Topic of Interest

In Motion

A Publication of the American Orthopaedic Society for Sports Medicine
sPorT plus physical therapy, LLC

Article 2: Exercise and Asthma Can Go Together
By Daniel Solomon, MD

Asthma is among the most common medical conditions affecting athletes. More than 20 million people in the U.S. have been diagnosed with asthma, though not all need ongoing medication. Exercise-induced asthma (EIA) affects 12-15% of U.S. population. Athletes, coaches, athletic trainers, and parents should be familiar with common symptoms and triggers, and have an asthma treatment plan.

The most common cause of breathing difficulty during or after workouts is undiagnosed or untreated asthma. Common symptoms include:

EIA prevalence increases in cold, dry weather, or if air-borne particles, including allergens, pollen, and air pollution are present. Other health issues, such as hay fever or allergies, upper respiratory infections or gastroesophageal reflux (GERD), or poor physical conditioning can predispose people to EIA. Because of the prevalence with cold, dry air, winter sport athletes have increased susceptibility. Chlorine may also play a role; swimmers, especially in indoor pools, may be at higher risk. Certain medications, including aspirin, Beta-blockers, non-steroidal anti-inflammatories (NSAIDs), and diuretics can also trigger EIA.

Treatment in an acute event includes removing athlete from competition or practice, administration of a rapid-onset metered-dose inhaler (albuterol is the most common). Spacer devices may help deliver an appropriate medication dose in more anxious patients. If the initial treatment fails or is unavailable, transfer to an emergency medical facility may be necessary.

Long-term treatment includes avoidance of trigger situations and prevention. Warm, moist air is most helpful. Proper warm-up and breathing techniques may also minimize symptoms. Relapses can occur, so an athlete who experiences an acute EIA attack should be monitored and kept out of play until respiratory effort and breathing is normal. If symptoms do not resolve completely, the athlete should not return to play.