Playing Sports with Asthma

Playing Sports with Asthma

By John M. Robertson, M.D.

One of the most frequent questions asked by parents after their child is diagnosed with asthma is "Can he or she play sports?” Asthma is a chronic disease caused by inflammation of the airways that makes it hard to breathe. Typical asthma symptoms are one or more of the following: wheezing, coughing, chest tightness, or poor exercise tolerance. Some children only have asthma symptoms when they exercise, but most children with asthma develop asthma symptoms with exercise. So, if exercise can trigger asthma, shouldn't someone with asthma avoid sports? By no means! Long gone are the days when the asthmatic was forbidden from participating in sports. In fact, there are a number of professional and Olympic athletes with asthma such as Jerome “The Bus” Bettis, Amy Van Dyken, Kristi Yamaguchi, and Jackie Joyner-Kersee.

"Initially I thought that with asthma, I couldn't be involved in any sports or other activities. Thankfully, my mother encouraged me, instead of discouraged me, to play. She said, 'As long as you take your medicine, the doctor told me that you will be fine.‘” - Jerome “The Bus” Bettis, Super Bowl XL Champion Pittsburgh Steelers Running Back (1996-2005)

Modern medications combined with simple warm-up and breathing techniques make full athletic participation the norm for asthmatics. One common method to prevent exercise limiting asthma symptoms is to use a “rescue” medication, such as albuterol or levalbuterol, about 15 minutes before exercising. This helps to prevent or minimize the changes in the asthmatic lung that cause symptoms and limit exercise. This may be sufficient for the athlete who only has asthma symptoms during or after exercise. However, the athlete with asthma symptoms on and off the court may benefit from a daily “maintenance” (also called “controller”) medication on top of their “rescue” medication.

Today, asthma medicines are so effective that, if a child with asthma is unable to participate in sports because of breathing problems, then the top three most likely culprits are...

1. The child is not on the right medicine.

2. The child is on the right medicine, but not the right dose.

3. The child is on the right medicine, at the right dose but is not using it correctly.

The secret to controlling asthma is the right medication at the right dose and used the right way. In addition, there are simple warm-up and breathing techniques an athlete can use to further reduce asthma flare ups during or after exercise. Aerobic warm-up exercise of mild intensity, like jogging, for 20 minutes activates the body’s own anti-asthma defense mechanisms. This warm-up can be done before beginning strenuous exercise to prevent exercise induced asthma symptoms. Proper breathing during exercise can further minimize the triggering effect exercise has on asthma. Cold, dry air tends to promote asthma symptoms. The nose warms and humidifies air as it travels through toward the lungs. Therefore, athletes with asthma are taught to breathe in through their nose and out through their mouth to eliminate the exposure of their lungs to cold, dry air. Combined with proper medicine, these techniques can eliminate asthma as a barrier to athletic participation.

All of these interventions are not right for all child athletes with asthma. This is a situation in which a specialist such as a pediatric pulmonologist can help. Pediatric pulmonologists are trained to care for children (from birth to 18 years of age) whose asthma is still limiting their quality of life despite proper treatment by their primary care physician. A pediatric pulmonologist will evaluate the child’s current asthma symptoms, medications, and how those medications are being used. They will prescribe a plan tailored to the specific needs of the individual patient. This individualized plan will include teaching on the proper use of asthma medications and instruction on warm-up and breathing techniques to eliminate the impact of asthma on athletes.

Modern asthma management is extremely effective. In almost all cases, it is only when asthma is ignored or improperly treated that it limits a child’s ability to participate and enjoy athletics. A specialist like a pediatric pulmonologist can design a treatment plan to meet the individual needs of the child athlete, and can eliminate asthma as a barrier to athletic participation.

“It [asthma] interferes with almost everything I want to do from sleeping to laughing. But I've been able to work with my doctor on a good medication regimen so that it doesn't affect me as much.” - Amy Van Dyken, 6-time Olympic Gold Medalist in swimming (1996, 2000).