Winding occurs due to a temporary paralysis (spasm) of the diaphragm muscle. It is often caused by a direct blow to the abdomen and/or chest, a fall on the back, or a fall on the buttocks. Although it can be briefly traumatic, often leading the athlete to panic or hysteria, the condition is of no real significance.

Signs and Symptoms

  • Inability to breathe in.
  • Pain just below the breastbone (sternum).

On-Site Management

ABC's. If the athlete fails to initiate breathing on her/his own, start artificial respiration.

Relax the Athlete. Assist the athlete to a position of greatest comfort. Have the athlete breathe in slowly through the nose and out through the mouth or encourage diaphragmatic breathing (the stomach is pushed out to cause the diaphragm to descend while inhaling and the stomach is pulled in while exhaling). Continue this process until you can start a thorough examination.

Note: When an asthmatic athlete gets the wind knocked out of them, they may need additional sideline care, such as a their inhaled medication.

Return to Activity
The athlete can return to activity if their breathing and pulse return to normal and the athlete has no deformity or no more pain in the area.


  • Be sure athletes wear the recommended protective padding for their sport. This is especially important in football and hockey.
  • Adequate warm-up, including stretching before activity.
  • Pre-season strengthening and stretching.
  • Appropriate footwear

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