Asthma

Asthma is a chronic condition in which the smooth muscles around the air passages in the lungs become inflamed, constrict and excrete thick mucus making breathing difficult. Allergens in the air, exposure to cold environments, upper respiratory tract infections, emotional triggers (uncontrolled laughing or crying) and adverse response to exercise can precipitate an asthma attack. Each asthma attack varies in duration and intensity and can negatively affect athletic performances.  Many people are able to control their asthma using appropriately prescribed medications.

Types of Asthma:

 There are four classifications of asthma: mild intermittent asthma, mild persistent asthma, moderate persistent asthma, and severe persistent asthma.  These classifications vary based on frequency of symptoms and daily changes in pulmonary function and is more useful for clinicians than patients. Patients with all of these classifications of asthma can experience mild to severe episodes and should be appropriately monitored. 


Exercise induced bronchospasm occurs when people have trouble breathing after intense exercise due to an increase in airway resistance. Both diagnosed asthmatics and those with no history of asthma can suffer from this.


Signs and Symptoms:

  Tightness in the chest.
Inability to breathe (particularly exhale).
Inability or trouble speaking
Dry cough• Wheezing noises when breathing.
Pulse rate may increase dramatically
.• Anxiousness.
 Exhaustion
Some can feel nauseous.
Some athletes can have swelling of the face, palms and/or feet.
Athlete almost always reports a history of asthma.

On-Site Management:
 
Reassure the Athlete Place athlete in a comfortable upright position, attempt to relax and reassure them that they will be alright. Encourage the athlete to perform controlled breathing exercises (deep breaths).
 
Provide Asthma Medication If the athlete's doctor has cleared them for medication, assist them in administering their asthma medication (usually only one or two puffs of a bronchodilator or similar medication). Never permit athletes to share their medication.
 
Monitor Athlete Monitor their breathing, pulse rate, and skin colour.
 
Medical Referral Send for emergency medical assistance if the athlete does not improve following administration of their medication.  Refer the athlete to their physician for a complete diagnosis and diagnostic testing and treatment plan.  Treatment plans vary per individual and can include both pharmacological and non-pharmalogical treatment. Non-pharmalogical treatments include breathing into masks, nose breathing, exercise training, warm ups including short sprints and sub maximal workloads.  

Prevention
 
Be aware of your athletes who have asthma, and ensure that they bring their medication (usually inhalers) to all practices and games.  Pay special attention to these athletes in the cool down segment of exercise or immediately following exercise as this is when asthma is generally reportedA proper warm-up of about 15-minutes of light exercise (60% VO2 max) followed by 2 puffs on their inhaler, should protect them against attacks in subsequent intense exercise, but always have your athletes follow their doctors orders.
 
Brukner, P. and Khan, K. Brukner and Khan's Clinical Sports Medicine Brukner, P. and Khan, K. (2007) Brukner and Khan's Clinical Sports Medicine. 4th ed. North Ryde: McGraw-Hill.