While some studies show that 10 to 20% of kids who participate in youth sports are diagnosed with a form of asthma, that doesn’t have to prevent them from participating. Many parents and coaches believe asthma will sideline a child, but with proper management, children with asthma can play the sports they love.

“The best thing an athlete can do is get out there and participate,” says Dennis Coonan, Manager of the Sports Medicine Center and athletic trainer. “Their body will get stronger, their cardiovascular system will get better and the long-term management of asthma will get easier.”

As an athlete with asthma and someone who works with young competitors, Coonan explains how to handle asthma while continuing to perform.

What is asthma?

Asthma is an inflammation of the bronchial tubes (airways), the part of the lungs that lets in and air out to breathe. Muscles around the airway constrict, and produce mucus that further clog the tubes, making breathing very difficult. While some children can have chronic (long lasting) or congenital (from birth) asthma, there’s another type of asthma that’s exercise induced. For young athletes, asthma can occur in any of these ways and be worsened by their sport, playing conditions or lack of management.

Signs and symptoms of asthma during sports

Those narrowed tubes lead to symptoms like wheezing, coughing, chest tightness and shortness of breath.

“I usually teach people that an asthma attack feels like if you were to take your hand and just create a tiny little hole in your fist and breathe through that heavily. That's the amount of air that's getting in,” Coonan says.

While asthma can happen anytime, especially at night when lung function slows, exercise and exertion are common triggers for young athletes. Those triggers, or things that can set off an asthma attack in some kids, can be different for everyone. Common triggers among young athletes with asthma can include:

• Environmental: air quality, cold or dry air, altitude or allergens such as pollen
• Physiological: sickness, hormonal changes or new medications
• Emotional: strong emotions that cause crying, yelling, anxiety or altered breathing
• Exercise: sustained deep breathing or long duration of activity

“Longer activity and more intense activity can have a higher risk of triggering an asthma attack, but the conditions are also important.” Coonan says. “Asthmatic athletes that participate in sports that tend to be in cold, dry air, for example a soccer player that's playing outside in January, could see more triggers.”

Asthma management and care plans for young athletes

Maybe your athlete was born with asthma, or maybe it's specific to exercise. Either way, a care plan is important to make sure your child can perform safely and effectively.

Coonan notes the first thing to do is identify triggers. Is there an allergy at play like pollen? Is it long distance running? Does playing in the cold air versus the warm gym make a difference in symptoms? That information not only helps athletes understand how their sport affects their asthma but also supplies ways to cope and manage symptoms alongside a care team.

If you notice your child is having symptoms and doesn’t yet have a diagnosis, it’s important to see a pediatric physician or pulmonologist (breathing specialist) to get evaluated and form a treatment plan. They can help with prescribing medications like inhalers, a device that delivers medicine as a spray or powder directly into the lungs through breathing, or other daily medications. Mostly commonly, athletes use rescue inhalers as needed on the field or longer lasting inhalers that contain corticosteroids (anti-inflammatory medications) for daily control.

Alongside medications, it’s important for athletes to be mindful of other parts of their routine that might affect asthma:

• All athletes need a full night rest to perform their best, but for athletes with asthma, lack of sleep can increase symptoms, reduce lung function and weaken immunity that could lead to more attacks. Make sure proper sleep is a part of the routine to perform the best.
• Drinking water is crucial to play, but with asthma, water breaks down mucus, supports lung function and reduces inflammation that can prevent asthma attacks. Proper hydration is not only important to keep fueled but can help keep symptoms away, or lessen the severity.
• Warmups and cooldowns aren’t just for muscles and ligaments. Proper preparation and recovery before and after play helps prevent attacks by transitioning the respiratory system.
• Although medication can be helpful, Coonan advises to work on other coping skills to help before or during an asthma attack. Breathing techniques such as belly breathing (inhaling to expand the belly, instead of the chest) and breathing through the nose instead of the mouth to warm the air can help ease symptoms.

While controlled asthma shouldn’t affect long term participation, an action plan is important to manage and prevent asthma attacks. This plan should be shared with coaches, teammates (age dependent) and staff to have safe participation:

• Personalized instructions outlining symptoms, unique triggers and what to look out for
• Daily management information such as medications
• Exercise precautions like air quality
• Exercise modifications like a longer warm up or cool down
• Flare-up procedures
• When to stop activity and seek immediate care

Overall, athletes with asthma may face obstacles other athletes don't, but with proper treatment and management, asthma shouldn’t sideline their goals.

“Don't let it deter you,” Coonan says. “There will be challenges. Young athletes might have to rest more often, stop and catch your breath or use your rescue inhaler. But in the long run, it is more beneficial to be out playing sports.”