I have heard it several times before, from the time I was a child and even in present times- Asthma can be cured or its all in your head. Well this is not at all scientifically true. Before you say that to someone, or you listen to someone who believes this, remember there is alot of mis-information present in the athletic community about asthma. Whether you are a Group Fitness Leader, Personal Trainer, or Physio-therapist, remember you are not a respiratory therapist or cardiologist so judging someone's symptoms, or stories at a surface level can be harmful.
Many people assume that only people who do not exercise or eat properly have it, and it can be completely cured through the ladder or through things such as hypnosis or meditation. Although all of these therapeutic methods CAN HELP, Asthma is NOT a one size fits all medical condition, nor is it directly caused by poor diet, lack of exercise, stress, intense emotional triggers, etc.Although how a person takes care of their body and age can affect the symptoms of their asthma a person is generally born with it. Some people do not develop severe asthmatic symptoms until adulthood after they have endured long term exposure to environmental pollutants.
Another important note is that Asthma is NOT COPD. COPD can cause symptoms that are similar to the ones caused by asthma, but COPD develops later in life just like Adult On-set Asthma. A person is not born with COPD, a person with asthma is. This is a very important distinction to understand.
Chronic Obstructive Pulmonary Disease (COPD) is a lung disease that includes chronic bronchitis and emphysema.
In 80-90% of cases, it is caused by smoking. Other causes of COPD can include:
- genetic reasons (alpha-1 antitrypsin deficiency)
- occupational dusts and chemicals
- second hand smoke
- frequent lung infections as a child
- wood smoke and other biomass (animal dung, crop residues) fuel used for cooking.
- In chronic bronchitis, your airways become swollen and can be filled with mucus, which can make it hard for you to breathe.
- In emphysema, the air sacs (alveoli) in your lungs are damaged which can make it hard for you to breathe.
What is true is that you can drastically improve the outcome of athletes with an asthma in terms of their performance by managing their symptoms through medical and natural therapeutic measures as well as proper nutrition. What is NOT true is that you can simply grow out of it. Asthma sufferers symptoms demonstrate themselves on a spectrum. Meaning, someone can have mild to severe asthma that can be controlled, but currently is not. If it is un-controlled the consequences of such during an asthmatic episode can be deadly. I had severe asthma as a kid that doctors had difficulty controlling. I maintain a strict diet, dance, walk, bicycle, use my inhalers, have in-home air purifiers, do not smoke, drink, or do drugs, do not have alot of pets, maintain a clean home, do not use mostly non scented natural cleaning and hygiene products, use herbs and hot showers to open up my lungs, and I avoid anything that irritates my asthma that is within my control. Because I control it I only have mild symptoms and only use my rescue and prevention inhaler when the environment I am deems necessary or I become sick.
No matter how fit I have been or am or how well I take care of my health it will never go away. This is important as #asthmashaming is a real thing that people do without having a medical understanding of what it is, and is not. There are tons of things that contribute to people having cardio vascular issues, and unless you have medical training in asthma prevention and treatment you should not assume an athlete can not perform well due to having this condition.
Unfortantley many coaches or physical literacy educators fail to educate themselves in Asthma and so can put their atheltes at risk when training them. Some educators give up completly and see athletes with asthma as a liability, when really if properly taken care of they can do quite well in sports. This mindset of asthma can be cured does need to be stopped, as the athlete may have successuflly managed their asthma, or may have mild asthma that is not being triggered from environmental stimulants anymore.
WHY IGNORING ASTHMA IN ATHLETES IS NOT ONLY LIFE-THREATENING TO THEM IN THE PRESENT & FUTURE
(referenced from: https://breathe.ersjournals.com/content/8/4/286)
Why screen athletes for EIA/EIB?In athletes, asthma diagnosis is particularly relevant because of potential implications on competition performance and training, as airway narrowing during exercise could compromise ventilatory capacity and efficiency. Moreover, asthma is definitely the most common chronic medical condition among Olympic athletes . It is also well known that it is more frequent than in the general population, as well as more prevalent in elite athletes (particularly those who participate in endurance events, swimming and winter sports) than in recreational athletes [4, 6].
Additionally, asthma has been highlighted as a significant risk factor for unexplained death in young and healthy subjects , and a high proportion of asthma-related deaths have been reported in athletes associated with a sporting event . Moreover, there is a subgroup of athletes who are asymptomatic but present with objective evidence of EIB , which raises the question of its potential under diagnosis and the resulting under performance.
Furthermore, and as occurs for all asthmatic subjects, this untreated condition results in chronic sustained inflammation associated with persistent epithelial damage, which contributes to airway remodelling and fibrotic changes, progressive lung function decline over time and fixed obstruction .
So, bearing in mind that care should be taken to ensure that sport does not affect the health or welfare of the participants, as stated by the International Olympic Committee (IOC) Medical Commission, it is easy to understand the imperative focus that should be posed in the diagnosis of asthma.
HOW YOU CAN IMPROVE YOUR ATHLETICISM AS AN ATHLETE WITH ASTHMA
(referenced from: https://breathe.ersjournals.com/content/8/4/286)
Optimal asthma treatment aims to control both symptoms and inflammation, with minimal or absent adverse effects of the medication, allowing full participation in physical activity and sporting activities.
There is no evidence supporting different treatment for EIA/EIB in athletes and non-athletes. However, when choosing treatment for a specific athletic population compared with the common asthmatic patient, some additional factors should be taken into account. For the top athlete it is important not only to control symptoms of asthma and prevent progression, but it becomes equally imperative to reduce its impact on sporting performance, often practiced under extraordinary circumstances. Therefore, the possibility of a side-effect (e.g. systemic effects of inhaled treatments or sedation of some H1-antihistamines) from a prescribed treatment should also be carefully considered .
Several types of drug combinations are frequently needed to fully control EIA/EIB in athletes, and comprise two categories: controller (anti-inflammatory) and reliever (premedication before exercise and treatment of symptoms) medication (table 3). The same principles for asthma management in the general population are applicable to athletes , including a “step-up” approach if worsening of EIA symptoms occur, as it may be a sign of inadequate control of underlying asthma .
- Develop your lung capacity through controlled cardio vascular training program. Be mindful of how exercises in your training plan are affecting your breathing capabilities in a positive or negative way. If the exercise you are participating in is triggering in your asthma slow it down, or change what you are doing completely. Train at a safe, healthy, customized pace.
- Avoid foods and beverages that trigger asthmatic symptoms
- Take your inhalers pre and post workout/ training
- Be mindful of the area you are training in (indoors or outdoors) and its environmental triggers such as dust, mold, etc. If you have to train in those areas be mindful or how long you are in those rooms. Get as much fresh air as possible. If you are already training outside and feel symptoms coming on take your inhalers. If taking your inhalers does not help you may have to choose a different place to train.
- Learn how to mediate, and control your breathing through lung capacity strengthening exercises such as Yoga.
- Be mindful of your breathing patterns, and heart rate through the use of technology assisted devices such as FitBit. Avoid over working your lungs, even if you are trying to strengthen them. If your lungs are worked up from illness do not engage in strenuous exercise and allow your lungs time to heal.
- Be mindful of how caffeine affects your breathing, and easy does it on the "energy drinks". If you have to rely on caffeine to breath better than you are probably over working your lung capacity and could be causing permanent damage to your lungs.
- Most obviously avoid exposure to irritants such as smoking cigarettes/ vaping/ etc as you are essentially breathing in chemicals that will do permanent damage to your lungs faster.
- Avoid smoke machines, incense, scented candles, air fresheners and any other smoke causing device. Use vapour mist machines in the evening by your bed side to help clear your airways, especially at night.
- Be mindful of the materials you wear on your body, and what cleaners you use to clean them. Your skin is the largest organ on your body, and even triggering allergies can irritate your asthma.
- Clean your bed sheets often, and use hypo allergenic pillows, bed materials etc. A person's bed can make them very ill from the chemicals that remain in the material during manufacturing. Beds if not shampooed regularly can hold on to dust mites.
- Learn about nutrition, and how it can make your asthma better or worse. Adjust your diet to improve your breathing capacity.
- Avoid exposure to carpets, and areas that are not cleaned regularly from dust and mold. Often dirty carpets and walls in a building can have an affect on your health.
- If you have pets bathe them regularly and keep good household and personal hygiene as their fur can be very dirty and trigger asthmatic symptoms.
- Limit your use of personal hygiene products that are known to be filled with chemicals and carcinogens such as nail polish, shampoos, deodorants, body wash, hair spray etc.If you do use these types of products try to use a natural brand that does not spray chemicals into the air for you to breathe in.
- Stretch your upper body regularly and lift weights as this promotes good posture and an open diafram which will ultimately help you breathe better.
- Before you go to sleep drink warm tea, have a hot shower or bath to help open up the airways with steam. You can also do this through out the day, especially when exposed to cold temperatures for a long duration of time.
- Avoid spending long periods of time outside during very dry, or very humid temperatures as this can make breaking more difficult. if you are not experiencing any symptoms right away, it does not mean your body is not reacting to it and they could develop later in the day.
BOTTOM LINE: PREVENT EXPOSURE TO HAZARDS YOU ARE AWARE OF, AND IF EXPOSED TAKE PRECAUTIONS IMMEDIATELY AND STOP DOING WHATEVER IS MAKING YOUR SYMPTOMS WORSE.
HOW YOU CAN SUPPORT AN ATHLETE WITH ASTHMA
Preventive strategies of Prophylaxis of EIA includes not only premeditation but also some interventions beyond pharmacotherapy which should be considered. These include allergen/irritant avoidance (when possible) and immunotherapy in patients with specific allergies. A mask that facilitates warming of inhaled air for exercise in cold air, and also warm-up and cool-down exercises  may be helpful to prevent or minimise EIB. A warm-up of 10–15 min, including calisthenics with stretching exercises with an objective of reaching 50–60% of maximum heart rate, should be encouraged .
Comorbidities such as infections, gastro-oesophageal reflux and sinusitis should be promptly addressed. Exposure to pollutants and tobacco smoke must be avoided. In light of the pathophysiology, hydration should be encouraged.
Breathing through the nose may allow cool dry air to be humidified and warmed, which reinforces the importance of rhinitis treatment and control.
Although no limitations in sport selection should arise for patients with EIA/EIB, symptoms may be decreased by selecting a sport based on its low asthmogenic potential .
WORKOUTS FOR ATHLETES WITH ASTHMA
According to the AAAAI, sports that are less likely to trigger exercise-induced asthma symptoms include:
- Leisure biking
- Free downhill skiing
- Short-distance track and field events
HOW NOT TO BE DISCRIMINATORY TOWARDS ATHLETES WITH ASTHMA
- Remove the word cure from your vocabulary, and as an expectation from your athletes.
- Do not assume the athletes potential based on their asthma
- Do not shame them for being asthmatic, having asthma is not a decision. An athlete has not done anything to give themselves asthma
- Above all else avoid accusatory statements of neglect. Despite an athletes best attempt to control their asthma it will never be controlled 100% of the time from the same methods. Athletes with asthma must work with their doctor and/or naturopaths on a regular basis to ensure they make adjustments to their prevention care plan when needed.
- Do not over push them in their training. Know when to stop, and listen to your athletes when they tell you they need to. If ever unsure consult with the medical team they are. Talk to them, and keep a log of symptoms and how different training methods are affecting them. The log should include the categories describing their daily nutrition, sleep patterns, supplements, medications taken etc. This is so you can monitor them and ensure you are doing the best to prevent them from incurring long term lung damage from over training.
- Ensure your locker room, and training areas are free from asthmatic triggers. This includes asking parents and fellow athletes to maintain a scent, smoke, drug free area. This can be difficult because people may not want to cooperate, but ultimately an athletes potential should not be thrown away because they are not willing to be accommodating. Asthma is a legitimate, medical condition that deserves the same level of respect and care as any other disability that affects an athlete in sport.
- Ensure your training environment is set up to be shame free. Athletes and other parents are not allowed to bully or harass an athlete who has challenges in training or performing due to their asthma. Many times athletes may have to stop during a game or training due to breathing difficulties, this has NOTHING to do with weak will.
WHEN YOU NEED TO HAVE AN ATHLETE WITH ASTHMA MEDICALLY ACCESSED
The clinical presentation of EIA includes wheezing, cough, shortness of breath and/or chest tightness, generally occurring within 5 to 30 min after intense exercise (and sometimes during) [1, 11]. Gradual spontaneous improvement is common after finishing exercise. Physical examination can often reveal expiratory dyspnoea, expiratory wheezing or rhonchi and other signs of bronchial obstruction, such as respiratory retractions [6, 13].
A variety of symptoms and signs associated with allergic rhinitis can be part of the clinical presentation as allergic rhinitis affects a high percentage of elite competitive athletes. A significant increased prevalence of hayfever has been observed when compared with the general population, and is highest among endurance athletes. Therefore, sneezing, anterior rhinorrhoea and bilateral nasal obstruction, as well as ocular symptoms such as teary, burning and itching eyes, should be addressed . Other symptoms include significant loss of smell (hyposmia or anosmia), snoring, post-nasal drip or chronic cough, and itching ears, nose and throat. Besides, physicians should be aware of the fact that in athletes the clinical presentation of rhinitis is frequently more subtle and might include poor-quality sleep, fatigue, reduced exercise performance and difficulty to recover after more demanding exercise sessions .
But it should be noted that in athletes symptoms have been shown to be poor predictors of asthma . Asthma-like symptoms in elite athletes are not necessarily associated with classic features of asthma. Athletes may not suffer from the obvious symptoms like regular asthmatic patients do, but rather suffer from cough  or some nonspecific complaints, such as poor performance or “feeling out of shape”, abdominal pain, headaches, muscle cramps, fatigue and dizziness .
In the specific case of competitive athletes, this poses several issues unique to this population for diagnosing EIA/EIB. Heavy training with the extremely high level of physical fitness and maximum oxygen uptake reached makes it difficult to discriminate between physiological and pathological limitations to maximum exercise . Moreover, some athletes will not reveal their symptoms due to fear that their asthma disclosure will be detrimental, whereas, on the other side, athletes without asthma may try to secure asthma treatments in an attempt to gain a competitive advantage , although several studies have proved that anti-asthmatic drugs do not enhance performance in healthy subjects  this is still a general misbelief. Therefore, objective evidence of asthma should always be part of the assessment in these subjects.
However, the answer to this question is not that simple. Baseline spirometry is poorly predictive of asthma in competitive athletes. Often they record lung function values higher than the general population; they may appear to be within the “normal” range, although, in reality, show a pulmonary deficit on the basis of what is expected for an athlete [4, 18].
*****Disclaimer: I am not a General Medical Practitioner, Respiratory Therapist, or Cardiologist, nor do I assert that this Article contains any medical recommendations. This is a personal article created for the purpose of general education to the general public. If you believe you or someone you know has Asthma, and is now or in the future considering participating in athletic endeavours, I recommend you see your General Medical Practitioner, or a specialist before beginning to do so.
It may seem like elite athletes don't ever have asthma. After all, athletes need a robust supply of oxygen during their competitions.
Accomplished Athletes Who Have Asthma
- David Beckham. ...
- Jackie Joyner-Kersee. ...
- Greg Louganis. ...
- Paula Radcliffe. ...
- Jerome Bettis. ...
- Peter Vanderkaay. ...
- Amy Van Dyken. ...
- Tom Dolan.
In conclusion, a person with Asthma can be successful in Athletes, but they do need to be properly taken care of before, during, and after engaging in exercise, and asthma is not something that can be cured, but CONTROLLED. Athletes with asthma have just as must potential in sport as athletes who do not have this medical condition, however their post recovery, and pre-exercise care needs to be monitored more than a non asthmatic athlete. Failure to recognize this condition as an un-curable, but controllable condition can lead to death, and permanent damage to an athletes health. It is a coach or trainers responsibility to help an athlete with asthma to control their symptoms, and provide adequate non negligent care. In addition, all athletes with asthma should be given the same opportunities to participate in sport as athletes without asthma.