Asthma: No Contest for Olympians

The correlation between elite athletes and asthma is unclear

girl using inhaler

Asthma isn’t exactly the talk of the Olympic Village, but maybe it should be. Studies show that the breathing disorder is more common among Olympians and other elite athletes than the general population.

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A recent article reported that 25 percent of Great Britain’s 2012 Olympic team has asthma, compared to 8 percent of the general population. U.S. gymnast Danell Leyva, who won the 2012 bronze medal in the men’s all-around in London, has asthma, too. And so do other celebrated U.S. Olympians, including figure skater Kristi Yamaguchi, heptathlete Jackie Joyner-Kersee and diver Greg Louganis.

(Stats for the 2012 U.S. Olympic team aren’t available, but reportedly, more than 20 percent of the 1996 team had asthma.)

It may seem surprising, considering a vast majority of asthmatics say exercise triggers their symptoms. So, how do so many Olympians manage it? Wouldn’t it be better to avoid the exertion that brings on breathlessness, tight chest, coughing and wheezing?

No, says Cleveland Clinic pulmonologist Sumita Khatri, MD.

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“Good physical conditioning is important for successfully managing any kind of lung condition,” she says. “Exercise actually can help those with asthma improve their ability to function and better control their symptoms.”

The correlation between elite athletes and asthma is unclear. It’s possible the disease manifests itself more in people who train vigorously more than 20 hours a week, says Dr. Khatri.

One recent study indicates it’s most common among endurance athletes, such as long-distance runners and cyclists.

“Any vigorous physical activity can trigger symptoms in exercise-induced asthma,” says Dr. Khatri. “When the rate and depth of breathing increases — especially when breathing through the mouth instead of the nose — inhaled air naturally becomes cooler and dryer. The change in air humidity and temperature is what causes airways to narrow and bring about asthma symptoms.”

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To control the symptoms of exercise-induced asthma, Dr. Khatri advises her patients to:

  • Warm up before exercise and cool down gradually afterwards to adjust their breathing and acclimate their airways.
  • Cover their mouth and nose with a mask or scarf before exercising in cooler or cold weather. The covering can trap moisture, so it not only warms but also humidifies the air they breathe.
  • Take medication. First line is albuterol or other short-acting beta-2 agonists, five to 10 minutes before activity. It can prevent asthma symptoms for up to four hours and the dose can be repeated at least once during exercise. If this lacks efficiency, then other medications, such as a leukotriene antagonist — taken 30 minutes prior to exercise with a duration benefit of up to 10 hours – can be added.
  • Manage chronic asthma (if they have it in addition to exercise-induced asthma) with their regular anti-inflammatory medications.

Asthma should not limit anyone’s ability to have an active lifestyle, notes Dr. Khatri.

“I tell my patients that we’ll take baby steps to control their symptoms. But when they start feeling better, they should push the boundaries of what they’re able to do,” she says. “I ask patients what their goals are, and then we keep moving the goal posts.”

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