We encourage a child to participate in any sport that he or she is interested in. Regular exercise is important for health, and sports should play a role in any child’s life, regardless of whether they are diagnosed with asthma or not. When a patient wants to play a team sport or participate in a particular athletic activity, physicians should help them realize their goal.
Some types of exercise are especially advisable in the setting of asthma, whereas others have a greater potential to trigger exercise-induced bronchospasm (EIB) (see Questions 66 and 67). In the latter category, distance running or crosscountry skiing, for example, can cause symptoms of cough, breathlessness, or wheezing. Distance running, cycling, and cross-country skiing involve very good aerobic conditioning, but the activity is steady, without breaks or interruption, and takes place in the outdoor environment with exposure to temperature variation, aeroallergens, and sometimes atmospheric pollutants. Athletic activities that incorporate breaks in the intensity of exertion, including competitive sports such as tennis, baseball, golf, volleyball, and lacrosse, are less likely to cause asthma symptoms because they allow time to “catch your breath.” Exercise and sports should be encouraged for all asthma patients. For the majority of children who have asthma, there should be no limitation in their ability to participate in any sport. The use of a short-acting bronchodilator, such as albuterol, inhaled 20 to 30 minutes before selected participation may be indicated for a child with asthma and exercise-induced bronchospasm, and should provide sufficient protection to permit them to enjoy their sport.
Even children with well-controlled asthma may experience an asthma exacerbation from time to time, as discussed in Question 32. Part of the treatment of the exacerbation will likely include a temporary “break” from strenuous physical activity, including sports and athletic competitions. When control of asthma is re-established, then your child should be able to resume his or her favorite sports! Parents sometimes ask what sport may be best for their child with asthma. Swimming is an excellent form of exercise for any age child. The warm, humid air in an indoor swimming pool is especially gentle to asthmatic lungs and unlikely to trigger symptoms. Swimming is also outstanding aerobic exercise. It develops muscle groups symmetrically and helps develop a healthy awareness of breathing while increasing a person’s overall fitness and well-being. Because swimming is not a contact sport, musculoskeletal injuries are rare. Swimming is a form of exercise that you can enjoy your entire life. Be aware, however, that swimming in a cold atmosphere, in water that is too cold, or in a heavily chlorinated pool can trigger asthma. Ozone treatment and disinfection of swimming pools has been practiced in Europe for more than fifty years, and is slowly being introduced and accepted in the United States. Swimming pools disinfected primarily with ozone have enhanced water clarity and greatly reduced chemical odors. The pool water is purer and far less irritating to skin, eyes, and lungs. If you live in an area with a choice of pools to swim in, you may want to research whether any of the pools are disinfected with ozone. For instance, the first commercial indoor pool in New York that was primarily disinfected by ozone is located in New York City, at the 92nd Street Y in Manhattan.
Sports that have been associated with greater EIB include track, cross-county running, soccer, field hockey, distance swimming, ice hockey, and cross-country skiing. You will notice that they all involve endurance high-ventilation activity, and several are also winter sports. Sports that tend to cause lesser EIB are golf, baseball, softball, bowling, football, volleyball, and gymnastics. In conclusion, well-controlled asthma is no barrier to fitness and sport. Let your child decide which sport he or she likes best.
