Whether you play in a community softball league or on an NFL football team, chances are some of your teammates are asthmatic. Twenty years ago, a diagnosis of asthma meant the end of a sports career, but medical advancements allow asthmatic athletes to compete at a high level, according to the American Academy of Allergy, Asthma and Immunology (AAAAI).

A study in the Journal of Allergy and Clinical Immunology showed that one in six athletes representing the United States in the Atlanta summer Olympics had asthma. Thirty percent of the asthmatic athletes took home team or individual medals. They fared as well as athletes without asthma (28.7 percent of whom took home team or individual medals).

"Yes, athletes who have asthma can compete at high levels," said Dr. Christopher Randolph, FAAAAI, chairman of the AAAAI Sports Medicine Committee. "However, in order for these athletes to remain healthy and competitive, they must be diagnosed with asthma and take proper steps to control their condition."

What's Exercise-Induced Asthma?

Approximately 7 percent of the population, or about 18 million Americans, are reported to have asthma, according to AAAAI. With strenuous physical exercise, most of these individuals experience asthma symptoms. In addition, many non-asthmatic patients (about 11 percent), often those who have allergies or a family history of allergy, experience asthma associated with exercise.

"People with exercise-induced asthma (EIA) have airways that are overly sensitive to sudden changes in temperature or humidity," Randolph explained. "During strenuous activity, people tend to breathe through their mouths, allowing the cold or dry air to reach the lower airways without passing through the warming, humidifying effect of the nose. In addition to mouth breathing, air pollutants, high pollen counts and viral respiratory tract infections can also increase the severity of wheezing with exercise."

Symptoms of EIA can include:

• Breathing difficulty within five to 20 minutes after exertion begins;

• Prolonged shortness of breath, often beginning five to 10 minutes after brief exercise;

• Wheezing;

• Chest tightness;

• Coughing; and

• Chest pain.

"It is crucial for coaches and referees at all levels of competition to be on the lookout for these symptoms," Randolph said.

Managing the Condition

Most asthmatics, whether athletes or not, take two medications. One is a daily, long-acting medication that controls the bronchial inflammation at the root of asthma. The other is an inhaled, short-acting ("reliever") medication, which relieves acute asthma symptoms.

"It is important for asthmatics to take their medications as prescribed, especially if one of those medications is a long-acting medication," said Randolph. "Asthmatics also must be able to recognize their acute symptoms and take the appropriate relievere medication at the onset of symptoms. Taking a break from the practice to take your reliever medication may not be a 'macho' thing to do, but it may save your life."

Inhaled medications taken prior to exercise are helpful in controlling and preventing exercise-induced bronchospasm, according to Randolph.

In addition to medications, a warm-up period of activity before exercise may lessen the chest tightness that occurs after exertion. A warm-down period, including stretching and jogging after strenuous activity, may prevent air in the lungs from changing rapidly from cold to warm, and may prevent EIA symptoms that occur after exercise.

Athletes also should restrict exercising when they have viral infections, when temperatures are extremely low or -- if they are allergic -- when pollen and air pollution levels are high, according to Randolph.