Q: [All Ages] My son has been out of breath during soccer practice. Should I be concerned?
A: Watching your child having trouble breathing with exercise can be a big worry. You hope that maybe he or she is just out of shape or needs more time to get up to speed. In the back of your mind, is there that nagging concern about a more serious type of medical problem?
If any of the following conditions appear familiar, or if you have concerns about your child’s ability to breathe during exercise, make an appointment with your regular medical provider or a sports medicine specialist.
Any discussion of breathing troubles with exercise must consider heart issues, especially in children who report:
- Pain in the chest, particularly on the left side
- Feeling dizzy during exercise
- Feeling a sense of wanting to pass out/faint, or actually passing out/fainting during or after exercise (a big red flag)
- Heart beating way too fast or appears to jump out of the chest
- Pain that starts in the chest and moves into the left shoulder or arm
- Any past history of heart problems
If there is any concern about heart problems, stop any/all exercise (including practices, rehearsals and performances) and get immediate medical evaluation.
Exercise Asthma or Bronchospasm
With asthma or bronchospasm, two things happen that limit the ability of lungs to move air:
- The medium and small lung airways get narrowed (this is the “bronchospasm”).
- Those medium and small airways get blocked by swelling and inflammation.
With exercise, main issues are trouble getting air out of the lungs, chest tightness and coughing both during and after exercise.
Cooler weather can be a trigger, as can freshly cut grass, days with poor air quality, and even chemicals such as in pools or even exhaust fumes in ice rinks.
If your child has been told they have asthma, then there is a pretty high chance (80-90 percent) that they will have symptoms with exercise.
Vocal Cord Dysfunction (aka Exercise Associated Laryngeal Disorder)
The term VCD not only stands for Vocal Cord Disorder, but also for a Very Confusing Disorder. During exercise, the vocal cords should open up to allow air movement. In many athletes and performers, for reasons that aren’t always fully understood, the vocal cords close up and limit air movement in the throat.
To add to the confusion, symptoms of VCD may appear similar to exercise asthma or bronchospasm. Some children may even have evidence of both disorders.
What indicates VCD?
- Trouble getting air in
- Tightness in the throat
- Feeling of choking or even near vomiting
- A weird “whoop” sound with breathing in
- Singers who can’t hold notes or keep pitch especially during performances
Treatment for VCD often includes speech therapy and exercises which can often be game-changing or even life-changing.
Acid Reflux or Heartburn
That burning desire to win may be reduced by a burning feeling in the airway.
Stomach acid is produced to help digest food, and ideally should stay in the stomach during exercise. However, in certain sports such as endurance running or cycling, that acid can travel north into the esophagus (swallowing tube), throat or even the lungs.
Dr. Chris Koutures is a dual board-certified pediatric and sports medicine specialist who practices at ActiveKidMD in Anaheim Hills. Please visit activekidmd.com or follow him on Twitter (@dockoutures).