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Getting Back in the Game: The Link Between Asthma and Exercise

If your child often ends up on the sidelines because of breathing problems, he or she may be one of the more than 6 million children with asthma. Exercise is a common trigger for chronic asthma, and there is another condition called exercise-induced asthma, where people feel good during an exercise but experience typical asthma symptoms after they stop. Unfortunately failure to diagnose either of these types of asthma can cause children, and adults, to skip out on exercising. And in rare cases, untreated asthma can lead to death.

Dr. Jack M. Becker, chief of the section of allergy at St. Christopher's Hospital for Children in Philadelphia, and his colleagues studied asthma death during sports in a study published in the February 2004 issue of the Journal of Allergy and Clinical Immunology. Below, he talks about the importance of recognizing and treating asthma so that these individuals can get out and exercise safely.

What is the difference between exercise-induced asthma and asthma triggered by exercise?
There's a huge difference between exercise-induced asthma and asthma that is triggered by exercise. Exercise-induced asthma is when within 10 minutes after completing your activity, you have a decrease in lung function and experience trouble breathing.

What the vast majority of the population has is not exercise-induced asthma, but asthma that is poorly controlled and therefore is triggered by an activity. Exercise is a trigger for 90 percent of people with this form of asthma, and they will probably not get through the activity without having symptoms or signs of respiratory problems. So, the child who has to come off the soccer field after playing 10 minutes because he or she is wheezing doesn't have exercise-induced asthma. That's asthma that was triggered by activity.

What causes exercise-induced asthma?
What experts theorize that, when you're exercising, you're basically cooling and drying the airways, which leads to restricted air flow. Some 45 percent of athletes in the 1996 Summer Olympics said they had asthma. Now that number is way too high for it to be caused by chronic asthma. That would infer that asthmatics are better athletes than non-asthmatics. So if you're talking about exercise-induced asthma, you're probably talking about a very competitive athlete who can train at extremely high levels.

Why is it important to distinguish between the two?
That's actually a huge issue because many physicians as well as family members don't appreciate the difference. So they're saying, "Oh, my kid just has exercise-induced asthma. And therefore all I need to do is use a rescue medication before he or she plays and they'll be fine." Where the truth is, what they may have is mild or moderate asthma that's being triggered every time they play, and they need long-term, preventative treatment.

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