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Keeping Exercise-Induced Asthma at Bay

Typically, we think about asthma being triggered by smoke, pollen and other environmental factors, but exercise can be a major trigger for many children. In fact, about 80 percent of children with asthma experience asthma symptoms when they exercise.

Summer sports, winter sports and fall sports can all trigger asthma attacks in young athletes. It’s particularly important for parents, coaches and teachers to understand and recognize exercise-induced asthma (EIA). Winter sports in particular can compounds the problem and upper respiratory infections can worsen asthma.

In general, sports that require short, intermittent bursts of energy, such as football, wrestling, gymnastics and track are easier on the airways than sports that require endurance, such as hockey, long-distance running and basketball.

How asthma works
When children (or anyone for that matter) breathe normally, air is warmed and moistened by nasal passages, preparing it for absorption through the lungs. When playing sports, however, children tend to inhale short, shallow breaths through their mouths. This type of quick breathing takes in cold, dry air and causes the airway muscles to contract and spasm. When the airway becomes narrow, this brings on asthmatic symptoms of wheezing, coughing, chest tightness and shortness of breath.

There are preventive actions one can take for exercise-induced asthma. With proper medication and conditioning, kids with asthma will be able to participate fully in sports.

Relaxing the airways
Asthma medications can prevent these airway spasms. A short-acting beta-2 agonist (such as albuterol), inhaled 15 to 20 minutes before exercise, can prevent spasms for several hours. A long-acting bronchodilator will work for 12 hours. Long-term inhaled anti-inflammatory medications may also be required to “quiet” the airways.

During exercise
Children may not be in control of their environment during a game, but they can adapt the way they practice by:
• Wearing a scarf and breathing through it to pre-warm the air
• Avoiding exercising outdoors in frigid temperatures
• Doing 10-minute warm-ups and cool-downs to help their airway adjust to the colder temperature

Control through teamwork
Gaining and maintaining optimal control over EIA often requires teamwork. Letting the coach know that your child has asthma is so important—and having an inhaler close at hand is key. All parties should know the proper dosage and how to use it before and during an asthma episode. This will help keep your child’s asthma well-controlled, so that exercise is less likely to trigger symptoms.

Cleveland Clinic pediatric sports medicine physicians are available to help you manage your child’s asthma. For an appointment, call 877.440.TEAM (8326).

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