A top athlete who is exhausted and underperforming but experiencing no other symptoms will nonetheless be tested for allergies or exercise-induced asthma and offered treatment. As is the case with many advances in sports performance medicine, however, knowledge about these breathing problems and how to treat them rarely makes it down to everyday athletes—people who could possibly benefit the most from it.
You might think that you would have been diagnosed by now if you had allergies or exercise-induced asthma. But you can suffer from these illnesses for years with no obvious symptoms. A person with seasonal allergies may appear fine at his annual physical in November; another may breathe normally during a visit with her doctor any time of the year but become asthmatic when she starts exercising and demands more of her body.
If you experience unusual exhaustion, fatigue and underperformance, allergies should be your first suspect. The only obvious symptom may be that you don't perform well during certain times of the year. Exercise performance physician Massimo Testa, M.D., discovered this during his work with cyclists. Michele Bartoli, for example, became a very strong one-day racer and two-time World Cup winner only after he was diagnosed with seasonal allergies.
Bartoli managed his allergies by avoiding races during May and June, when his allergies were at their worst. He didn't push himself when his body was vulnerable, even in years when he was doing very well. Instead, he altered his training schedule so that he would peak for races before or after. In July and August, for example, he would be allergy-free and ready to peak in time to win the World Cup races.
If you experience months or seasons when your body mysteriously underperforms, you may have seasonal allergies. See a doctor for a diagnosis and for help managing your symptoms. Like Bartoli, you may have to identify times of the year when you can push yourself extra hard and expect optimal performance, and other times when you need to back off.
The symptoms of exercise-induced asthma are equally subtle. Exercise-induced asthma consists of mild bronchial spasms (or asthma) triggered by exercise. Many sufferers aren't even aware that they have it. Symptoms include coughing during warm-up or cool-down periods, the sensation of shortness of breath when you are breathing cold or polluted air, and breathing that is cut short. If breathing problems force you to quit workouts or leave you lagging behind your workout partners, it's worth talking to your doctor.
Testa recalls an athlete he worked with in the 1980s who was "an underachiever. She had potential, but for some reason she was never at her best," says Testa. "In particular, she had trouble at the beginning of the race, but she was one of the strongest at the end."
Testa sent her to a pulmonology lab and found she had exercise-induced bronchial spasms: asthma. "We started treatment with medication," says Testa, "and she went on to win a medal at the world championship."
Have a physician address any similar symptoms that bother you or affect the quality of your workouts. Meanwhile, avoid starting workouts too quickly in dry, cold or polluted air, particularly when you are dehydrated. (Dehydration is a key trigger of exercise-induced asthma. That extra air you breathe dries out your airways, making their receptors hypersensitive, which causes coughing.)
You may also need longer warm-ups so that your muscles, heart and lungs are prepared when you begin your workout, alleviating the need to breathe as deeply or as often. If you start slowly enough, you may be able to exercise through asthma.
At present there is no cure for asthma, but you can increase your threshold. Rarely do people with mild asthma require inhalers; their lung function in resting condition is normal. Simple medication, modified warm-up methods and breathing exercises that strengthen your respiratory muscles may be all you need for mild asthma.
( Eric Heiden, M.D., a five-time Olympic gold medalist speed skater, is now an orthopedic surgeon in Utah. He co-authored "Faster, Better, Stronger: Your Fitness Bible" (HarperCollins) with exercise performance physician Max Testa, M.D., and DeAnne Musolf. Visit www.fasterbetterstronger.com.)