Children and exercise-induced asthma: Playing sports safely

Children with asthma can benefit from participation in sports. To ensure your child's safety, control the condition, have an asthma action plan and communicate with your child's caregivers.

If your child has exercise-induced asthma, preventing flare-ups is a big concern. As with asthma triggered by other things, exercise-induced asthma occurs when the main air passages of the lungs, the bronchial tubes, become inflamed. The muscles of the bronchial walls tighten, and cells in the lungs produce extra mucus. This can cause signs and symptoms that range from minor wheezing to severe trouble breathing. But your child doesn't have to let asthma limit physical activity. In fact, regular exercise strengthens the lungs, making breathing easier for kids with exercise-induced asthma. Taking a few steps to ease symptoms can help your child avoid asthma flare-ups — and get off the sidelines and into the game.

Control asthma first

Before your child participates in sports, be sure that his or her asthma is under control. Controlled asthma means that regular symptoms and flare-ups are rare. If your child is on medication but continues to have symptoms or regular flare-ups, check with your child's doctor for possible changes to medications or dosages. Work with your doctor to create a detailed asthma action plan.

Treatment to control asthma varies from person to person and is based on symptoms and triggers. Along with avoiding triggers, a typical treatment plan involves a combination of long-acting medications to control the asthma over time and short-acting inhalers for quick relief of symptoms. Many children benefit from using a short-acting bronchodilator such as albuterol about 15 minutes before exercise.

Use an asthma action plan to stay on track

Work with your child's doctor to create an asthma action plan, a step-by-step guide for preventing, recognizing and treating an asthma attack. Every child with asthma should have an asthma action plan. Typical asthma action plans include a list of medications and dosages, symptoms and average peak flow readings, signs of an attack, when to seek emergency care, and contact numbers.

Choose activities wisely

Certain physical activities are more likely to cause asthma attacks, particularly those that require sustained effort with few breaks, such as:

• Basketball
• Cross-country skiing
• Cycling
• Ice hockey
• Long-distance running
• Rugby
• Soccer

If your child is especially sensitive to exercise as a trigger or has exercise-induced asthma, you may want to consider activities that are less likely to trigger asthma, such as:

• Baseball
• Golf
• Sprinting
• Swimming
• Weightlifting

While sprinting and swimming are strenuous activities, they're less likely to cause symptoms than are some other sports. Sprinting is high intensity, but doesn't require endurance. Swimming can be high intensity and high endurance, but the warm, humid environment associated with indoor pools usually protects those with asthma from having attacks. Golf usually requires less intense exercise; however, the outdoor exposure may trigger asthma for kids who also have allergies.

Although some activities are more likely to cause symptoms, your child may be able to participate in any sport he or she chooses with the right medications and asthma control. With good asthma control, most children with asthma can exercise as hard as they want.

Competition: Use a treatment plan to stay on track

A combination of high-endurance sports and competitiveness can be dangerous for children with asthma. Younger children tend to slow down their activity level when they feel discomfort. Older children are more likely to push themselves to perform even when having asthma symptoms. This is usually because they want recognition or find satisfaction in competing on the same level as their peers.

Following a treatment plan is the key to good asthma control. It's especially important if your child is competitive. Using a treatment plan will help you and your child monitor asthma symptoms and make adjustments as needed. Better control of asthma may result in better athletic performance — as well as fewer flare-ups and less danger of a serious asthma attack. Involving your child in the decision-making process makes it more likely that he or she will follow the plan.

Keep preventive tips in mind

In addition to controlling symptoms with medication, be sure your child follows these practical tips to avoid flare-ups:

• Always warm up and cool down. Help your child make it a habit to spend 15 minutes warming up before more intense physical activity, and to do another 15 minutes of cool-down after exercise. While it's a good recommendation for all athletes, warm-ups and cool-downs are especially important for those with asthma.
• Pay attention to environmental conditions. Cold temperatures, poor air quality and high concentrations of pollen in the air make conditions right for an asthma attack. If possible, encourage your child to stay indoors during these times. When the weather is cold, your child may be able to control symptoms by wearing a scarf or mask to warm the air before it enters the lungs.
• Exercise only when healthy. Asthma attacks are more likely during or immediately after a cold or other respiratory infection. Have your child wait a few days after cold symptoms subside before resuming physical activity.
• Use a peak flow meter to monitor airflow. A peak flow meter is a hand-held tool that monitors how well your child's lungs are working from day to day. With the help of your child's doctor, you first determine your child's average peak flow reading. A drop in the reading may indicate an increase in airway inflammation, even when your child feels fine. A low peak flow reading prompts you and your child to take extra precautions that day to prevent an attack.

Involve your child's school nurse, teachers and coaches

Because teachers, coaches and other caregivers may have different levels of education on asthma, it's important that they know exactly what to do if your child needs help. Make copies of your child's asthma action plan and give them to your child's caregivers, and be sure to regularly communicate the importance of knowing the plan and having it accessible in case of an attack. This important tool helps ensure that you, your child and other caregivers all follow the same plan if action needs to be taken. Talk to your child's coaches so that they're aware how serious asthma can be — and can better judge your child's needs and abilities.

With the help of your child's doctor, revise the plan regularly. Your child's symptoms or treatment needs may change based on different seasons, sports and age.

Asthma and sports can be a winning combination

Children with asthma can participate in sports. In fact, your child's condition may improve with regular physical activity. First, have an asthma action plan in place. Second, communicate regularly with your child's teachers and coaches. These and other practical steps allow your child to enjoy sports in an environment that keeps him or her safe.

By Mayo Clinic Staff
May 31, 2008