Rowing with Asthma. A Growing Problem?

By Melissa Bray

The finish line has whipped past in a blur of beeps. The body stops moving but the lungs keep heaving at an alarming rate. She tries to gulp in as much air as possible but the throat feels tight, swollen and constricted and a raspy cough comes out instead.

“Calm down. Take small breaths,” these are the words she has repeated to herself many times at the end of a hard race or workout. This is the routine of living with exercise induced asthma.

Exercise induced asthma (EIA) is believed to be triggered by environmental allergens, pollutants or other irritants that are inhaled during exercise. Prolonged, strenuous exercise without rest periods and exercising in cool dry conditions can also bring on exercise induced asthma. The symptoms include chest tightness, shortness of breath and coughing.

This kind of asthma is not uncommon amongst rowers and research indicates elite athletes suffer to a greater extent than amateur athletes. On top of this the number of sufferers is higher amongst aerobic athletes – which includes rowing – as compared to athletes of other sports. Elite rowers therefore are amongst the main group of asthma sufferers.

A study carried out on the 1,060 athletes of the Italian Olympic team preparing for the 2000 Games in Sydney showed that 20 percent of the aerobic athletes (long-distance running, swimming, cycling and rowing) were affected by wheezing or asthma compared to just over 10 percent amongst the other two groups of anaerobic and aerobic-anaerobic athletes.

The number of elite rowers that suffer from asthma, however, is hard to determine partly because diagnosis can vary and many athletes do not declare a problem. Current studies count asthma sufferers in a range from 10 through to 50 percent of athletes. But one thing is for sure, the number of sufferers appears to be increasing.

Biesenthal, two Olympic bronzes despite asthma
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Laryssa Biesenthal, Canada’s assistant women’s coach suffered EIA when she competed for Canada as an elite rower. ‘It did not affect my performance, however I would have a post race cough for up to three days after a race,” says Biesenthal. “Coughing at night was the worst, so recovery was probably not as good as it should have been as I had trouble sleeping. Also coughing that much was hard on my ribs.”

The attacks were stimulated most by intensity workouts and 2,000 metre racing. “All work at or above race pace,” says Biesenthal.

Now retired from competitive rowing Biesenthal says that her asthma has all but gone. “When I really exert myself like during cross-country skiing or running it comes back a bit, but not to the extent it was when I was racing.”

Two-time Olympic bronze medalist, Biesenthal says that during major regattas at night she would have an uncontrollable urge to cough. She felt sympathy for her room mate, Buffy Williams who had to endure these night time post-race coughing sessions.

Williams, a Canadian two-time Olympian and current elite rower, also suffered from asthma and says she had it growing up although at the time it was diagnosed as bronchitis. In 1997 it came to a head for Williams during a 2,000 metre erg test. Williams felt like she was suffocating.

“In the middle of it (the 2,000m test) I started hyperventilating,” remembers Williams. “I finished but my lungs were going crazy. I was wheezing for three days.”

Like Biesenthal, Williams found that she was most affected during intense practices. “For long steady state rows at low intensity I was fine.”

Steroids are sometimes prescribed for asthma sufferers but as it is a banned substance, as set by the World Anti-doping Agency (WADA), Williams instead used a ventolin inhaler. This is also banned for athletes but it can be used if it is declared by submitting a therapeutic use exemption certificate to FISA.

FISA’s sports medicine commission member and former Great Britain team doctor, Dr. Peter Thomas says rowers with asthma are often treated with beta-2 agonists such as Ventolin inhalers and/or inhaled corticosteroids. Both require a therapeutic use exemption certificate which means the athlete must declare what they are using to FISA as a requirement of WADA to prevent a possible banned drug violation.

Asthma no longer affects Williams
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Williams says she was always discreet about her asthma and chose not to use her inhaler in front of everyone. “I just didn’t want to advertise it,” she says. “I didn’t want to show anything that may have been seen as a weakness.” But Williams admits that she never saw it as weakness for herself. “It wasn’t that big of a deal.”

Williams competed internationally through the late 1990’s finishing with bronze in the eight at Sydney. She then took a break from rowing and coming back to international competition in 2002 Williams found she no longer had asthma. Williams has not had an asthma attack since. She has yet to discover an explanation for the disappearance of her EIA.

Thomas says he does not have exact statistics in the numbers of sufferers but when he was Great Britain’s team doctor he estimated about 33 percent of the Great Britain squad had had asthma at some stage of their rowing careers.

“In Great Britain last year 22 percent of all the Olympic teams (all sports) when tested in the lab were found to have asthma,” says Thomas. This compares to about 15 percent of children in Great Britain that suffer from asthma.

Thomas also noted at the Sydney Olympics a higher number of Anglo Saxon countries like Great Britain, Australia, the United States and Canada declared the use of inhalers. “But,” says Thomas, “it could be that those countries had better medical care of their athletes.”

United States doctor and member of FISA’s sports medicine commission, Dr. Jo Hannafin predicts the total number of asthma sufferers ranges from 15 – 18 percent of the US rowing team in any given year.

Hungary’s team doctor and member of FISA’s sports medicing commission, Dr. Peter Kokas believes asthma is a problem that has become frequent in the recent years. Although Kokas does not have exact figures, like Thomas, he sees that asthma appears to affect Anglo Saxon countries to a higher degree. 

Dr Michel receives CHEST award from US TV star Paul Shaffer
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The prevalence of asthma was evident when last year’s Governors Community Service Award from The CHEST Foundation of The American College of CHEST Physicians went to Dr. Franz Michel. Michel is the co-founder of Powerlungs, a programme set up for young asthmatics in Lucerne, Switzerland and designed to use exercise, especially rowing, to help asthmatics.

“Our Powerlungs programme has received several awards from Swiss companies, but the international award from The CHEST Foundation is certainly the most important one to date,” said Michel.

The goal of Powerlungs is to promote the therapeutic benefits of sport as part of an asthma treatment programme and rowing has been chosen as the key sport. Rowing was selected because the water environment causes less frequent attacks because there is less dust and irritants over water. Michel also touts the advantage of using all of the body’s muscles “equally and systematically.” 

“The slow, calm, harmonic motion of rowing helps to reduce the stress and strain that often brings on an asthma attack,” says Michel.

“Contrary to common belief, sports and asthma are not incompatible. Fortunately, just the opposite has proved true for asthmatics who row.” Michel cites the example of American rower and asthma sufferer Jen Devine who recently rowed at the Athens Olympics.

For further information on Powerlungs go to: www.powerlungs.com