Recognition, Prevention & Management of Asthma in Athletics

Tips Offered on How to Help Athletes Recognize, Prevent and Manage Asthma in Athletics

DALLAS , Sept. 22 -- Many athletes have difficulty breathing during or after workouts, sporting events and practices. Although various conditions can predispose an athlete to such problems, the most common cause is uncontrolled or undiagnosed asthma. In the United States, 20.3 million people report having asthma, with 9 million children under 18 being diagnosed with the condition. Studies suggest that as many as 15-25 percent of athletes have signs and symptoms suggestive of asthma. To provide athletic trainers and other health care professionals, parents and coaches with guidelines on how to help athletes recognize, prevent and manage asthma, the National Athletic Trainers’ Association (NATA) has issued its position statement in the fall issue of the Journal of Athletic Training on the “Management of Asthma in Athletes” – ( ). The position statement is the result of 17 months of research, interpretation and writing, conducted by Michael G. Miller, EdD, ATC, CSCS, John M. Weiler, MD, University of Iowa and CompleWare Corporation, Robert J. Baker, MD, PhD, ATC, FACSM, James Collins, ATC, head athletic trainer, San Diego Chargers and Gilbert D’Alonzo, DO, Temple University School of Medicine. “Athletic trainers are in a unique position to recognize breathing difficulties caused by uncontrolled or undiagnosed asthma,” says Miller. “Once the diagnosis is made, the athletic trainer should play a pivotal role in supervising therapies to prevent and control symptoms. The recommendations contained in the position statement describe a structured approach for the diagnosis and management of asthma in an exercising population.” “The National Heart, Lung, and Blood Institute launched the National Asthma Education and Prevention Program in March 1989 to address the increasing prevalence of asthma in the United States and its cost to society,” says Baker. “At the same time, the Global Initiative for Asthma developed guidelines for asthma awareness and management worldwide. These guidelines are extremely comprehensive and have regularly been updated. Nevertheless, they do not describe the role of the athletic trainer or other allied health care professionals, coaches or parents in recognizing and managing asthma in an athletic population.” Among the position statement’s key recommendations, athletic trainers and other health care professionals should:

  • Mandate that all athletes receive preparticipation screening evaluations to identify the possible presence of asthma.
  • Be aware of the major signs and symptoms of asthma, such as coughing, wheezing, tightness in the chest, shortness of breath and breathing difficulty at night, upon awakening in the morning or when exposed to certain allergens or irritants.
  • Devise an asthma action plan for managing and referring athletes who may experience significant or life threatening attacks, or breathing difficulties.
  • Have pulmonary function measuring devices, such as peak expiratory flow meters (PFMs), at all athletic venues, and be familiar with how to use them.
  • Encourage well-controlled asthmatics to engage in exercise to strengthen muscles, improve respiratory health and enhance endurance and overall well being.
  • Refer athletes with atypical symptoms; symptoms that occur despite proper therapy; or other complications that can exacerbate asthma (e.g. sinusitis, nasal polyps, severe rhinitis, gastroesophageal reflux disease [GERD] or vocal cord dysfunction), to a physician with expertise in sports medicine. They include allergists, ears, nose and throat physicians, cardiologists and pulmonologists trained in providing care for athletes.
  • Consider providing alternative practice sites for athletes with asthma. Indoor practice facilities that offer good ventilation and air conditioning should be taken into account for at least part of the practice.
  • Schedule practices during times at which pollen counts are lowest.
  • Encourage players with asthma to have follow-up examinations at regular intervals with their primary care physician or specialist. These evaluations should be scheduled at least every six to 12 months.
  • Identify athletes with past allergic reactions or intolerance to aspirin or non-steroidal anti-inflammatory drugs (NSAIDs), and provide them with alternative medicines, such as acetaminophen.
  • Be aware of Web sites that provide general information on asthma and exercise induced asthma. These sites include: the American Academy of Allergy, Asthma and Immunology –; the American Thoracic Society –; the Asthma and Allergy Foundation of America –; and the American College of Allergy, Asthma & Immunology –

About the NATA: Athletic trainers are unique health care providers who specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. The National Athletic Trainers' Association represents and supports 30,000 members of the athletic training profession through education and research. NATA, 2952 Stemmons Freeway, Ste. 200, Dallas, TX 75247, 214.637.6282; 214.637.2206 (fax).

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