Breathing Difficulties are Common in Young Athletes

Know Signs, Symptoms and Simple Solutions

For a parent, coach or physician, it is often challenging to identify a respiratory problem and make sure the child stays safe on the field so that he can reach his full potential. A description of the exact complaint, either from the child or a trusted observer, can help pinpoint a diagnosis. 

Below are some respiratory conditions and the common complaints, symptoms or visual cues associated with each.

Simple steps may help an athlete overcome symptoms temporarily while on the field. Often lung function testing can be helpful in differentiating the cause of breathing difficulty and helping a physician develop an appropriate treatment regimen. 

Deconditioning

Signs and symptoms:
This is when the athlete’s muscles and cardiovascular system are not ready for the activity. The athlete will complain or show signs of:

  • Very rapid, heavy breathing (often in and out with the mouth open)
  • Noisy breathing
  • Gasping for air, complaining he can’t get enough air

And a very fast heart beat, or tachycardia, is often associated with deconditioning and can be uncomfortable, causing chest pain. 

Recommendations:
Typically, slowing down or resting improves symptoms without any further difficulty. Have the child warm up slowly, gradually increasing intensity over time and keep to a pace that allows speech.

Anxiety and Hyperventilation

Signs and symptoms:
A child or teen may not recognize that anxiety is associated with a sporting event; altered breathing may be the first and only clue. Sometimes hyperventilation is in response to overexertion itself. Symptoms include:

  • Very fast, shallow breaths (similar to a pant) which often continue even after the activity has stopped
  • Tingling in the jaw, hands or feet
  • Dizziness
  • Light-headedness  

Recommendations:
During these times it is very important to help the athlete slow down their breathing. Calm, relaxed breaths in through the nose and out through puckered lips (like blowing out a candle) can help control symptoms temporarily.

Asthma

Signs and symptoms:
Asthma is a chronic condition in which airways become swollen and inflamed, mucus fills the airway and the muscles around the airway spasm. This leads to narrowing of the airway and difficulty exchanging air. 

Asthma can be made worse by breathing in cold air, poor air quality and exposure to allergens (such as pollen). 

Children often describe a feeling of:

  • Chest pressure
  • Squeezing
  • Tightness or heaviness
  • Difficulty getting air out
  • Persistent, dry cough
  • Wheezing (a whistling noise that is heard when the child exhales). 

Coughing and wheezing associated with asthma may occur during an event or up to 30 minutes after stopping.

Recommendations:
If a child has asthma, this does not mean exercise or sports should be limited. However, it is important to work with your physician to develop an asthma regimen that allows for full activity. Remembering to breathe in through the nose and out through the mouth, hydrating before and during practice, and warming up slowly will all help to improve performance.

Rhinitis

Signs and symptoms:
This occurs when the membrane in the nose becomes swollen and inflamed and excess mucus is produced. Many underestimate the effect of nasal congestion on all levels of athletes. The nose plays a very important role in warming, humidifying and filtering harmful particles from the air we breathe, which is especially important during times of respiratory stress such as exercise. Common complaints include:

  • Not getting enough air in
  • Heavy or loud breathing
  • Gasping for air
Recommendations:
Often, mouth breathing during exercise can trigger the airway muscles to spasm leading to an asthma exacerbation. Managing nasal congestion is often very challenging. Some helpful tips include:
  • Rinsing nose with saline regularly
  • Hydrating before, during and after exercise
  • Limiting outdoor activities during times when pollen counts are high or air quality is poor

Routine email alerts can be found at the air quality and local pollen counts websites.

Vocal Cord Dysfunction (VCD)

Signs and symptoms:
This is a unique condition often confused with asthma. The vocal cords are muscles that guard the entrance to the trachea, or windpipe. Normally they open widely while breathing, vibrate and partially close during speech and only completely close briefly with swallowing or coughing. In some patients, irritation or spasm may cause vocal cords to partially close during breathing, thereby limiting the amount of air that can enter the lungs. 

Although more common in older children or teens, VCD can affect any age. Athletes will complain of:

  • Difficulty making sounds for speech
  • Air getting “stuck” or “blocked” in the throat
  • A sharp/harsh sound when breathing in. 

Recommendations:
Most importantly, during an event, patients must try to stay calm and slow down their breathing. Slow, less turbulent air flow has an easier time getting through the narrowed space and gives the muscles time to relax. Again, breathing in through the nose and out through puckered lips can help during an acute event.