something is going wrong.

Why strength training works out differently

This is where those two things meet. Exercise-induced asthma needs sustained high ventilation, and strength training consists of short efforts with real rest in between: a set of ten to fifteen repetitions, then a few minutes of nothing. Your breathing goes up and comes back down. That sustained high ventilation never builds up.

That is not a theory of mine. The literature puts it quite plainly: people with asthma can safely do strength training to get stronger, with a lower risk of exercise-induced asthma. The prescription that goes with it looks remarkably like an ordinary training week.

The image of the shouting trainer pushing you past your limit is not just unpleasant. With asthma it is simply bad training practice. What works is building on what your body can handle, and that is where every intake session with me starts.

So how hard can it get?

The guideline is more concrete than people expect: thirty to forty minutes of moderate exercise, three to five days a week, plus strength training two to three times a week on the major muscle groups. That is not an adapted programme for sick people, that is the advice I would give someone without asthma too. What comes on top are the conditions around it:

A warm-up of five to ten minutes, and with exercise-induced asthma deliberately with a few short brisk bursts in it. That sounds contradictory, but it brings on that less sensitive period before you start the real work.
Your reliever inhaler within reach. Always, even if you never need it.
Talking as your gauge: at moderate intensity you should be able to hold a conversation, even if you cannot sing.
After an attack or a chest infection, wait with building up until your symptoms and lung function have recovered.

One more figure, because it tips the picture. Among Olympic athletes asthma is more common than in the rest of the population, not less: in a Norwegian study of one hundred and thirty-five Olympians, about half of the endurance and winter sport athletes had an asthma diagnosis, against eight to ten per cent in the general population. Part of that is the sport itself, because years of breathing cold dry air is not kind to airways. But it means there are people with asthma performing at Olympic level. Which makes the question not whether you can train with asthma, but what your training should look like.

What you can do with this yourself

Make your warm-up ten minutes and put intervals in it. Not steady spinning on the cross trainer, but alternating: half a minute a bit harder, a minute easy, repeated a few times.
Start with strength rather than long cardio. Sets of ten to fifteen repetitions with a few minutes of real rest. You build strength and fitness without the sustained heavy breathing that triggers symptoms.
Make one appointment with your doctor and write the answer down. Which medication do I take how long before training, and what makes me stop? Once that is settled, you no longer have to think about it on the gym floor.

And if what is holding you back is mainly that image of falling apart on the gym floor, have someone look at it with you. Not to hand you a standard schedule, but to work out what your body can handle right now, and how we build on that calmly.

Frequently asked questions

Is exercising with asthma dangerous?

If your asthma is under control, exercising is not dangerous, and the European guideline actively recommends it rather than merely allowing it. In a review of twenty randomised studies in people with asthma, asthma control improved in more than half of the trials that measured it, and no study found that participants' symptoms got worse because of the training. What does matter are the conditions around it: keep your reliever inhaler within reach, take a proper warm-up, and after an attack or a chest infection wait until your symptoms and lung function have recovered before you build up again. If your asthma is not under control, that is a conversation with your GP (the Dutch family doctor) or your lung specialist first, and not a reason to train harder. Always tell your trainer that you have asthma, so the build-up can be adjusted to it.
Source: EAACI position paper on exercise in asthma (Allergy, 2025) →

Can you do strength training with asthma?

Yes, and with asthma strength training is one of the most favourable ways to train. Exercise-induced asthma comes mainly from sustained high ventilation, usually after more than five to eight minutes of continuous intense effort, which cools and dries the airways. Strength training works differently: short sets with real rest in between, so that sustained heavy breathing never builds up. The literature on training with asthma states it plainly: people with asthma can safely do strength training to get stronger, with a lower risk of exercise-induced asthma than with continuous endurance work. The prescription that comes with it is entirely ordinary: ten to fifteen repetitions, two to four sets, generous rest between sets, two to three times a week on the major muscle groups. That is exactly the build-up that makes sense without asthma too, so there is no need for a separate programme.
Source: review of physical training in asthma (Frontiers in Rehabilitation Sciences, 2023) →

Should I use my inhaler before I exercise?

That depends on your personal asthma plan, and it is a question for your GP or your lung specialist, not for your trainer. What the guidelines do say clearly: if your symptoms come on mainly during exertion, taking medication beforehand is a common option, and the Dutch Lung Foundation mentions a reliever inhaler shortly before exercise as agreed with your doctor. Just as important is keeping your medication within reach while you train, including on days when you do not expect to need it. A warm-up of five to ten minutes with a few short intense bursts also helps, because your airways are less sensitive for one to three hours afterwards. In cold air, breathing through your nose or holding a scarf over your mouth helps, as the air then reaches your lungs warmer and more humid. Settle those agreements once and you no longer have to wonder about them mid-session.
Source: Dutch Lung Foundation on exercising with asthma →