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Asthma and Athletics
Children with asthma no longer
have to watch from the sidelines!
Robert P. Lindeman, MD, PhD
Natick Pediatrics, PC

With today’s effective and safe asthma medications, and with appropriate diagnosis and management, parents of asthmatic children can sit on the sidelines and cheer their children out on the field. That hasn't always been the case.

I remember watching a high school varsity soccer game, and one player in particular. A senior, he was small but very quick and strong, and was the leading goal-scorer. On the field he always carried a small white plastic object in his right hand. Every once in a while he’d stop running, lift the thing to his lips and inhale a puff of white mist. Then he’d be off and running.

That was 25 years ago, and the boy in question played for my high school. The object he carried on the field was an asthma inhaler. This scene could never happen today. In most schools, students are not even permitted to carry asthma medicines with them during class, let alone bring them onto the playing field.

Changing times
Another reason this scene would never happen today is that 25 years ago we did not have the kind of asthma controller medications that would allow the boy to play without needing to use an inhaler. Today, asthma medications are so effective and safe that the overwhelming majority of children with asthma can participate in sports, even at the highest levels, without having to miss a practice or a game.

Many people have heard of at least one famous athlete with asthma. The most well-known are probably track star Jackie Joyner-Kersee and Jerome "The Bus" Bettis of the Pittsburgh Steelers. But there are literally thousands of athletes with asthma who are playing at all levels of sport.

Here are the stories of three "lesser known" athletes. They are children with asthma I’ve seen in my practice. None of the names I’ve used are real.

Ellie
Ellie was 9 years old when I met her. She loved to play soccer, and was pretty good at it, except her lungs kept her from doing what her legs wanted to do. She could usually play the first half of the game, but she had to play goalie in the second half. Her asthma bothered her at other times as well. She coughed or wheezed almost every day, and she couldn’t sleep as well as she should have, because of difficulty breathing. Breathing tests revealed that her lung function wasn’t very good either.

I prescribed two "controller" medicines for Ellie, to prevent her asthma symptoms. I recommended that she take her rescue inhaler before soccer practice or games as well. One month later, her lung function on breathing tests was normal for a girl her age and size. And her soccer playing improved as well. In the next season Ellie tried out for, and made a touring team that visited Australia. She would have only one asthma attack during the next two years.

CJ
CJ is a hockey player, born into a hockey family. He and his brothers learned to skate shortly after learning to walk. But CJ couldn’t keep up with his brothers or his hockey teammates. When I met him, at age 12, CJ couldn’t skate as many shifts as the other players, and usually tired well before his shift was over. He missed several days of school every year, and many hockey games as well. When I first performed breathing tests on CJ, I was surprised to find that he had a small amount of permanent blockage in some of his breathing tubes. This is unusual in children but it happens, especially when asthma goes unrecognized and/or untreated early in life. I was impressed that CJ could breathe well enough to skate at all, let alone play hockey!

I treated CJ with asthma controller medications as I did for Ellie. His breathing tests did not improve, indicating that the damage to his lungs was indeed permanent. To CJ’s surprise, however, his hockey playing improved. After several months, the true hockey player inside CJ began to emerge. He is now able to skate as long and as hard as his teammates. He plays hockey year-round now, several days a week, and has not missed a game because of his asthma.

Reid
Reid worried me. At 7 years old, he had the lung function of an old man. He missed large portions of the school year and made several trips to the emergency room with bad asthma attacks. Several other specialists and I performed extensive tests and procedures trying to figure out why Reid was so sick. Finally we concluded that Reid simply has one of the worst cases of asthma we’d ever seen in a boy his age.

But Reid wanted to play football. He lives in a community where folks are crazy about football, and Reid wanted more than anything to fit in. Of course football was out of the question in the shape he was in. And, because he could not breathe well enough to exercise, Reid became overweight.

I started him on a fairly intense regimen of controller medicines to try to "put out the fire" in his lungs. His asthma symptoms began to improve, but his lung function stayed poor. I expected that Reid’s lungs were irreversibly damaged by his asthma. Then a surprising thing began to happen: his lung function slowly and steadily began to improve, going from about 50% normal to almost 70% normal. For Reid, this improvement has had a very substantial positive side: he can now play football. Last year, when he was 10, Reid’s team made it to the conference championship (where they lost, though Reid played well). He has been sick only once in the past three years.

Higher expectations
Twenty-five years ago, children with asthma could not expect to participate in organized sports. Some could only play if they continually dosed themselves with rescue medication. For most, participating in sports meant watching from the stands, or at best, the bench.

Today, with the availability of effective and safe asthma controller medications, children with asthma can play sports at the same level as their non-asthmatic classmates. Many of them take controller medication every day, even in the off-season, to keep their lung function in top condition. Often these children will take a puff or two of rescue medication before practice or a game, to prevent an attack. For the overwhelming majority, however, this is the only time they take their rescue inhalers.

My patients with asthma who play sports visit me regularly so I can perform breathing tests, monitor their symptoms, and adjust their medications. The object is to keep them on the minimum amount of controller medication to prevent asthma symptoms, while allowing them to play their sport at the highest level possible.

For more information about Natick Pediatrics, or to talk to the doctor, please call the office at (508) 655-9699.

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Medical Office Building
MetroWest Medical Center
Leonard Morse Campus
67 Union Street, Suite 305
South Natick, MA 01760

(508) 655-9699
(508) 655-2984 fax

Posted: September 5, 2003