DID YOU KNOW

70-80% of those people with asthma and 30-40% of individuals with allergies have Exercise-Induced Asthma.

"All violent exercise makes the asthmatic to breathe short"

-Sir John Floyer, 17^th Century

DID YOU KNOW

Children with asthma have similar exercise capacity as other children.

(Boas & Danduran 1998, 1999)

DID YOU KNOW

Many of today’s world class athletes suffer from exercise-induced asthma including Olympic gold medallist swimmers Amy Van Dyken and Tom Dolan, track and field star Jackie Joyner Kersee, and diver Greg Louganis.

DID YOU KNOW

Failure to treat exercise-induced asthma may result in lower self-esteem as well as a loss of competitive edge, particularly in high-performance athletes at a sensitive time in their careers.

DID YOU KNOW

A recent study suggests that exercise may alter the body’s defense systems in children. In fact, moderate physical activity has been proposed to enhance the body’s ability to fight infection. (Boas, 1995)

EXERCISE-INDUCED ASTHMA

• Become short of breath with physical activity?
• Usually cough during or after running?
• Experience chest pain with exercise?
• Have trouble keeping up with his/her friends during sports?
• Have a history of asthma in his/her family?

If you answered YES to any of these questions, your child may have exercise-induced asthma. Exercise-induced asthma or EIA is a common ailment that affects many of the over 17 million individuals who have asthma as well as those with no clinical evidence of asthma. Both adults and children can be affected resulting in various degrees of reduced exercise tolerance. The good news is that exercise-induced asthma is treatable.

WHAT IS EXERCISE-INDUCED ASTHMA?

Asthma is a lung disease that causes the airways of the lung to become narrowed and inflamed. This narrowing is called bronchoconstriction. The inflamed airway also produces an overabundance of mucus narrowing the airways even further. The result of these events is the feeling of chest tightness and difficulty in moving air into and out of the lungs.

Many "triggers" are responsible for bronchoconstriction in the lungs. Exercise is one of the more common triggers. Bronchoconstriction during exercise is called Exercise-Induced Asthma. In most cases of EIA, bronchoconstriction occurs 4-8 minutes into the exercise and peaks about 10 minutes after stopping. Often this condition results in decreased performance. The airways usually return to a normal state within 30-60 minutes after the activity has ceased.

Asthmatic Lung Constricted, Increased Mucus	Normal Lung

WHAT HAPPENS DURING EXERCISE-INDUCED ASTHMA?

It is believed that people with asthma have airways that are highly sensitive to various conditions and environments. The airways of some people may be more sensitive to dust in the air while others have trouble breathing when the temperature outside is very cold. Those who have difficulty breathing when they exercise may have EIA. EIA is thought to be caused by very rapid cooling and drying of airways.

As you exercise, you breathe faster moving large amounts of cool, dry air into your lungs. This cool, dry air must be warmed. As we breathe faster and faster, the process of warming the air becomes increasingly difficult. This rapid change in temperature is thought to be one of the causes of airway narrowing.

Certain conditions, such as the environment and level of exertion, may put a child at risk of having an attack. These conditions are likely to increase the magnitude of stress on the airways of someone with EIA.

A 15 year old distance runner has the following symptoms:

• Recent declines in performances times
• Chest tightness during competitions
• Coughing and wheezing at end of the event
• More success at indoor meets

Chest tightness, shortness of breath, a cough or wheeze, and decreased performances are all very common symptoms of exercise-induced asthma in the competitive athlete. The patient’s recent frustration may very well be due to EIA. Importantly, if EIA is correctly diagnosed and treated, most athletes should be able to resume a high level of activity with minimal effect on their performance.

DIAGNOSIS

When the classic symptoms of EIA are present, your family physician may readily diagnose and treat asthma symptoms. If treatment is unsuccessful, consultation with an Asthma Specialist, such as a Pulmonologist, may be necessary.

Classic Symptoms

• Chest Tightness
• Shortness of Breath
• Wheezing
• Feeling Out of Shape
• Other Lung Problems
• Coughing

Click here to see a diagram showing how EIA is diagnosed.

If test results do not support EIA, a physician may need to consider these diagnoses:

• Gastro-Esophageal Reflux
• Vocal Cord Paresis or Dysfunction
• Deconditioning
• Anxiety
• Cardiac Dysfunction
• Sinusitis

TREATMENTS

The most common way to treat EIA is through medications prescribed by your physician. These medications work in a variety of ways and their therapeutic benefit is usually based on your child’s symptoms. However effective the prescribed medications prove to be, alternate treatments exist to further assist an athlete in dealing with EIA.

MEDICATIONS

The following table of commonly used medications is to serve only as an information tool and is not all inclusive. The medical protocol which works best for your child’s symptoms may include one or more of the medications listed below. By working in conjunction with your physician and/or asthma care specialist, treatment strategies for management of your EIA can be designed. For further information regarding each of the drugs listed below, consult your physician.

Q Will my child outgrow EIA?

A While your child may not completely outgrow EIA, his/her symptoms may improve or worsen based on the season, the environmental conditions, or even the current level of activity.

The thing to remember is that through awareness, exercise strategies, and proven treatments, your child can achieve the highest levels of competition, no matter what the sport.

Q Will having EIA affect my child’s relationship with his/her coaches or teachers?

A Coaches and/or teachers should be informed of your child’s condition. Educate them about treatment strategies and routines that will enable your child to perform at his/her peak level.

Through a team effort with your physician, family and coach, one can achieve success at every level.

Q My child is a swimmer who suffers from EIA like symptoms, should he/she consider a different sport?

A Swimming, with its warm and moist environmental conditions, is actually one of the best activities individuals with asthma can participate in. If the symptoms persist, your physician should be able to help your child deal with the breathing difficulties while they continue to develop within the sport.

Q Does being in better shape help reduce the risk of having an asthma attack?

A It appears that those individuals who keep themselves in better physical condition are less likely to have an attack, especially at intensities below a level of peak exertion. This may be due to the body’s adaptive response to chronic exercise. This adaptation allows the body to handle increasing intensities without increasing the breathing rate. However, during the maximal exertion there seems to be little protective effect of fitness level.

Q My child would like to play sports in college and has concerns about his eligibility and the use of his asthma drugs. What are the rules regarding such issues?

A The NCAA (National Collegiate Athletic Association) and USOC (United States Olympic Committee) both have a list of banned substances which may affect your child. This list is updated annually. Consult your physician or asthma specialist for up to date information.

EIA: TAKING CONTROL

Taking control of the symptoms of exercise-induced asthma is as simple as following the prescribed treatment plan. Don’t "tough it out." Never hesitate to ask your doctor or asthma care specialist about any concerns you or your child have and remember to comply with the treatment measures and medications. This will ensure that your child will be able to enjoy activities like exercising, playing sports, running, dancing, or whatever it is your child likes to do.

One final note

In the 1984 Olympics, 67 athletes with asthma won 41 medals in sports ranging from basketball to track and field to wrestling. In the 1988 games, 53 athletes with asthma won 16 medals. Clearly, exercise-induced asthma should not be viewed as a roadblock to achieving your goals and following your dreams.

©2005 Children's Asthma Respiratory & Exercise Specialists, Glenview, IL 60025; (847) 998-3434

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