Exercise-Induced Asthma: A Video Primer for Parents

Amy Valasek, M.D., Clinical Associate, Johns Hopkins Pediatric Emergency Department, explains that exercise-induced asthma is a condition triggered by exercise in which the lung tissue constricts, causing the athlete to have trouble getting the appropriate amount of oxygen in and out of the lungs during vigorous activity.

The pediatrician's role is to educate the child and the family to maintain their asthma condition and to be dligent in keeping it under control. As long as it is under control with medication, there are no restrictions.  Some other facts about asthma:

• Cold weather sports can trigger exercise-induced asthma more frequently than warm-weather sports or indoor sports;
• Each child has unique triggers, so it is important for pediatricians to work with the family to identify those triggers and steer them to sports that might better suited for the particular child; and
• Exercise-induced asthma is triggered in up to 80 to 90% of children with seasonal allergies, so it is important to treat symptoms of seasonal allergies, in the absence of which a severe asthma attack could be triggered.

Dr. Valasek says the steps parents should know about in treating and controlling exercise-induced asthma are as follows:

1. Talking to their child's pediatrician or pulmonologist and having an open discussion on a continual basis so they feel empowered to deal with their child's asthma;
2. Developing an asthma action plan, a simplified instruction sheet, using a green light, yellow light, red light system to know what steps to take in responding to an asthma attack, depending on its severity;
3. Using a peak flow meter to determine what the child's best score is and, if the number is too low, to refer to the asthma action plan (e.g. if in yellow, need to use inhaler; if in the red zone, need to take to emergency department).

Having an athletic trainer (AT) at games and practices is extremely important, says Dr. Valaskek, because they are in the best position to notice when a child needs to use an inhaler on the sideline or needs to be seen in the emergency department.  Parents need to make sure that the AT is aware of their child's asthma and their asthma action plan.

Exercise-induced asthma is controlled by following these steps:

1. Medication;
2. Lengthened warm-up and cool down periods before and after exercise;
3. Adequate hydration before, during, and after sports; and
4. In cold-weather sports, if possible, wear a scarf or a mask over the mouth to reduce the amount of cold air being breathed and keeps it more humid, reducing the risk of an asthma attack. 

Posted February 8, 2012  Updated March 20, 2015