Asthma and Exercise (Care of the Young Athlete)

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Almost every child (and adult) with asthma can
benefit from sports and physical activity. Also, asthma should not prevent young
athletes from enjoying a full athletic career. The following is information from
the American Academy of Pediatrics about asthma and exercise.

What is asthma?

Asthma is the most common chronic medical
problem in children. Children with asthma can have different symptoms at
different times. The most common problems are cough, wheeze, difficulty
breathing, chest “tightness,” and chest pain. Almost all children
with asthma will have one or more of these symptoms when they have a cold or
with exercise.

Many symptoms are brought on with allergies or
exposure to cigarette smoke, laughing, or crying. Most children with asthma have
symptoms while they exercise or right after they exercise. Children with asthma
symptoms only with exercise may have exercise-induced asthma.

What causes asthma?

The cause of asthma is unknown. Genetics may
play a role—children are more likely to have asthma if other people in
the family have asthma. However, many children with no family history of asthma
have asthma. Asthma is also more common in children with allergies. However,
some children with allergies do not have asthma and some children with asthma do
not have allergies. Exposure to secondhand cigarette smoke or pollutants makes
children more likely to develop asthma.

How does exercise cause asthma symptoms?

The symptoms of asthma are caused by narrowing
of the small bronchial tubes in the lung. The narrowing is caused by
inflammation and swelling within these tubes and by spasm of the muscles in the
bronchial walls.

It is unknown why exercise causes airways to
narrow. In general, exercise-induced asthma is most likely to occur with
endurance exercise in cool, dry air. However, there are exceptions, including
exercising in warm humid air with a lot of pollutants or in swimming in a poorly
ventilated space with strong chlorine fumes.

How can you prevent exercise-induced asthma?

The first thing to do to prevent asthma symptoms
with exercise is to make sure that the asthma unrelated to exercise is well
controlled. For many children this means the regular use of inhaled steroid
medicines and use of medicines before exercise. Ask your child’s doctor
about what medicine is best for your child and make sure your child learns the
proper technique for using an inhaler. If the asthma is well controlled but your
child still has problems during or after exercise, let your child’s
doctor know.

The following are other ways that may help
prevent exercise-induced asthma:

  • When exercising in the cold, wrap a
    scarf or mask around the face to warm up and humidify the air. Avoid
    exercise in the early morning or try exercising inside.

  • Increase fitness level (exercise-induced
    asthma symptoms improve as fitness improves).

  • Try a different sport or
    cross-training.

  • Do a short warm-up exercise before the
    main exercise session.

Warning: If a child still has
symptoms even with treatment, the exercise bout should be stopped. Asthma can be
life-threatening if the athlete tries to play through the symptoms. Once the
symptoms are controlled, the child can return to exercise.

What problems can “look like” asthma?

Probably the most common situation that is
mistaken for exercise-induced asthma is that a child is not in very good
athletic shape. It is normal for all of us to breathe harder when we exercise,
and this is especially true for someone who isn’t very active. Sometimes
this normal heavy breathing can be mistaken for asthma. The good news is that
it’s easy to “cure” this problem by doing more
exercise!

In athletes, another problem called
vocal cord dysfunction (VCD) can occur, and seems a lot
like exercise-induced asthma. The vocal cords are located in the throat, at the
opening to our trachea (windpipe), not in our lungs. They help us form words by
opening and closing to let different amounts of air out of the lungs. In VCD,
the vocal cords close when they are supposed to open, making it harder to
breathe in air. Signs of VCD include a high-pitched noise while breathing in,
breathing too fast, and a “tight” feeling in the throat. It can be
very difficult to distinguish VCD from asthma and may require referral to an
asthma specialist or ear, nose, and throat specialist.