Asthma Warning Signs and How to be Proactive

By: Thomas Simmons-Canty, ATC

As an athletic trainer, we must manage a variety of injuries and medical conditions. Today, I am going to focus on asthma. Asthma is defined as a chronic inflammatory disorder of the airways.  It is characterized by a variable airway obstruction and bronchial hyper responsiveness.  With this obstruction of the airway passages, this can lead to symptoms for recurrent episodes of wheezing, breathlessness, chest tightness, and coughing, particularly at night or in the early morning. Asthma can be triggered by a variety of stimuli such as allergens, pollution, inhaled irritants, perfumes, may run in families, and many other common vapors.

As common as the asthma triggers listed above, one can see why asthma is a concern for an athletic trainer. The reasons for concerns are as follows:

    1. About 1 in 12 people (about 25 million) have asthma, and the numbers are increasing every year.
    2. About 1 in 2 people (about 12 million) with asthma had an asthma attack in 2008; however, many asthma attacks could have been prevented.
    3. The growth of more Americans diagnosed with asthma is on the up rise.
    4. From 2001 to 2009, 4.3 million Americans were diagnosed with asthma; and within that same time period the CDC saw almost a 50% increase among African Americans.
    5. Asthma has been linked to 3,447 deaths in 2007 and that is an estimation of 9 deaths per day.
    6. The prevalence of asthma is growing within our nation.

As a society, and with the many growing apprehensions, we must take a proactive approach to ensure our youth are properly diagnosed and treated before they become another tragedy or statistic in America.  Some ways to be proactive in diagnosing asthma are educating parents and/or guardians of the recognizing symptoms and physical follow-up appointments with his or her physician.  One of the most important proactive measures is to educate the children and young adults on how to be responsible as an asthmatic or asthma patient.  As athletic trainers, it is our responsibility to watch over participants, but we cannot be in all places at one time.  A degree of responsibility has to be placed on the children at an understandable age and young adults.  Becoming more educated as an athletic trainer, society as a whole, and the parents/guardians of individuals with symptoms of asthma is key to early detection.  Early detection, diagnosis, and treatment can potentially reduce severe asthma related incidences.

Symptoms of asthma may vary according to age.  Therefore, it is important to know the different symptoms and how they affect the age of the individuals.  Asthma symptoms can be unpredictable and tricky at certain age levels.  Symptoms in toddlers may relate to a persistent cough, whistling sound in breathing, and a lingering cold.  Symptoms in children may relate to having trouble breathing during or after playing, wheezing or coughing at night, sleeping poorly and difficulty breathing.  Symptoms in teens and adults may relate to wheezing, loud or soft whistling noise when breathing, persistent cough and tightness of the chest, shortness of breath, sleeping problems due to coughing and breathing, and feeling tired after exercise.  When these symptoms occur, it is time to consult the medical doctor.   Your doctor will diagnose asthma based on your medical and family histories, a physical exam, and test results.  Your doctor will figure out the severity of your asthma—whether it’s intermittent, mild, moderate, or severe.  The treatment your doctor prescribes will depend on the level of severity.


Figure A shows the location of the lungs and airways in the body. Figure B shows a cross-section of a normal airway. Figure C shows a cross-section of an airway during asthma symptoms


Asthma is a long-term disease that has no cure. The goal of asthma treatment is to control the disease. Good asthma control will:

    • Prevent chronic and troublesome symptoms, such as coughing, and shortness of breath
    • Reduce your need for quick-relief medicines (see below)
    • Help you maintain good lung function
    • Let you maintain your normal activity level and sleep through the night
    • Prevent asthma attacks that could result in an emergency room visit or hospital stay

To control asthma, partner with your doctor to manage your asthma or your child’s asthma. Children aged 10 or older—and younger children who are able—should take an active role in their asthma care.

Taking an active role to control your asthma involves:

    • Working with your doctor to treat other conditions that can interfere with asthma management.
    • Avoiding things that worsen your asthma (asthma triggers). However, one trigger you should not avoid is physical activity. Physical activity is an important part of a healthy lifestyle. Talk with your doctor about medicines that can help you stay active.
    • Working with your doctor and other health care providers to create and follow an asthma action plan.

An asthma action plan gives guidance on taking your medicines properly, avoiding asthma triggers (except physical activity), tracking your level of asthma control, responding to worsening symptoms, and seeking emergency care when needed.  Asthma is treated with two types of medicines: long-term control and quick-relief medicines. Long-term control medicines help reduce airway inflammation and prevent asthma symptoms. Quick-relief, or “rescue,” medicines relieve asthma symptoms that may flare up.

Asthma 1

Commons Asthma Medications


With the rise of new asthma patients being diagnosed, it is very important that we are aware of the dangers of asthma.  Asthma identification and proper diagnosis are important to each individual.  With the proper diagnosis, we can help reduce the incidence(s) of severe asthma attacks that go on unmanaged and ultimately that may lead to death. With the knowledge provided, we as a society can help manage and hopefully reduce severe asthma related incidences in America.


  1. Health wise, Incorporated (1995-2014). Health wise, Health wise for every health decision and the Health wise logo are trademarks of Health wise, Incorporated.
  2. US Department of Health & Human Resources
  3. Services National Department of Health and Human Services
  4. Sinha T. David AK. Recognition and management of exercise-induced bronchospasm. Am Fam Physician. 2003;67(4): 769-774. 675.
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Elbow Injury Prevention

Elbow injuries in baseball players is on the rise.  Research is currently ongoing to determine measures that can help to prevent these injuries from occurring.  The link below features an article that details a new App released by Dr. James Andrews and Dr. Glenn Fleisig that is designed to help track pitch counts and calculate risk in hopes of preventing these injuries in baseball players.


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CPR: Save a life!

By: Laura Clarke, MEd, ATC

Cardiopulmonary resuscitation (CPR) is a lifesaving technique used in emergency situations where someone’s breathing or heartbeat has stopped.  Statistics show that immediate CPR can double, or even triple, a person’s chance of survival.  CPR helps keep oxygenated blood flowing to the brain and other organs until advanced medical treatment can be done.  Unfortunately, about 70 percent of Americans feel helpless to act during a cardiac emergency because they don’t know how to administer CPR.

The basic components of CPR include chest compressions and breathing.  The American Heart Association (AHA) recommends for adult, children, and infants to begin with 30 chest compressions followed by 2 rescue breaths for an unresponsive or unconscious person after calling 911 and getting an automated external defibrillator (AED), if available.


The chain of survival is important to remember in a life threatening situation.  The 5 links according to the AHA are:

  • Immediate recognition of cardiac arrest and calling 911 or your local emergency response system
  • CPR
  • Use of AED
  • Advance life support
  • Post care

These are the basic guidelines for CPR, but cannot replace real training to become CPR certified.

For more information and to find a course near you visit the American Heart Association at or the American Red Cross at


Eisenberg, Mickey. “LEARN CPR – CPR Information and Training Resources.”LEARN CPR – CPR Information and Training Resources. University of Washington School of Medicine, Oct. 2010. Web. 27 June 2014

“Cardiopulmonary Resuscitation (CPR): First Aid.” - Mayo Clinic. Mayo Clinic Staff, 7 Feb. 2012. Web. 30 June 2014.

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Importance of Hip Strengthening for Knee Health

By: Kelsey Littlefield ATC, VATL

The body is one unit, where each part affects the other.  The way the hip is positioned affects how the knee functions which in turn affects the ankle.  Knee injuries are prevalent in contact sports, and many people are trying to prevent these injuries.  Only strengthening the muscles surrounding the knee is not enough.  Many times the hip musculature is forgotten when going through a strengthening program to avoid knee injury.

Hip 1The muscles of the hip help to keep the leg in the correct position.  When the muscles are weak the knee suffers and can become misaligned.  This misalignment while playing sports can lead to knee injuries.  One of the main hip muscles responsible for alignment is the gluteus medius.

The gluteus medius keeps the knee from sinking into the mid-line of the body.  Without a strong gluteus medius, the medial (inner) portion of the knee will have increased stress.  The ligaments of the knee may be more prone to injury.  This is considered knee valgus.

Hip 6

Completing exercises to increase the strength of the hip could help reduce these risks of knee injury.  Some exercises are:

  1. Side Lying Hip Abduction  – laying on your side with hip and knee in straight line, lift leg with toes pointing up towards the ceiling. Repeat on both sides.  To increase level of difficulty, add weights to your ankles.Hip 3
  2. Clams- laying on your side with both knees bent, lift knee towards ceiling – keeping feet together.  To increase difficulty, add a resistance band around the knees.  Make sure to think about activating glute (buttock) muscles when performing this exercise.Hip 4
  3. Side steps – facing one direction step sideways pushing off the ground with the back foot.  This will activate the hip muscles more thoroughly.  To increase the difficulty add a resistance band around the knees as shown.Hip 5

When the hip musculature is strong the knee will have better alignment and the stress on the inner knee will be less.  The knee will not have the knee valgus as with weak hips. These are not just exercises that need to be done before an injury.  If you have already sustained an injury, hip exercises are also beneficial for rehabilitation and to help prevent further injury to the knee.  Hip strengthening is especially important for females because their hip strength is significantly less and the sinking of the knee inward is more prevalent. Strengthening the knee can help prevent knee injury, but it is only part of a full body strengthening program that everyone who is participating in athletics should be a part of. Every muscle is important and affects how the body moves and the ability to play sports.



Christopher M. Powers. The Influence of Abnormal Hip Mechanics on Knee Injury: A Biomechanical Perspective. J Orthop Sports Phys Ther. 2010;40(2):42-51

Mary Lloyd Ireland, John D. Willson, Bryon T. Ballantyne, Irene McClay Davis. Hip Strength in Females With and Without Patellofemoral Pain. J Orthop Sports Phys Ther. 2003;33(11):671-676



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Our new clinic in Hampton, Virginia is now open!

We are pleased to announce the opening of our Sports Medicine Physical Therapy and Sports Performance gym in Hampton, Virginia.  The gym is located at 421 Butler Farm Rd., Hampton, VA  23666.  Our clinic features state of the art equipment that makes physical therapy fun!  We have Expresso® Bikes for racing through your warm-up and conditioning, a Brewer’s Ledge Treadwall® to make you sweat and an Xbox One with Kinect to get your feet moving quickly.  In addition, we offer Dartfish® video motion analysis (which was used by NBC during the 2014 Winter Olympics) to analyze pitching, jumping and landing, and running mechanics.  For appointments in Hampton, please call 757-668-4511.

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