COACH'S CORNER: ASTHMA
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Author: Daren Molina, MD

Asthma is a common problem seen in athletes that involves wheezing, coughing, and difficulty breathing. As Spring rolls around, asthma and seasonal allergies may be more commonly seen in your athletes. It is common for athlete’s with asthma to have exercise induced asthma (EIA) as well. Athletes with asthma can be at risk of having trouble breathing whether playing indoors or outdoors. Several steps can be taken to help your athletes participate safely.

  1. PREPARE. Asthma may present for the first time during sports participation. The first line treatment for asthma involves inhaled albuterol. Albuterol inhalers should be available and labeled for each athlete with known asthma. Athletes with asthma should be identified during their pre-participation physical exams. They should be under the care of a doctor for their asthma. Paperwork for a therapeutic use exemption may be needed depending on the requirements of the sport’s governing body.
     
  2. IDENTIFY SYMPTOMS. A few of the most commonly seen symptoms in asthma are shortness of breath, trouble breathing, wheezing, coughing and chest pain. Athletes with EIA can begin to experience these during or after a workout. Many times athletes’ asthma may become worse with colds and other upper respiratory infections so be aware they may need more breaks or additional monitoring under those conditions.
     
  3. PREVENTION. It is best to prevent EIA before it starts. Athletes with known EIA should use their medication prior to all workouts, including practices and games. This is usually two puffs of their albuterol inhaler given about 15 - 30 minutes prior to athletic activity. This medication is usually effective for 2-4 hours. Depending on the severity of their asthma, an athlete may be required to take other daily preventative medications, as prescribed by their doctor. Athletes with asthma commonly have concomitant seasonal allergies and eczema. Treating their allergies may help their asthma as well.
     
  4. ON FIELD TREATMENT. Some athletes whose practices or competitions last over two hours may begin to show signs of their medication wearing off. If an athlete with known asthma begins to have trouble breathing, coughing, wheezing, or even chest pain, he or she should take two more puffs of their albuterol inhaler.
     
  5. CALL FOR HELP. If an athlete with asthma is not improving after two rounds of two puffs each of inhaled albuterol, then emergency medical attention should be sought.

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