Physical Activity and Exercise Considerations with Cystic Fibrosis

Everyone with cystic fibrosis (CF) should get regular exercise. Just as with the general population, exercise offers many benefits to the human body.

How exercise benefits cystic fibrosis

• Improves lung function by loosening mucus and causing coughing
• Builds stamina
• Improves mood
• Strengthens muscles, especially the breathing muscles and heart
• Improves the quality of sleep
• Helps with weight management
• Slows the rate of decline in FEV1 and may show small increases in FEV¹
• Increases rates of survival^1-3
• Helps maintain healthy bones⁴

Usually, aerobic exercise is considered a supplement to other airway clearance techniques; however, in a small proportion of adults with CF ages 20-40, exercise is their primary airway clearance method. People with cystic fibrosis should never substitute exercise for airway clearance techniques without consulting their medical team.⁵

“If exercise could be purchased in a pill, it would be the single most widely prescribed and beneficial medicine in the nation.” – Robert H. Butler

Activities to avoid

In general, people with CF should play any sport or game they enjoy. There are very few activities to avoid. These are scuba diving, skydiving, bungee jumping, and high-intensity activities at high altitudes. Those with an enlarged liver or spleen should avoid collision sports such as football, basketball, or soccer.^1,2 It is probably a good idea to talk to someone on your care team before participating in any new exercise or sport.

Special considerations about sweat

Cystic fibrosis affects all of the exocrine glands, and sweat glands are one part of that system. While the other exocrine glands are responsible for producing the thick, sticky secretions that clog the lungs and pancreas, the sweat glands are different.

In a person with CF, the sweat is a normal consistency but is two to five times saltier than normal. That is why salty skin is one of the first symptoms families notice about a baby with CF.

Because people with CF lose more salt when sweating, it is important for them to get more salt in their diet during sweaty activities, such as:

• In hot weather
• When exercising
• With a fever

People with cystic fibrosis may need to avoid exercising during very hot weather, in intense sun, or when they have a fever or exacerbation.²

Symptoms of low salt

While losing too much salt is rarely a problem in people with CF, it does happen on occasion. Losing too much salt can lead to dehydration and heatstroke. Symptoms of too little salt include:²

• Tiredness or weakness
• Vomiting
• Fever
• Muscle cramps
• Stomachache

Treatments for low salt

For people with CF, too little salt is seldom a problem because many of the foods we eat in the U.S. tend to contain plenty of salt. The good news is that losing too much salt is an easy problem to fix. Suggestions for getting more salt into the diet are:^2,3

• Drink sports or electrolyte-replacement drinks rather than plain water (such as Gatorade and Powerade)
• Add a little salt to plain water
• Eat a banana with salt sprinkled on it

Tips for exercising with cystic fibrosis

Regular exercise is an essential part of any treatment plan. The following tips can help make exercise more enjoyable:

• Choose exercise clothing with pockets to store extra tissues for coughing
• Perform huff coughs before and during physical activity to make help release more mucus
• Drink plenty of fluids before, during, and after physical activity
• Those with CF-related diabetes should consult their endocrinologist on how to monitor their blood sugar and adjust their carbohydrate intake with exercise. Those on insulin should also know how to adjust their insulin when they exercise.¹